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Inside Cover Page

Images from the book

This week Winnie and the General left for two months to the United States to meet with organizations affiliate with Maitri; U.N., Harvard University’s Public Health, Hinkley Institute of Politics, Salt Lake City, San Francisco. Before they left, we gave them a gift, a book of all the projects going on at Maitri and the projects we participated in. Included in the book were quotes or experiences by each of the interns. For the past two weeks, I've working on Adobe Photoshop to design the pages. My first graphic design gig (not in research)! I am so happy with how the book turned out that I might have to do this on the side...Pages up top

This morning we did a workshop with the students at Modern School. This was a very different audience than the students in Shillong. There were only 30-40 students there and they took the class as students who were interested in social work so they were very much aware of HIV/AIDS. The students were living in the Delhi and very much apart of affluent families. I think that the workshop design should have been done differently given the demographics and interests of the group. This would include more brainstorming discussions and how to be involved. Viraj, the ninth grade intern, created a facebook group for Maitri. I don’t send many group invites on Facebook, but if you are on, make sure to join Maitri Group! This NGO addresses HIV/AIDS issues in a multi-faceted way through women’s empowerment, health intervention, policy making, education. Domestically and internationally. Not an easy thing to balance...

UNAIDS Conference

Sonal informed me on our way to the UNAIDS conference that my report on India’s healthcare status was sent to both Boston and Australia for review. The report was in response to recent funding awarded by the Australian High Commission. Yay!

At the UNAIDS conference, I took meeting minutes and noted significant table discussion comments. I sat with Dr. Jean Louis Lamboray, Constellation, Thailand, Joe from Nagaland, India, and the UNAIDS country director, Denis Broun. It was definitely a privileged to brainstorm self assessment within the offices they worked. Internship with UNAIDS next year? Maybe? Definite possibility and definite interest. The levels of self-assessment included

Level 1: We are aware

Level 2: We react on it

Level 3: We act

Level 4: Continuous action, systematizing what we do

Level 5: The practice is part of our life-style

The HIV/AIDS criteria to assess levels included: acknowledgement and recognition, inclusion, linking care and prevention, access to treatment, identify and address vulnerability

Within the UNAIDS office, Denis mentioned his office frequently self-assesses. At certain levels his own UNAIDS office may be at a 3. Other organizations realized that some criteria, such as linking health care and awareness, the organizations may fall at a 2.

The message was that it is possible to reach Level 5s. But, I’ve been thinking whether it is possible to achieve Level 5 of all HIV/AIDS criteria for an organization. The Level 5 visions differ between organizations. For example, to an education/awareness NGO, Level 5 health criteria may be providing solely primary health or Level 5 education/awareness to a health providing NGO may be to address HIV transmittance only. There is obvious remove to include more in Level 5 and to improve in the criteria, but an organization can do so much. Eventually, if an organization reaches Level 5, the criteria for Level 5 becomes the baseline, it is expected, and a new Level 5 and vision can now be defined. Level 5 is not about gawking at, hovering about, wavering at, sitting on top of Level 5; it is about progress, redefining.

Universal Yoga

Workplace Yoga: Universal Yog

Vijay, our yogi, a glowing smiling, healthy young man, gave us a paper power point presentation today in our apartment. His mission is to spread yoga to the masses. Yoga is a big deal here. In the Delhi Diary, similar to SLC weekly guide, there are daily meditation and yoga classes at a number of places. Yoga is supposed to make one feel energized, calm, relieve stress, enhance concentration, promote positive thinking, build relationships, and cure ailments among other things. Besides working with sedentary office workers, military, police, Vijay works with NGOs to empower women through yoga. Aside from the flaws within the health system here in India that effect HIV treatment, distribution, doctor biases, prevention etc., which is the interface I hope to work in the future, women empowerment, is absolutely essential in combating the disease. Unlike in Shillong and parts of the north east, where it is a matriarchal society, here the patriarchal society in addition to a lack of sex education poses interesting ethical dilemmas for women on 3 fronts; education/discussion, transmission, intervention

Today is July 13, 2008. There was somewhere important I was going with this last paragraph a week ago, but I’ve already written about it. I had six hours of sleep. The internet finally turned on, and I was up late talking about my issues with Kasey, Katie, Mom, and Nikhil on Skype. According to Vijay, if I do the meditations right, I would need only 3 hours of sleep. The math is every ten minutes of correct meditation equates to 90 minutes of sleep. Thus, Mohammed Ghandi was able work 21 hours each day; 3 hours to rest your body, 30 minutes to rest your mind. 8-9 hours of sleep is not needed. Vijay came on his motorcycle, helmet, goggles, white kurta to the Maitri office today. We all crammed into the little office, sitars tinkling in the background. Today was a Workplace Yoga Workshop. We stretched and ommed. 30 minutes of meditation last night and sleeping with a purpose did not remove the thick heavy air that still clouded my brain, muscles this morning. It was near impossible to see the dark place behind my forehead in glaring fluorescence and sleep clouds hazing my mind vision (visibility 5%) during the extra 5 minutes of meditation in the office. Tonight is another yoga session with Vijay at 8 PM. Running, Pilates, and Yoga. Writing, reading The God of Small Things (Top 3 Books). I will not finish Holy Cow. More Workplace/Corporate Yoga.

HIV/AIDS Workshops

I will think before I act because....

Talking it out...

Taking a survey

The interns presented on HIV/AIDS awareness prevention and education at the Army School and KC Secondary School. These students have had no formal sex education. The parents just won’t allow it. Now India is facing an HIV/AIDS epidemic and the NGOs have had to supplement prevention material where the public health sector has failed to do in a timely manner. The government of India spends less than 1% of the gross domestic product on the public sector. The majority of healthcare spending is put into the unregulated private sector where rural and the poor are unable to afford the out-of-pocket payments. We were presenting to students who when we were that age, we were sitting in a classroom being shown pictures of STDs and STIs. The difference between our education and these students is that this material is crucial, urgent even. The risk of HIV/AIDS is too great here. Before I left for this internship, several people had asked me “What is the big deal? It’s a behavioral problem. I don’t understand why we should put money into research when it’s because people are promiscuous.” Try telling a married woman unable to negotiate condom use to her migrant worker husband or the patient who is receiving unscreened HIV-positive blood under professional, medical supervision, a doctor even, that their behavior was morally wrong. Because of the complicated nature of HIV/AIDS, a chronic disease with serious social and political implications, it cannot be discussed or debated as a moral issue. People do not know how this disease is transmitted let alone how to describe or name a ‘foreigner’s disease.’ The virus itself was discovered in U.S.A in a race against France for discovery rights.

After the workshop at KC Secondary, the students swarmed all the interns with questions like, what’s your favorite colour? How do you contract HIV? How do you avoid substances if you already are addicted? All very substantial questions. Nothing too difficult, not until Winnie called me over from across the room.

“Nancy, this boy has a question for you”
“Ok,” I looked at the boy; he looked very young.
“He wants to know what ‘oral sex’ is. Could you explain it to him?”

Did we cover oral sex in the presentation? Oh yeah it’s on the survey and now I have to explain it to this boy barely 13. I flushed, ummed, paused, and then sputtered a pathetic explanation.

“Well, uh, so, it’s when, sex organs, male or female, are in contact with the mouth instead of the traditional sense. You know um, (or I don’t know if you know), when a male sex organs are in contact with female organs, um (or some other permutation, I didn’t want to go into any more details I had to).You see, oral means mouth. Does this make sense?”

I felt lame. It would have been more understandable if I wasn’t grapping for words that would make my explanation easier for me to stand to a younger boy. We describe our actions with such euphemisms or scientific jargon to hide from embarrassing motions of human life. For example:

“When did you poo last? Was it hard or soft?” is instead
“Can you tell me when the last time you had a bowel movement? Was the excrement solid or more liquid?”

“Does your ass hole itch?” is instead
“Do you have anal irritation?”

“How many people have you had sex with?” is instead,
“How many people have you had relations with being sexual in nature?”

And so on and so forth….

Of course, HIV/AIDS, sex education, requires tactfulness. If certain words are said or topics discussed, the recipient may completely ignore what you are trying to say. However, I wonder how much of the message we are trying to communicate is lost when our primary concern is saving ourselves from personal embarrassment rather than tactful education. In any case…

“So, you can get HIV from oral sex. In your mouth there can be unseen cuts. Like we mentioned in the presentation, HIV can be transmitted through sexual fluids and blood. So if you have a cut in your mouth and your mouth contacts with sexual fluids in any way, there is a possibility of infection. Does this make sense?”

Bye,bye,bye Auntie from our Hee a aaa rrrtttssss!!

St. Bethany's School (she stays at Mother Teresa too)

Mother Teresa Home

Every person we met in Shillong seemed to be involved in some humanitarian project. The postmaster of 7 states in India’s northeast region ran campaigns through her office since the post service reached rural areas NGO could only dream of reaching and sold organic products made by groups of women. The schools we visited all had an equally charitable edge. We made trips to the St. Bethany’s School, KC Secondary School, Army School, and Mother Theresa Home and Orphanage. All very different schools with amazing and unique programs! Bethany’s School integrates both able and disabled students in their curriculum. Not only are they able to effectively teach the students in a supportive environment equipped with Braille printers and expensive programs, they teach the older disabled students vocational skills. As we toured the vocational classrooms, each room was different from the next. One room had a group sewing, another room, baking, another weaving, and then finally furniture weaving. The students could not only learn a trade to sustain themselves, but they could also enjoy and be proud of their wonderful work.

Mother Teresa Home-my personal favorite. The children and the sister here are lovely. We stood there listening as the kids sang to Winnie since she had purchased them all watches. They have beautiful voices. Apparently, children born in the northeast are born singing….

(sang to some Scottish tune)

“We thank you, thank you auntie. We thank you, thank you auntie. We thank you, thank you auntie from our heeeeeeeeaaaaaaaarrrrts. We thank you, thank you auntie. We thank you, thank you auntie. We thank you, thank you auntie from our hearts.”

Followed by…

“We love you, love you, auntie. We love you, love you auntie. We love you, love you auntie from our heeeeeeeeaaaaaaaarrrrts. “We love you, love you, auntie. We love you, love you auntie. We love you, love you auntie from our hearts.”
And, then….

“We bye, bye, bye, bye auntie. We bye, bye, bye, bye auntie. We bye, bye, bye, bye auntie from our heeeeeeeeaaaaaaaarrrrts. “We bye, bye, bye, bye auntie. We bye, bye, bye, bye auntie. We bye, bye, bye, bye auntie from our hearts.”

The orphanage was well kept by the sisters. Many of the babies were abandoned at hospitals or found at the side of the streets. They lay peacefully in the cribs sucking away at bottles that at by their sides. Winnie is fantastically at ease with the children...

NOTE: If any of the destitute children of India or the world are going to have a chance at a happy life, it would be these children. They are in such a supportive environment which value them as individuals. How wonderful it was for me, as I am sure it is for any person living in a privileged society, to come to these programs and leave feeling a sense of hope for the world, children, humanity, whatever, after a short visit. For me, the visit illustrated an important point; there are many, many, many unseen children that did not make it safely to the care of St. Bethany’s or the sisters, but could have similar hopeful opportunities. The programs paint a real, inspiring picture of what could happen for these invisible children. For the pessimist, the cynic, the embittered it gets the wheels turning…

Helicopter to Shillong and Nakedness!!!

Massage Place

View from our Shillong Home

Punk Shillong Kids

So I hate to disappoint everyone, but the helicopter was canceled due to weather, but I promise nakedness here!!!! For the last week we traveled from Delhi to Guwahati to the mountainous northeast region of Shillong the capital city when the Brits colonized the area, 100 kilometers from the Bangladeshi border. The General was based in Shillong at one point and Maitri, NGO, started because of Winnie and the General’s experience here. Because of the constant downpour, Shillong contains an area with the most statistically annual rainfall in the world, we did not take the highly anticipated military helicopter. Instead we negotiated winding turns uphill in a car avoiding a few cows, cabs, leafy drop offs, and large military trucks.

The region contains many tribes and non tribal people in the region and illegal drugs and terrorism has made a fair industry here. The city itself is an educational hub for students from all over India and Southeast Asia, Thailand and Korea. For those wondering, yes, Shah Rukh Khan, the famous (and proliferative, he’s everywhere) actor, studied in Shillong. There is a high school (called a college) on almost every corner. However, because of all the youth, exposure to intravenous drugs, and a lack of a sex education, the students often engage in risky behaviors, increasing their risk to HIV/AIDS.

I will have to admit, the week was very unexpected, exciting, confusing, inspiring for me. The first day we met with Sanjay and Bonnie, the graphic designers of Maitri. After discussing his grassroot efforts in nearby villages and the coal community, where the sex industry thrives, we discussed our plans in Shillong.

“Yes, you should try massage, traditional kerala ayurveda massage. They use lots of oil and it’s all organic.”

So the next day, we all went to get oil massages. It was nothing like the foot massages I received in Delhi. The masseuse stood there watching me in the dank room and answered “off” as I hesitantly removed a shirt first, tank top, pants under her stare until I was standing there naked, laughing inside because the tattered curtain barely covering the open window flitted back and forth as men chatted outside. It wasn’t a deep massage. She poured various hot oils and lathered them into my skin as I lay on a hard table. So for an hour, I laughed because I felt like a beach whale or a greasy pig and the chatting continue outside the window. After the steam bath and shower, we sat there in the foyer, oily, sticky, and light headed from the steam bath. I didn’t feel quite refreshed, but the pain in my neck was gone. Yay!

I hate blogging sometimes

I decided I hate blogging. Journaling can be so much more liberating. I don’t think I’m going to be very good at this.

WHO? WHO? Reports

Llamaji, the award winning, overweight, beagle is so cute. He received alot of backrubs this week from me.

Winnie took us to a talk at the Hyatt this week after work without any notice. Everyone was dressed impeccably. I was very self-conscious of my plain t-shirt and shirt. However, whatever blush colored my cheeks was mitigated by greeting Rotary Club members. It was their weekly meeting. The talk was on Safety Injections given by a man who worked for the WHO and now worked with BD Industries. Note to self: I will probably have to start brining a change of clothes to work everyday ...Also, the ice cream served at the meeting is second to Winnie and the General's ice cream and first to the ice cream served at Big Chill, Khan Market.

Week 2: I am working on a report of the current public healthcare status on India for a newly funded project by the Australian government (due Friday). Numerous World Health Organization reports show that India has been improving over the last 5 years in healthcare infrastructure and government funding. In my interpretation, the statistics are still very, very dismal despite some progress. For example, India is contains the second largest HIV/AIDS infected population in the world. However, India’s therapy coverage is only an eighth of what other developing countries with a similar economic profile are covering. Similar trends continue when medical personnel per 100,000 people and hospital beds available per 100,000 are compared with other countries. Problems are exacerbated by shear country size and inconsistencies of health care systems within each state.

Varanassi

Looks like no trip Jaipur and Agra. The roads are closed due to protestors; the tribe Gujjars. Their request to remain lower castes which would have allowed them specific benefits was rejected by the state of Rajasthan. As such, protestors have stopped highway traffic and trains to all roads leading to Agra and Jaipur from Delhi…Like everything in India, all plans are subject to change. So this last weekend, we went to Varanassi, the holiest city in Hinduism.

The overnight sleeper train ride to Varanassi was basic. Bunks, no AC, gated windows, mosquitoes. I didn’t bring any sheets. The trip was literally planned on the spot. I usually sleep like a champ, anywhere, anytime, but my senses were assaulted all night and there was no way I would get sleep. Sellers would up and down the aisles repeating “Chai, chai, chai” or “pani, pani, pani (water) or “omelet with mango chutney. Very good!” I would wake to my skin sticking to the dingy plastic bed, or some smell burning my nose or swooshing, cracking noises as other trains rushed by. Flickering fluorescent lights did not help. Rough night. The AC train on the way back from Varanassi was 150%+ like the cost of the ticket.

After arguing with the TAXI driver, we finally arrived at the Ganges Guest View House at Assi Ghat. The place has a British colonial era feel to it. Stepping outside our room is a larger, brighter room with windows framed with light curtains overlooking patios and the Ganges. This room was my favorite place to journal this weekend. Artists (Varanassi is known for art and music) work round the clock painting miniatures and large murals for the hotel. Two dachshund roamed about the black and white tiled floors. Dinner was fantastic.

Varanassi is described as the “quintessential India,” and it’s trippin’. The wide display of human activities and emotions are unbelievable and overwhelms the sense as you walk down the ghats. Everything revolves around the river. Cows, water buffalo and goats are shitting as they meander along the stone ground while a man shits nearby while ten feet away are boys splashing around in the Ganges while 200 meters downstream a grandson gives his grandfather last rites in the same water while a pyre, where the body will be cremated, burns 5 feet away while a man fishes in the river as gigantic bats fly overhead. The Ganges This is only the evening.

The next morning at 5:00 AM, a different jumbled events are happening; a priest welcomes the sun with smoke and incense as sun worshippers meditate while staring directly at the orange orb rising above the Ganges, while Aghoris meditate, skin gray from the ashes of the recently deceased, and a yoga class is amplified through speakers and illustrated above a crowd of children and chanting is sung round the clock. There is more bathing, this time by the women. The men overlooking the cremation are now turning over the Grandfather's skinny body with a long stick. The ghats are where everything is happening at the same time at the same place. Varanassi it like a page from Where’s Waldo India except living it is more of a shocking realization of the bare essentials of human living in one scene rather than an amusing scene of antics on a page.

More pics to come

Hinkley Institute of Politics Shout Out

I could go on and on about Llamaji or Varanassi or rickshaws or train rides (later blogs), but before I do, I'd like to give a shout out to the Hinkley Institute of Politics for making international internships possible. As such, I'll be summarizing work and highlights! at the end of each week for you and Courtney.

Week 1: A lot of settling and becoming familiar with all of Maitri sites around Delhi; a closed classroom, a classroom and a women’s training center, the office and attached classroom all on the outskirts of the slums.
Working on a short research topic effective modes of HIV/AIDS communication within 4 populations. Haven’t found much on India’s situation, but findings in Africa should be sufficient case studies. I’m surprised that I have not found more on India. Joined AIDS/India E Group

Initial Reaction: Everything I expected

India was everything I expected when I arrived the next night. Rain storms hailing in the beginning of the monsoon season, mangoes signaling in the beginning of the mango season, cars weaving in and out. India smells fresh and humid, almost like Vietnam.

Wheeling and dealing: JFK, Terminal 4

JFK airport was funny. I’ve never experienced Terminal 4, JFK like I did on May 21, 2008. After finding that my direct flight to New Delhi, India was cancelled and rerouted, I had three hours in my possession. The terminal is split into two levels; a pit and an upper level. Tel Aviv, London, Buenos Aires, Mumbai flights were that night, and the pit was brimming with ethnicity and fabric. It was apparent I was not in the U.S. when I went to compare the rates at the foreign exchange booth. The conversation with the man at the booth was hilarious because I was having it in JFK Airport and not in India or Vietnam. It went something like this…

“How much do you want to exchange?”

“$200”

“Exchange more and I can get you a deal. See here.” (pointing to a leaflet)

“Alright, what about $300? And what’s the fee?”

“The fee is $6, but for you, $3.”

“What?! Can you do that? You just can’t do that. It doesn’t make sense. What about $2 then or $1.45?”

“I’m trying to give you a deal. You don’t want a deal?”

I hesistated, trying to think of the loop hole.

“Ok, ok, ok. I need to get more money…”

“I will be waiting” (smile)

[interlude while I went to pull more money and to think]

“I forgot to ask, what is the exchange rate?”

“36 rupees to 1 dollar”

“What? No way. Its rupees to 1 dollar”

“Where did you look? Hotel rates? Those are incorrect.”

“It’s supposed to be 40 rupees to 1 dollar. I’m planning on exchanging in Delhi. Just tell me, should I exchange everything in Delhi?” (smile)

Yassuf smiles back and leans in closer to the plastic pane.

“I am supposed to tell you to exchange here because I work here, but since you are so nice, I will tell you to exchange in Delhi. You can get at least 40 rupees at the airport, and even better on the streets, blackmarket, 42 rupees. Is someone coming to get you? They would know where. Look, now you know, what you are supposed to get. It’s between 40-42 rupees. Here, I was trying to save you some money on the fee.”

The advice was helpful and proved to be correct later on. As I walked up and down Terminal 4 pit, Indians from Mumbai or Delhi asked me if I was going to India or how to use international phone cards. An Indian man offered me his driver to where I needed to go when I landed. At the Lacome station, I got a free hand and face massage. Moisturized and relaxed I was ready for the 12 hour flight towards Delhi according to the masseuse.

Pre-Intro: Are you leaving?? No, I'm not

I missed my plane flight out of SLC to JFK to India. The month leading up to this trip was packed full of everything but lunches. I wrapped up 5 years of undergraduate work, 3 years of cancer research, sent lab equipment and, more importantly, data, to Toronto, squished in medical school paperwork, emergency root canal, and India pre-departure tasks up until my pseudo last night in SLC. So when I realized my plane had taken off without me, I felt stunned, then calm and strangely anti-climatic.

I really needed to miss that plane flight, though. If I was coming to India for two months, I couldn’t leave my brain in Utah. I needed to be mentally prepared to leave, be focused, to learn and to work in India if I was going get the best of this tremendous experience. The day I was supposed to be sleeping on Air India was the best day I spent in SLC in two months.