The last week traveling...and back home!

Once we were finally on the bus...heading out of Siliguri up to Gangtok!
The bus convoy we were apart of that included a police escort to get us through the blocked roads from the strike in West Bengal.
The first place we camped on our trek.
Prayer flags at our 2nd campsite - there are many Buddhist monasteries in the area.
Me looking down toward our second campsite.
This was where we were supposed to see mountains...the weather did not cooperate!
Valentine's Day dinner at our lovely hotel in Gangtok - momos are the crescent-shaped food you see and they are DELICIOUS!
A view of Gangtok, capital of Sikkim.
Z bought Tabla! Luckily we were about to bring them back safely to the U.S. as well.
Our last night in Delhi, just before we left the city center to head to the airport...what an incredible trip!


Hello from snowy and cold Minnesota!

We had quite an eventful last week traveling together, and now have returned to a solidly winterized Minnesota - quite a shift. Our last entry was from Bangalore, where we enjoyed time with our new good friends, Gautham and Paro. The day before we were to depart for our next "act" in our journey, we learned (luckily) that there was a pretty significant strike that had just started in the region we were set to travel in. Apparently, some people in W. Bengal (which is a Northeastern Indian state w/ a border to Bangladesh) have been unhappy about their working conditions and decided to strike. After a long morning researching many different options and making many phone calls, we decided to continue with our plan to fly to the region, however knew that we would need to divert our travels to a different place in the hopes that we would still be able to do some trekking.

We were put into contact with a very kind man names Bickey, who met us at the airport in northern India (we flew into Siliguri, W. Bengal). Then we went with him to the bus station. The roads were all blocked with strikers, but travelers and locals were still able to get on limited government buses, which daily were being escorted in a large convoy by the police to a state north of W. Bengal called Sikkim. Sikkim is the northernmost Indian state in that region and has borders with Nepal, China/Tibet, and Bhutan. After realizing that there was quite a lot of chaos at the bus station, we discovered a tourist office that was helpful, mostly because it put us into contact with a number of other tourists who were able to offer some advice. We returned very early the following morning to get into a line to hopefully be able to buy tickets (separate lines for women and men...that is the case throughout India, including at the airport). After quite a lot of waiting, asking questions to of people who only spoke limited English, and wondering if we were ever going to get out of there, all of a sudden a man approached us (by that time we were a group of about 10 tourists all waiting to buy tickets) who said he had just found a bus to take us up to Gangtok (capital of Sikkim), but that we would have to RUN immediately to get onto the bus before other people realized that it was departing. Mild panic ensued, which luckily resulted in all of us getting ourselves and our stuff safely on the bus into seats. Phew!

Once we arrived in Gangtok, the next challenge we faced was finding a trek that would work for us. We had to cut our plans by 2 days because of the strikes, and the trek we had booked (though luckily hadn't paid for) was not available from Gangtok. We met with a friend of Bickey's, who did offer us a trek for 4 days, departing the following day. We departed around noon the next day, and had 3 days of trekking in the jungle mountains in the lower altitudes of the Himalayas. Unfortunately, our weather was incredibly cloudy and foggy, so any altitude that we were able to gain did not result in the views we had so hoped for. We returned on Valentine's Day a bit discouraged, but hunkered down at a wonderful hostel for 2 days, made good friends with the staff there, and explored a bit of Gangtok the following day.

We were lucky enough to get a bus down to Siliguri, even though the strike had continued while we were there. Another surprise we discovered was that trains in India hardly ever run on time, so we had to give up our long train trip across northern India to get to Delhi for our flight back to the states. Instead we flew to Delhi, which allowed us one more day to explore in Delhi last Friday. It was a beautiful and relaxing last day for us, which included a nice rooftop breakfast in a bustling area, a long walk to the National Museum, a great little market where we did some final shopping, and an evening meal complete with the sunset. Then we headed to the airport and flew for 16 hours to get home...just ahead of the snow!

So those are the stories...or some of them, at least. We have really enjoyed keeping you updated on our travels and have many, many more pictures to share if any of you would care to take a look. We are so incredibly thankful to have had such an intense and foreign experience together, and we will be digesting all that we learned there for a long time.

Namaste,

L&Z

The travelers' first update

The Taj! It was so beautiful in the morning light. We were both awestruck.
This is inside the Taj - so many of the windows had marble carvings that created beautiful light designs on the walls.
This is outside the Taj - such a striking contrast of the white marble against the blue sky.
This is at Agra Fort - a temple room inside the huge military fort. All of the walls are made of carved white marble and inlaid precious stones.
This is "Baby Taj" - a smaller tomb in the city of Agra that is built in the same style as the Taj.
A spot where we had breakfast and dinner with the Taj in the distance.
This is Z attempting to drink coconut water out of a coconut. Usually tourists drink with straws. It looks a bit more like a passionate embrace rather than drinking, don't you think?
Our hike outside of Bangalore with our friends, Gautham and Paro. Beautiful hot day!
It was quite steep at the top!
Our celebratory descent!


Well, we've made it to Bangalore (Bengaluru)! Our first "act of India", as Z likes to put it, was up north in Delhi and Agra. What an incredible weekend there! We managed to navigate ourselves from Delhi to Agra, stayed in a quaint spot quite close to the Taj Mahal, evenings were spent dining on rooftops with a great view of the amazing building we were there to see. We made good friends with our hilarious driver, Ram (who we hired in Delhi...a story all in itself). We worked out a system to not get too annoyed by all of the hawkers (SO MANY here!). And we enjoyed 1 full day of sight-seeing, including the Taj Mahal at sunrise, Agra Fort, Baby Taj, Akbar's tomb, Fatephur Sikri. Check out the pics!

Then we got onto a plane and flew down to Bangalore, where we were warmly greeted by our new friends and hosts, Gautham and Paro (Gautham is one of my co-worker's cousins). They are both musicians, Gautham is a recording engineer and Paro sings and does voice-over work. And they are a great duo! They live in a comfortable bungalow in southern Bangalore and have been incredibly generous with their time and attention. Yesterday we hiked with them up to the top of a 4000ft stone mountain outside of the city - it was beautiful! And quite hot! We enjoyed it tremendously. After a 4-hour hike in the hot afternoon sun, drinking coconut water straight from the fruit was a much needed refreshment.

We have one more day here to explore Bangalore with our new friends and tomorrow we depart for "act 3" - our trek up in the Himalayas. We're not sure that we'll have internet there, so our next post might be once we return to the states. Enjoy the pics!

Z&L

One more post...

A visit earlier this week to a local PHC (primary health center) with Nandini and Jenny (a Canadian who is interning with SVYM doing public health work)
On the visit with Jon to the local village for diabetes screening
Teaching Ani and Abhi (sons of some of the physicians who work at the hospital) how to throw a disc forehand, or "flick" - they caught on so quickly!
Some writing in one of the PHC's we visited that lists the pregnant women in the village and when they are due - right out in the open!
In the OT (operating theater) with Dr. Bindu (OB/Gyn) assisting in a hysterectomy.


Time is running quite short for me here! I have just a few days left here to enjoy and soak up my rich experience. It is incredible that time has gone by so quickly, and my last few days have been great.

This week has been filled with some interesting meetings and village-visits, as well as preparing for a few presentations that I will give prior to my departure. I leave here Friday morning, then traveling to Bangalore, then getting on an evening flight up to Delhi to meet up with Zach, who is flying over from the states for 2 weeks of traveling together. My presentations this week should be great - one is a talk I'm giving to the kids at the school about some of my Arctic canoeing/camping experiences. It should be great for them to see an entire different environment, and hopefully have some good questions to ask me about the experience! The other is a medical talk I will give to the physicians, etc at the hospital.

I was able to go on a village visit yesterday with Jon, who is the friend who is here for a year doing diabetes research. I have also been on the wards with the general medicine team and have gotten a few great lectures about tropical medicine and practices here.

As my time winds down here, there are so many things and people that I know I will miss when I leave. A month is hardly enough time to really start feeling at home somewhere, but, of course, as soon as you dig in and get to know people and have attachments is right when you have to leave. The experience has opened my eyes to so many different things - practicing medicine in resource-poor settings, public health concerns in a rural, underserved population, not to mention the people of India and how warm and welcoming and friendly they are. I have been incredibly lucky to have met so many wonderful people here!

I am not sure whether Z and I will be able to continue the blog while we're traveling - it will depend on our internet access. If I can, I will upload pictures of our adventures for all of you to see. Otherwise, we'll do it once we return to the states in mid-Feb (we return Feb 19th). Thanks for following my adventure and for all of your comments and support while I was here!

Laura

Elephants, cows, and monkeys

Here are some kiddos as they prepare for their "cultural show" last weekend - it was GREAT!
This dance was incredible - the girl wearing the head-piece danced with that heavy piece on her head for over 5 minutes, walking on top of people's backs and bouncing around. She was quite tired at the end...
This is an example of some bench-work at the lab. This method of "mouth pipetting" isn't done regularly anymore, but it was until relatively recently!
Cows in India are sacred. And they are always painted various colors - their bodies, their horns, everything. It is quite comical to see painted cows wandering around in the streets of a busy city. I haven't gotten used to the site yet.
These are my friends, Jon and Judith. They are here for a year; he is doing research on diabetes and she is working in the school (he is a physician and she is a teacher).
This is the market in Mysore - all sorts of different colored dyes for different "bindis", which is the dot that is placed between the eyes for many Indians.
This was a beautiful flower stall in the market. Many women wear fresh flowers strung together in their hair.
An example of a "Haddi", or tribal village where the mobile clinic visits to provide basic medical care.
Elephants! So many elephants today on the mobile clinic - we went into the forest and saw so many animals.
Here I am on "rounds" with Dr. R. Prasad and the nurses, as well as a dental fellow (he is taking the picture).


Goodness, it has been a while since I last posted! That is because I have had a busy week, which is never a bad thing. Let me give a quick summary of what I've done:

First of all, I GOT BETTER! That was huge. Antibiotics did the trick and I felt better the next day, thank goodness. I didn't want to waste any more of my precious India-time feeling crummy. There was a large celebration last weekend for the school kids (SVYM has a school just behind the hospital) - this was their end-of-year celebration, complete with dances and costumes and awards and speeches. I stayed for most of it, and LOVED the cultural show.

This past week has been filled with 2 mobile clinic days (including one today where we ventured into the nearby forest to treat tribal communities there and saw many elephants, monkeys, and deer), a day spent touring some of the local government hospitals and public health centers in neighboring towns, a day spent learning about how the lab is run here and how they decide which tests they need to run and not (VERY interesting to learn about, as this is most certainly a resource-poor setting), as well as daily rounds and lectures.

Wednesday was a holiday for India, as it was their Festival Day, celebrating India as an independent nation. I went into Mysore with my friends Jon, Judith, and Nandeeni and had a lovely day there shopping and taking in the sights of the closest city to Sargur. Jon and Judith are here from California spending a year working - he is doing diabetes research and she is working in the school. Nandeeni works here at SVYM in the management department.

I continue to be surprised daily by all of the things I am learning while being here. There is so much pathology to see on the wards, so much medicine to learn from, both in the hospital and in the field. My excursions to learn about the public health aspect of practicing here are equally stimulating and informative, as I get a better picture of how SVYM fits into it's surrounding community and environment, as well as what the major needs of the community are.

I have only a few more days here, which is incredible for me to think about. Tomorrow I am off, and will go to the smaller hospital for an Ayurvedic massage treatment, something recommended to me and I am quite curious and excited for the experience. I have interesting things going on each day this week, including giving a presentation to the kids at the school on Thursday on my Arctic experiences, which should be great fun. Friday morning I depart for Bangalore to begin the next portion of my India adventure, which is purely tourist-based. I'll have 2 weeks with Zach to explore many different parts of India - Agra, Bangalore and the surrounding area, and West Bengal and Darjeeling, which will include a 6-day trek on the India-Nepal border in the Himalayas. We are VERY excited.

Hopefully I'll be able to post again before I begin the tourist-portion, when I'm not sure about my internet availability. Enjoy the pictures above!

Laura

On getting sick in India...

Here is a painting on the side of a wall outside the school that SVYM did - they do yearly assessments of these schools, map out all of the houses in the community, and keep track of how many houses have toilets (none), wells (2), working pumps for drinking water (3), etc. The writing you see is in Kannada, which is the local language.
Here are some of the girls I screened. They are in 7th grade.
Here I am checking in the mouth of a boy - he is in second grade. Quite small for his age, as you can see - that was a very common finding.
Here I am with some of the kids I screened. They were quite playful and enjoyed me, once they realized I wasn't going to hurt them:)
This is the team that went with me. The gentleman to my right (with his eyes half-closed) is Dr. Dennis, an Ayurvedic practitioner who mostly works at a different hospital started by SVYM, but he runs a mobile clinic once/week, as well as doing the school screenings when needed.


Well, I suppose that isn't the most jolly of titles, but it's all I can come up with at this moment. And don't worry, I'm not JUST going to talk about getting sick in India...but I might just start with it. I didn't get the kind of sick I assumed I'd get (the belly-kind)...instead, I ended up with strep throat. After experiencing my first high fever in as long as I can remember, I decided it was time to take some action today. I'm not 45 minutes into my first course of antibiotics and tylenol to help break the fever, and I'm already feeling better. That could be me mentally willing it to be, but I know when my fever breaks I'll feel worlds better. So, moral of the story for me is...don't get sick in India:) It takes away from all the other really cool things I could be doing! Like attending a huge celebration for all of the school kids this afternoon and evening. I'm hoping to still be able to make some of it, as I've heard their dances are quite cute.

Onto a better topic, the end of the week went pretty well for me. I spent Thursday going out and doing school health assessments at a school about 45 minutes from here. It is in a tribal community where SVYM has been working for quite some time, and they send a mobile clinic there every week, as well as helping them with their sanitation and subsidizing their food. We screened 41 children of the 90 who are enrolled in the school (a few ran away when they say us, a number of them were not in school that day, which is pretty typical apparently). The biggest things we screened for were tooth decay, anemia, malnutrition, and skin diseases. All 4 issues were quite common, particularly the malnutrition and tooth decay (one leads to another, as you might imagine). But the kids were adorable and my colleagues great with them, giving out vitamins and anti-parasite medications to all kids. I really enjoy the time I spend in the field here, as getting a glimpse into their lives and struggles is quite compelling and helps me understand more fully their health issues.

Tomorrow (provided I feel up for it) I will head out on another mobile clinic. This week is packed with many activities, with a day off on Wed, as it is some sort of celebration, though I'm not sure what. More to come!

Mobile clinic

Here is Dr. Bhavana, an Ayurvedic provider who I accompanied on the mobile clinic - she is standing outside our clinic van, getting set to go.
Here is the nurse and the medical supplies that are in the converted-ambulance.
Here we are assessing a woman who has a diarrheal illness and giving her some treatment, as well as rehydration packets.
These school boys were quite interested in what we were doing - and we needed to treat 2 of them for skin wounds which were infected.
Here I am assessing an old woman, who had come with complaints of stomach burning and cough. She looked quite old, though I suspect she was in her 60s. She had had a stroke previously and walked stooped with a cane. She was quite thankful for our treatment.


Yesterday I went out on a mobile clinic. It involved myself, an Ayurvedic physician, Bhavana, a nurse, a community worker, an aid, and the driver. Our van (see above) was actually quite well out-fitted, complete with a sink, many different types of medications and exam equipment. We went to 10 local tribal communities. The community worker would head out down the row of houses once we arrived, rounding up patients. The driver would sound the "alarm" on the top of the mobile clinic van (converted ambulance) to let everyone know we were there. And slowly people would trickle in to be seen. We saw a total of 30 patients, with a few of the communities not having any patients because everyone was out working in the fields when we were there. Mostly, our patients were women and children.

It was fascinating work for me. Bhavana speaks wonderful English, so she and I saw the patients together and discussed what we thought was going on and what we could do for them. The nurse doled out the medications, while the aid took notes, wrote prescriptions (so the patients would know how to take the medications, though I think it was more a formality, as I doubt most of the patients can read, let alone read English, which is the language of medicine in India) and collected money for our services. The tribal patients were changed 2 rupees (about $0.04 US) if they were given any form of medication. If they were not given medication, they were not charged. We gave out meds for colds, upper respiratory infections, gastritis, bronchitis, arthritis, sprains and strains, skin infections, diarrheal illnesses, headaches, dizziness, anemia, malnutrition, and dehydration. We also checking in with any TB patients that were in the communities, assessing any barriers to them taking their daily medications. We also tried to register and see any pregnant moms, and did give a few referrals for patients to be seen in the hospital.

I loved the work. Being with the community people, seeing their struggles and doing my best to help treat their illnesses was incredibly rewarding. The children are precious and their mom's shy, but concerned about their well-fare. Everyone was incredibly appreciative of the care we provided them. SVYM sends out mobile clinics 6 days/week, and visits different communities everyday. There are between 120-140 tribal communities in the surrounding areas, and SVYM attempts to have contact with as many of these as possible. Outstanding work.

On India and it's roads...

This is the village where we visited to give some positive reinforcement of the DOT program and providers (see explanation below).
This was during the meeting...can you spot the only white lady?
Administering Vitamin A to all the children
Me and one of my new buddies...
Here is one of the challenges of driving...hay drying on the road. Roads in India have many uses outside of driving.
Cows, cows, cows everywhere. And they don't move out of the way as quickly as you'd think!
People use the road for personal transport as well.
Roads are also only intermittently paved - above shows a paved section.
There are also random speed-bumps that appear and are quite intense - the car slows to about 2-3 miles/hr to go over them. Also, there usually isn't any warning that they're coming. The drivers are just always on the lookout.



Now, don't worry people. I have no interest or intent on driving while I am here. I have, however, experienced being driven...which is an experience all in itself. Today I accompanied a crew out to a local village about 40 minutes away for a meeting to acknowledge their DOT providers and patients (DOT = directly observed therapy, which is done for TB patients). The community was small, only about 250 people. See above for photos of the meeting, as well as the illustrations of why the roads are fascinating to ride upon.