CASI Student Blog
Our final days at Samaj Pragati Sahayog were a whirlwind of activity. After an unsuccessful attempt to visit the ancient city of Mandu the previous week, we decided to make the trip on our final Sunday, days before our final presentation. Although it might have led to some late nights finishing up our presentation, the day trip was entirely worth it! Mandu, an ancient fort city in Madhya Pradesh, was simply amazing! There are three grand building that act as the main tourist destinations plus countless smaller ruins spread throughout the city. Since we waited for monsoon to visit, the whole city and surrounding area was covered in tinges of bright green; even the ruins were growing green mosses!
After Mandu we hit the grind for a few days, preparing our final presentation and trying finishing up all of our projects, in addition to squeezing in one last field visit. In the end together, Bevan and I worked on 6.5 projects. Although we essentially worked together on all projects, I focused on: documenting SPS’s Participatory Groundwater Management Program, creating publicity materials for RamRahim Pragati Producer Company, coming up with measurable indicators to track the success/progress of the watershed program, and compiling background research on groundwater use and technology history for a movie by the media team. Bevan worked on many of these projects as well in addition to documenting the story of the honey hunters behind Kumbaya’s wild honey and researching uncultivated and traditional foods of the area. Finally, we each helped out a bit with researching funding opportunities for the Kumbaya company (which is the .5 to the 6.5 projects).
Most of the other interns (and the employees for that matter) worked specifically with one SPS program; however, I was so glad that we got to work across programs as it allowed us to learn so much about what SPS does and how each aspect of the NGO works. Also, each program is inherently intertwined with the others so being able to work with many helped us to see how all of the programs fit together to support the same common goals.
Throughout our final week I realized just how much I will miss SPS, mostly I couldn’t wrap my head around the idea that although I may see some of the people I became close to again, I likely will never physically return to the SPS campus. Thus, the thought of leaving, probably for good, made me sad and nostalgic as I reflected back on how enjoyable and impactful this summer has been. Regardless, I am so exceptionally happy that I had the opportunity to spend two and a half months in rural Madhya Pradesh at SPS—it truly was a once in a lifetime experience.For anyone who is curious, here is the link to Bevan and I’s final presentation—which was essentially just a snapshot overview of what we worked on this summer that we presented (over the course of 3 hours!!) to other interns, employees and founders: https://docs.google.com/presentation/d/16VVT2lp4RqtntCJwpZEWcYyXeMgohoM_dfrMNAnu39g/edit?usp=sharing
Also a link to the timeline on groundwater history I made for the media team: https://cdn.knightlab.com/libs/timeline3/latest/embed/index.html?source=1yuyrf5F–0PdTOjsuOUirWCqhXAZAO-RQz4DHmzcPOs&font=Default&lang=en&initial_zoom=2&height=650
Finally, here’s my photostream link which includes many more beautiful photos of Mandu and rural Madhya Pradesh (+ some photos of my current travels that I will update you all about in my next blog!): https://www.icloud.com/sharedalbum/#B0g5nhQSTiLTpt
I realize that with all my traveling and long days at work (I don’t leave the office until around 6pm) I don’t really get to explore much of Bangalore. However, every time I return from one of my weekend trips I am so glad to be back, so I decided to take a break from traveling and explore Bangalore for a weekend. Amazing things happened. Here is a rundown of my adventurous Bangalorean weekend.
On Saturday I went to the Yogisthaan café a place my friend Jacob who interned at Jana last summer recommended. I spent hours lounging around reading a book, drinking tea and having the best veggie burger I’ve ever had in my life. After this I went to Jayanagar to check out D-Mart for some groceries. D-Mart is basically the Indian version of Walmart and it was really fascinating to visit a hypermarket here, since I do most of my grocery shopping in my neighborhood family owned grocery store. In Jayanagar there is a night market that a colleague had suggested. I went to the market which was only a 10-minute walk from D-Mart. The market was really incredible, parts of it were inside and parts of it were outside and it housed literally everything you could need. Ranging from fresh produce to clothing, flowers, hair products and school supplies. All this time I had been traveling to other cities to go to markets, yet the best market I’ve been to in India is right here in Bangalore!
On Sunday, I went for a run at Cubbon Park, which reminded me a lot of Central Park in NYC since they are both the “lungs” of their respective cities. On Sundays the roads around the park are closed for traffic and it is really a runner’s paradise, although outdoor running doesn’t really seem to be a thing here and people prefer to walk their dogs and do other leisure activities in the park. After brunch, I headed to MG road to visit “Bookworm”, a famous bookstore that one could easily spend all day in. After visiting a few other book stores I decided that I wanted to take the metro for the first time! I missed being able to take the subway to get around and the Bangalore traffic only made my nostalgia stronger. The Bangalore metro is not extensive but it is very clean, fast and very cheap. I ended my weekend feeling very happy.
I’m really lucky to be spending my summer in Bangalore. Thousands of people migrate to Bangalore from all over India for the work and other opportunities. The great weather, friendly people and green spaces make me appreciate not just working in Bangalore but living here (even if only for a few months). As my time here is more than halfway through I am beginning to realize that I have become very accustomed to many things here. I remember thinking how overwhelming this place was during my first week, but that also means that it has so much to offer and I’m really glad to be taking advantage of what the city has to offer.
Updates on my project: Last week, I met with the JFS team to present the data we have been working on and to get their feedback on how we should proceed. Our deliverables have become more clear and we are working towards fine tuning the data to give JFS a short list of agents in Bangalore that they should reach out to, with the three main criteria being proximity to Jana Center, loan size and segment. Most of the data analysis at the beginning of my internship was exploratory and looking for trends so it is really exciting to finally be putting all of that together to reach a final deliverable.
Dharamsala welcomed me with warm waves of memory and an angry fever that lingered for days. On my first day, while I sat in a canteen, inquisitive and nervous, waiting for the office at the Library of Tibetan Works and Archives to open so I could collect my keys, my ears were battered by the clamor of construction. There is perpetual construction in Dharamsala, as if it is a town that is always in the state of becoming. I learnt that they were expanding the office space of the CTA (the Central Tibetan Administration, the name of the Exile Government). People say that the unending construction will collapse the space, but every year more buildings are built, more space is created out of no-space.
In the canteen the tables were all taken. I sat on the parapet. The man running the canteen was new. He brought me a chair to sit on, because Tibetans believe that the cold floor can make you unwell.
I looked around at new faces. I had lived here for several months, just a year ago, and yet the faces were unrecognizable. That’s when I spotted her, a warm memory of my past; an old friend, speaking to one of the groups of monks having lunch. I called out to her. Her twinkling eyes and warm smile made my nervousness evaporate. In the one year that I had been gone, Tselha had become the National Director for SFT (Students for Free Tibet), a prominent youth political organization in Dharamsala, championing Rangzen (རང་བཙན) or independence for Tibet. She had come to the library to give a talk to a group of Indian students about the work that SFT does. Tselha is a passionate activist, incredibly hardworking, sharp witted and astute. Her clear intelligence has problematized so many set concepts I had learnt in my anthropology classes. She was the subject who wrote her own narrative and often, with her, I became not an anthropologist, but a scribe.
Being in Dharamsala reminded me again of how the field always challenges the sanctity of theory. When you are in the field, the ‘field’ never really exists; the field only exists in theory.
Every day I walk down from Mcleod Ganj to the Library of Tibetan Works and Archives, I meet people who smile warmly and ask (ག་དུས་ཡོང་བ་ཡིན) when did you come? Or (བདེ་བོ་ཡིན་པས) how are you? Each of them have stories, have a life that expands beyond categories—subject/informant, situated/global, and so on. Meeting them I want to be a storyteller. I want to write many stories about many lives. Lives of exile and escape, of nostalgia, of loss, of regeneration, of hope, and of infinite warmth. I want to write about their love for Bollywood music and their incredible capacity to sing songs throughout the night, I want to write about their uncompromising generosity, their passionate and differing viewpoints, their internal anxieties, I want to write about their quite resolution to be Tibetan, in their own differing ways, amidst historical erasure. But singular stories will take away from the collective story and perhaps, as an anthropologist, I have silently promised them a collective story to the best of my narrative ability. So, as I grapple with ideas of subject, field, informant, I remind myself that many of them will never be subjects, they will be teachers and friends; that Dharamsala will never be a field, it will be another home, and by trying to tell a collective story I will never erase the kaleidoscope of lives and dreams that have made Dharamsala what it is.
As I sit here in Dharamsala, I wonder not just about what the place means to me, which is more complex and variegated than can be captured, but also about history, about memory; I wonder if, perhaps in the future when the world of the Tibetans has changed, Dharamsala will be remembered as a space that became a home for a people without a country.
I would like to take some time to introduce myself. Although I realize that I haven’t followed the exact format of blog writing that was expected, I hope I will be able to jump right in to contribute to this vibrant community.
My name is Ishani Dasgupta and I am a doctoral student at the University of Pennsylvania pursuing a joint PhD in South Asia Studies and Anthropology. This summer is focused on gathering some preliminary data to prepare me for my year of field research. I am going to divide my time between doing ethnographic field work and collecting particular political documents in Dharamsala and doing archival research in West Bengal.
During this summer research trip, I want to explore the concept of the Bodhisattva, as it is being applied to political martyrdom within Tibet by activists and Tibetans in exile. In the second half of my trip, I want to study historical archives to understand how anti-State protests were being formulated, in the late 18th century, by the Tibetan monastic community. This was a historical period when they were facing political disenfranchisement.
The first part of my research will be located in the headquarters of the exile community at Dharamshala. I will spend much of my time at the Library of Tibetan Works and Archives, to look through documents regarding self-immolations inside Tibet, and the discourse created around it in contemporary times. I will also meet with activists and source public speeches delivered by them to understand the rhetoric within which they are framing these acts of martyrdom.
The second part of my research will be in West Bengal. On account of the brilliant work by Indrani Chatterjee, I have recognized that the borders between Tibet and India were fluid, with networks of trade and political relationships that stretched from upland Tibet to the Bengal planes. She terms this region a ‘monastic geography’, where monastic estates often settled disputes and collected revenue from lowland areas, providing patronage and also helping the flow of trade. The monastic geography consists not solely of Tibetan monks, but also of Shaivite and Vaishnaivite monastic groups.
As the East India Company tried to usurp rights to land revenue, they deemed the monastic militia as bandits and disenfranchised the monastic estates from their previous politico-economic role. This led to an armed retaliation against the British. My aim is to go through the British judicial criminal archives from the period between 1750 to 1793 (when the Permanent Land Settlement Act was established) to understand both the forms of resistance employed, and the way the British administration framed these protests. I am hoping that by drawing parallels and contrasts between this historical period and the current moment, I will be able to better interpret Tibetan acts of resistance.
While immersing myself into the Indian lifestyle, specifically in Tamil Nadu South India, I became engrossed with the local penchant for the film actor Rajnikanth. I even made it a goal that during my time in Pondicherry I would see a Tamil film starring Rajnikanth. If you don’t know him, then you have not interacted with enough people from South India (if this includes you please be directed here https://en.wikipedia.org/wiki/Rajinikanth_filmography, this is apart from the Wikipedia page dedicated to him). Just being Indian, I had heard mention of Rajnikanth growing up, not because I had ever watched a Tamil film, but rather because of his popularity, which extends into Bollywood (Mumbai-centric equivalent of Hollywood especially for North India).
I was excited to learn he had a film, “Kabali”, coming out during my time in Pondicherry. Despite being here for twelve weeks I certainly do not have enough of a command on Tamil to carry a conversation, let alone follow an entire movie. But hearing people talk about the ‘Rajnikanth film experience’ made me want to attend. A midnight premiere of a Rajnikanth starrer is unlike anything Americans would expect. In contrast to the midnight premiere of say a ‘Harry Potter’ movie, where everyone dresses up as a favorite character, watches the movie intently, and cries at the ending (which I have no shame in admitting I do), no no—a Rajnikanth movie is a completely different ball game. Chaos takes over the theatre district as the launching looms close. Tickets are sold out and the scale of scalped tickets rival the superbowl; and this can go on for weeks if it is a hit as his star powers command! Attendees do not expect to hear the movie’s dialogue because of the constant screaming, cheering, whistling, and ‘then some’ at his mere appearance on screen. It’s even hard to follow the story line because of people approaching the screen, even throwing things from their seats —flowers, coins, currency notes — akin to temple offerings!
To call Rajnikanth a legend would be an understatement. “Kabali” is marketed ubiquitiously through town with his poster face staring back from all buildings, signs, and buses at every nook of daily life. Originally, “Kabali“ was to released on July 1st, giving me ample time to squeeze in a show two or three weeks after the premier. I would be safe attending (saloon type brawls are not unusual) and maybe even appreciate the movie and his acting. Unfortunately, the release date kept getting pushed off, ultimately, landing on July 22. I would be on my way out of South India. You know what else happened on July 22? In anticipation of the long awaited premier, many South Indian states/provinces declared the day a holiday—colleges, universities, schools, and government business would be closed! Officials and administrators knew that students and workers, for that matter professors and bosses, would not show up anyway! For further examples of companies ordering a holiday for the premier, read http://www.bbc.com/news/world-asia-india-36842524. While I am sorry to miss the experience, I am reassured that there will be many more chances despite his age of 65.
This ‘Rajnikanth fervor’ is just one example of how passionate Indian people can be once they have decided to favor you! Men and women alike, across all social, religious and political lines unite in their love of Rajnikanth. This love extends outwards with greater implications for India as a whole – the people here find it easy to love and care for anyone they see as their one of their own.
After surveying 107 patients and sitting down to sift through an excel sheet that seemed to stretch like a desert, I’ve discovered the obvious. Patients that make less money, patients that are less educated, and patients that don’t speak English (attributes correlated with one another) all are less knowledgeable about their disease in the glaucoma clinic here at Aravind. While this is something that most people would assume to be true, isn’t groundbreaking, it does highlight a situation far from ideal.
It’s easy to witness deviation from an ideal situation so frequently that the current state of affairs is accepted without question. This happens in the U.S. often enough, while movements like Occupy Wall Street and #BlackLivesMatter attempt to bring awareness to unjust situations that many are desensitized to after a great amount of exposure. Ideally, each patient that walks into the clinic here at Aravind should have the same opportunity to walk away with basic information on their disease given that they are willing to listen and learn.
However, this isn’t the case.
From initial analysis of the data, patients whose families make 5000 rupees (~$78) per month or less have a 99.98% likeliness of not identifying blood relatives when asked who is at increased risk for glaucoma.
This is despite three posters in the clinic that provide an illustration of a family as well as text in three different languages that informs patients that glaucoma is a hereditary disease and advises family members to have their eyes checked. In addition to the posters, doctors and other staff who counsel the patients frequently provide reminders that glaucoma is carried genetically and can only be detected by an examination. Aravind has even begun organizing events just for the families of glaucoma patients to undergo an examination, either free of charge or subsidized.
However, despite this outreach, 23 out of 54 patients in that lowest income bracket weren’t able to identify blood relatives as at risk for glaucoma, compared to 4 out of 53 patients in the other income brackets.
One may expect less wealthy patients to absorb less knowledge about their disease, but after seeing their rate of incorrectly answering that question rise to a number six times that of a wealthier patients, it seems that something isn’t right in patient education.
These trends continued with patients who were uneducated or only completed some primary education (Grade 1-8) and patients who don’t speak English. Questions that these demographic groups were unable to answer correctly ranged from the purpose of follow-up visits to the consequences of not treating glaucoma (which is often blindness).
Understanding the consequences of not treating glaucoma is considered to be one of the most important things that patients should understand. Of the eight glaucoma doctors I’ve interviewed, each doctor said that it’s critical for a patient to understand that untreated glaucoma leads to permanent optic nerve damage and eventually blindness. This was the only piece of information that received a “critical” score of 5/5 from each doctor, which made me think about why the doctors consider it so important.
Information given by the glaucoma clinic that isn’t foreboding, such as how to administer eye drops, or when follow-up visits should occur, is more directly helpful to patients. A patient isn’t likely to learn a frightening fact about a disease deemed the “silent thief of sight” and experience more effective treatment. Knowing the ultimate consequence of glaucoma, total blindness after pressure on the optic nerve of the eye causes damage beyond repair, isn’t a very actionable fact.
But nonetheless, it gives the patient responsibility. When a patient is told that they’re on a path to an adverse outcome like loss of vision, and then presented an opportunity to slow their pace, they’re given the responsibility of their own health. That one piece of information can empower them to become their own personal health advocate, and gives them the first glimmer of something that every good patient needs; autonomy.
For the average new patient, they enter the clinic, wait for a doctor, undergo an examination, take a prescription, talk to a counselling professional, then pick up medication from the pharmacy before leaving. Patients don’t wield a lot of choice or power throughout the visit. Normally all they can choose to do is stay or leave, listen or don’t listen, pick up medication or don’t. All their decisions boil down to following orders (which are typically in a patient’s best interest) or to not following orders.
This made me think that maybe a patient’s lack of decision-making, or their lack of an opportunity to make a judgment, is what stops many patients from taking initiative in their treatment and follow-up. I wondered if introducing a placebo choice for medicine, where a doctor has the patient choose between medication A or B (with the pharmacy dispensing the same pill for A and B) would enable patients to feel involved in their care.
However, this made me think about if I asked my other interns for coffee or tea. Camilo may like the freedom behind making the tea or coffee decision. However, Aditi may be entirely paralyzed and taken aback by the weight of the decision, however trivial the choice may seem to some. Some people can only function with autonomy and need to have some degree of control or power in their life, yet there are others who don’t cope well with the pressure from decision-making. For this reason, giving a placebo medication could easily backfire for many patients and lead to some patients, who are apprehensive of making decisions about their health, developing a fear of the hospital.
What I realized was that although patients don’t seem to make a lot of medical decisions at the hospital, they actually make a lot of essential decisions about their treatment and follow-up outside of the clinic. Patients have to decide the who (will assist me with taking my medication), where (can I leave my medication so I always remember it), and when (is a time that I’m consistently available to take medication) of their treatment. If someone can’t provide help with medication, or if the medication is left in an inconvenient place, or if the patient is always away when they should be taking their medication, there’s a good chance that no habits for taking medication will develop. Consistent missed medications almost always lead to progressed glaucoma, evident by increased inter-ocular pressure which leads to optic nerve damage and vision loss. Doctors want patients to understand this relationship so badly because they believe that patients will take their medication if they understand what’s at risk.
This is not guaranteed for work.
Fear only provides brief motivation for the patient to take their medication, but that motivation will leave the patient by the next week, in the same manner that the fear will.
If patients can be taught how to be disciplined with taking their medication, to set up a system of reminding that never fails, then the patient has a much better chance of adhering to their medication consistently. If the patient can develop autonomy over their treatment by making a plan about it, taking power over the decisions available to them, and hopefully continuing to learn more about glaucoma, then the patient will truly be their own best advocate.
Which leads to my work in glaucoma clinic for the duration of my internship. How can a small group of hospital staff help patients at least begin a plan to adhere to medication? How can patients feel empowered and in control of their treatment in the brief time that they spend in the clinic? How can a patient be informed of the consequences of progressing glaucoma but given the tools necessary to take control of their treatment and blaze a trail to controlled glaucoma?
These are all questions I’ll be focusing on for the near-future. But they’ll probably also stay in the back of my mind for the rest of my career.
About a week or so ago, I woke up (slowly) for work at Shahi and grabbed my phone for the daily check-notifications, stroll-through-insta morning activities. Instead of the usual Farmville invites, I found myself added to a Facebook message group by Miru, one of my close friends from Penn, with 45 or so other people on the thread.
I opened the thread to realize that Miru had messaged a group of APIA (Asian Pacific Islander American) Penn students interested in campus issues. Saddened and angered by the recent terror attacks, and further frustrated by the lack of media attention to them, Miru reached out to the group to ask if any kind of action could be done to show solidarity. Given that most of the students on the thread were not geographically close to each other (with some people, like me, being much farther away), it would have to be digital.
After we all started discussing and brainstorming, news about a white cop shooting Alton Sterling began to break. Confusion followed on the group, as some of us felt that we should now focus on supporting and showing solidarity with #BlackLivesMatter, while some of us felt we should also continue with the original solidarity action and show support for both.
While this conversation continued, my own newsfeed began to be filled with news of the shooting. I saw many of my black friends post statuses talking about pain and fear, and calling on ‘allies’ (both white and non-black people of color) to speak out.
As I was reading the posts, I started to think about my own privileges as a non-black person of color in the United States. Although these conversations do not happen enough, in recent weeks I have heard of different APIA circles calling on their communities to support #BlackLivesMatter. These have included a call to action, as well as an open letter from Asian Americans individuals to their families, talking about anti-blackness within our communities. The statuses, as well as the open letter, have undoubtedly started some much needed conversations within APIA families on #BLM.
While I was proud and happy to see this work, given that I am in India right now, I wasn’t exactly sure how to respond. I paused for a little bit, and part of me wondered, “should I say anything, if anti-blackness isn’t as relevant in India? What is my part in this conversation as an ally?”
After further processing and reading posts and articles of friends on Facebook and other media, it became more and more apparent that this thought of mine was completely misguided. Anti-blackness has existed in South Asia for centuries. And black people here have been trying to talk to us non-black South Asians about it. Just a simple Google search proves this. The first hand experiences of black Americans and Africans with racism, and even more despicable reactions of the Indian government to them, were appalling–but shouldn’t be surprising. If I am privileged as a NBOP in America, my racial privilege here in India is even more ridiculous, systemic, and ancient. Although racism does not seem to be discussed in the same way in India, it definitely exists. And it’s not solely verbal harassment either–there have been incidents of physical and sexual violence, and deaths from anti-black racism from Indians. In fact, even Bangalore, my home for the summer and supposedly such a cosmopolitan city, has had several incidents of anti-black racism. A couple of incidents, discussed in many of the linked articles, are harrowing: verbal abuse, beating, and Indian government officials responding by making statements that people from Africa “are like cancer.”
In fact, I can remember a number of times when my own brown family members have talked about anti-colonialism, white supremacy, and so on, and turned around an hour later to say something Islamophobic or anti-black. Whether I was in America or not, then, did not change my complicity in systems that have marginalized black folks.
While this conversation was happening, I had just returned from visiting my hometown of Hyderabad the weekend before, where there had been a terror threat that very weekend. It reminded me of a couple years before, when I woke up in the U.S. to news that one of my cousins was almost caught in a blast in Hyderabad, and another series of blasts had destroyed some of my mom’s favorite places from her college years. India has never been (and chances are, won’t ever be) affected in the same way as #Baghdad, #Dhaka, #Istanbul, and countless other places. But when the blasts in Hyderabad happened, I remember feeling angry that no one else in my immediate circle knew about them except my family and me. When I told one of my white, American friends about this, he shrugged his shoulders and told me “things like that are common in those places. They happen all the time. Hyderabad is so small in the large scheme of things, you know? Paris isn’t.”
As the conversation continued on this Facebook group, some APIA students (including myself) found ourselves struggling to ask how we can center #BlackLivesMatter while simultaneously mourning and standing in solidarity with victim/survivors of recent terror attacks in the Global South. How do we talk about both, without taking away from either?
This is when an article, shared by a mentor I admire, came to mind. There was one excerpt from it that really stuck with me:
“It is in the interest of the colonizer to rupture relationships between the colonized. The power of third world solidarity should never be underestimated. There is power in relationships between protesters in Palestine and Ferguson. There is power in Pan-African understandings of racial and ethnic systems of oppression. And there is power in understanding how our militarized government has impacted millions abroad.”
And in fact, what the article was saying, and many other black and brown activists and leaders have been saying is true: these two issues are inherently interlinked. The idea that the recent bombings abroad and shootings at home are mutually exclusive is a myth perpetuated by white supremacy. U.S. police states, anti blackness, colonial violence, Islamophobia, xenophobia are all interlinked. They survive off and sustain each other.
So where did this leave me, as an ally, as someone not directly affected but in fact privileged by many of these issues? A quote by bell hooks, a revolutionary black theorist, was perhaps the best way to frame it. She had recently said, “I don’t want allies, I want accomplices.” So I shared something, as a part of our solidarity action, reflecting my sentiments on these issues. However, in order to become a better ‘ally’ to these movements, the best thing I could do is to listen. So I went back to reading some statuses and articles by people directly affected by these issues. And most importantly, throughout this post and now, I wanted to share those words (with explicit permission, of course) and make room (which I can do as an ally) for voices of my black and brown friends: about #BlackLivesMatter, ally(accomplice)ship, what this means to them, and what it should mean to all of us.
*This post was meant to be primarily addressed to fellow nbpoc, especially those abroad, talking about how these issues manifest there. It is not meant to be an all-encompassing message regarding #BLM or the recent terror attacks.
There’s something awe-inspiring about the mountains that touches everyone universally. Standing at an overlook, I was taken aback by the green abundance and the wispy blue sky; I felt simultaneously tiny and powerful. I was tiny because the valley that spread at my feet contained thousands of people—their stories, fears, and dreams. The view rolled out into the misty mountains, made dark by the distance, and I could think of nothing but the vastness of nature. I was powerful because I could see with clarity for miles and miles, and it gave me the sense that I could control and validate everything my eyes could take it in. I had just trudged up a rocky pathway strewn with wet branches and gravel, and because my muscles had not betrayed me, I felt that I could take on the world.
From last Tuesday night to Monday dawn, I was lucky enough to be in the Western Ghats, South India’s very own mountain range and the pride of Kerala. We traveled with our fellow interns, our co-workers Rahul and Ekta, and Ekta’s mother. It would be an understatement to say that I was woefully unprepared for the beauty. In addition to sweeping valley views and gravity-defying peaks, the terrain was lush with overflowing life. Birds of paradise decked out in all the hues of the rainbow flitted among the bounty of the earth, young coconuts and heavy bananas and pungent jackfruit. Monsoon clouds from the sea were trapped by the tall peaks and so they emptied their deluge on the landscape below. The difference was stark—as our bus wound its way up the tortuous, single-lane road, temperature changed by at least ten degrees and the hot, red dust of the valley gave way willingly to the cool breath of fresh rain. I remember wishing that I had more words at my disposal to describe everything to my family and friends back home. How many different synonyms for “green” could I conjure up to do justice to the unending vegetation that covered every square meter of the ridges and slopes? Photos could hardly show how precariously close our vehicles inched to the precipice or the tremendous vastness that left our mouths agape, as if our bodies already had the premonition that we wouldn’t be able to form coherent phrases.
To my own surprise, I felt oddly at home in these strange mountains on which I have never set foot. The hills, like the softly sloping shoulders of some gentle green giant, reminded me of the Appalachians. I recalled the vacations my family had taken to the Great Smoky Mountains and the Rockies, and I felt wonderfully familiar with all the elements that had made me fall in love with mountains in the first place. Thousands of miles and oceans apart from everything mentally comfortable, my heart still automatically grasps onto what seems known and safe. Perhaps this is the same, base instinct driving so much of what is going on in the world today: fear of the unfamiliar, whether it’s skin color or religion or politics. I skim the news and I’m saddened by what I read. Even surrounded by the most beautiful place I’ve ever been blessed to see and breath in, headlines from the past two weeks followed us until we disappeared into the protection of the mountains, where cell phone signal and Wi-Fi were too spotty to justify following world events. I let Trump and the Black Lives Matter movement and ISIS and Brexit and Turkey and Nice evaporate like the mists that perpetually swirled around Munnar, but disappeared for a few golden hours in the mornings. Or I was simply making excuses for myself.
It wasn’t easy to write this blog post, and I had wanted to keep it light. I had started off so well. But reality still looms, and no matter what I tell myself, the stories that unravel outside the microcosm of my existence cannot be ignored. As I stand on the overlook and feel tiny and powerful at the same time, I desperately grab onto what is familiar because I know I am scared, but I also want to hope and to remember that there is beauty in the familiar—India is helping me find it.
On Geshe Wangdu’s recommendation, I visited the educational NGO he established, the Spituk Khamzang Education Society, housed in a small office on the third floor of a building just beside the Leh bus stand. Inside was a monk sitting on the floor typing away on his desktop, surrounded by stacks of Tibetan books: books on philosophy, medicine, science, meditation, Himalayan history, Tibetan literature. He looked up from his work, sighed with relief when I spoke to him in Tibetan (“I’m too shy to speak in English,” he said starring at the ground), and invited me take a seat beside him on the floor.
6 days a week, for 8-10 hours a day, Gen Thubten Takpa sits crossed legged in front of his computer, surrounded by books, at work on an unprecedented project: the creation of a comprehensive, culturally appropriate series of pre-K through class 8 Ladakhi language textbooks.
“It’s a strange situation. None of us had any experience writing textbooks. And the three of us, we’re all monks, so obviously none of us have any children. But the kids weren’t learning our language, our culture. They needed books; books they could understand, relate to, have fun reading. This needed to be done and no one else was doing it. So we just started doing it.”
Gen Thubten was showcasing trademark monkly humility. “Just” writing these textbooks was preceded by more than 2 years of intensive research. Gen Thubten, Geshe Wangdu, and one Tibetan monk-scholar traveled to schools throughout Ladakh and the Tibetan exile communities in Himachal Pradesh, interviewing Ladakhi and Tibetan language teachers about what materials would best improve their classes. The three scholars poured over all the Tibetan language textbooks published in the Himalayas, including all the Tibetan-speaking regions of India, Nepal, Bhutan and China. Geshe Wangdu even traveled to England for an intensive English course, not to learn English so much as to learn Western pedagogy for language acquisition, all with the aim of improving their future Bhoti textbooks.
Concerned that all of this work would be useless if the textbooks were not used, Geshe-la made informal agreements with Ladakhi language teachers at private schools throughout Ladakh, agreeing to send regular drafts of the books and incorporate teacher feedback for revisions on the condition the books would be used on final publication. The active solicitation of teacher feedback, extensive research, (and likely also the Ladakhi deference to learned monks), paid off: these textbooks are currently used by 95% of the private schools in Ladakh, including the schools with the highest proficiency in Bhoti language. Even the government schools have begun using the pre-K textbooks, having lacked any of their own.
As a student of Tibetan, I found myself wishing I had access to these textbooks when I began learning the language. The complex grammar and spelling rules are explained in a gradual and systematic way and the books are full of original poems, songs, and illustrations perfectly suited to the beginning learner. The books are also designed to inculcate Buddhist values of altruism and compassion in the students, against an increasingly urban-centric education that focuses on individualism and moneymaking. Gen Thubten, gently thumbing through the pages, showed me a song about an apple from the grade 2 textbook. The chorus repeated, “half for you, half for me,” explaining that apples tasted better when they are shared. In the grade 1 textbook, he showed me a poem recited by a boy about the kindness of his mother.
“We tried to incorporate traditional Ladakhi values into our textbooks. Before in Ladakh, people always cooperated and worked together; this was our way of life. This is increasingly being lost on the new generation, as more and more people are only thinking about money and competing with each other to own more things. We wanted to make sure to emphasize the traditional values of our culture.”
To this point, the society has written and published seven textbooks, three pre-K books and books for classes 1-4. They are currently at work finishing textbooks for classes 5-8. Additionally, Spituk Khamzang has translated more than 20 children’s books into Ladakhi, which have been distributed throughout rural Ladakh by the NGO 17,000 feet. These are the first concerted efforts to create comprehensive Ladakhi language materials for children in the region. Prior to this time, the only children’s books Ladakhis could access were in Tibetan, which while identical in the classical language, can be very different in the colloquial language used by children.
When I asked Gen Thubten about the research and writing process, he responded, “At first, it was very difficult. But revolutions are never easy, are they?”
“Is this what you’re doing? Starting a educational revolution?”
“I think so. A quiet revolution”
I am not a particularly outgoing or adventurous person by nature. I like to think through all possible outcomes before I make a decision. And although this way of thinking keeps me safe and my actions responsible, it also limits my possibilities. Coming to India alone for 10 weeks was my first big gamble. I have never stayed in a different country without being in the care of family or
friends, and jumping into India with classmates whom I had never really met is definitely the most adventurous thing I have done. Since coming to India and traveling around with the other interns, I have found myself doing things I would have never considered doing by myself or even with my family. It is because I am fully in control of my actions and decisions while among a group of my peers that I have been able to push myself to try new things.
The first hurdle was the non-A/C sleeper buses. Before coming to India, I had been warned by many friends and relatives to be extra careful as a girl. I wasn’t even allowed to bring any of my own clothes with me (as they consisted almost solely of shorts and T-shirts) and instead bought an entire wardrobe of kurtas and patiala pants, which are essentially the Indian version of parachute pants. Normally I am incredibly sensitive to heat and would never wear such stifling clothes in 100+ degree weather. But because of all the warnings I started to fear for my own safety and did not even question it. Now in order to meet my fellow interns in Pondicherry, I would have to sweat all night without A/C on a bus full of people that I don’t know. The thought of doing this certainly scared me, and more than that, terrified my parents. But after the first hour of paranoia, even though I still stayed vigilant, I found that as long as the other two interns were close by, I wasn’t as scared as I had anticipated. And after spending a couple days in Pondi, I realized that the bus ride was a small price to pay for an amazing reward.
While in Pondi, we visited Auroville, which is a kind of intentional community centered around universal acceptance that transcends politics and nationalities.
And near Auroville, there was a small surfing school set up by children of Auroville residents. So of course we decided to go there and take surfing lessons. All morning I was openly dreading it because in the past I have even been scared of body surfing waves. I assured everyone that I probably wouldn’t even be able to enter the water. And once we got to the beach and changed into surfing gear, I was in an internal state of panic. When I heard surfing I assumed we would be out in the deep tackling waves that towered over my head. Instead I was pleased to find that the waves were essentially body surfing waves, and we were not even standing where the waves were breaking. Yet we were close enough to shore that I was always able to touch the ground. The class was structured as a step by step process that started with body surfing and finally went up to standing on the board, but right as we were about to try standing for the first time, an instructor saw lightning. So we were each allowed to try standing for one wave as we made our way back to shore. I pushed off with my board and the wave picked it up. I jumped up onto my feet and stood there for what was probably 0.05 seconds before I tumbled off, but for those mere 0.05 seconds I felt exhilarated. When we got back to the surf shop I couldn’t wait to come back, and kept suggesting that we drive back up for over an hour on our last day to surf again, even though at first I was the biggest dissenter. In the end, we couldn’t make it back, but I know that I am going to try surfing again soon, a thought I would not have even considered before I came to India.
My last big adventure so far has been hiking in Kodaikanal. I have never gone hiking before, and considering my utter lack of physical aptitude, I had never considered walking up and down a mountain in high altitudes to be a desirable experience. But nonetheless, I went with my fellow Aravind interns and some other friends we met at Inspiration hostel on a hike to dolphin’s nose (which is essentially a crag the sticks out over the mountain). At first the roads were paved and I thought that hiking was so easy, there was nothing to be worried about. But then we entered the real trail, a fairly steep mud path with footholds of branches and rocks. My pace quickly dropped to a near standstill, but I slowly made my way down, checking every foothold as I went. When we finally made it onto dolphin’s nose, my legs went stiff. When I was in 6th grade, I once got stuck on the playground equipment meant for the younger students because of my intense fear of heights. As I was about to walk onto a crag dangling over a multiple hundred-foot drop into the wilderness, my mind went blank. A tour-guide for a different group urged someone to go with me because he was worried about my panicked expression and unsteady stance. But I sat down
and scooted my way to the end of the rock, smiled for a picture, and scooted my way back to relative safety. I won’t even mention the climb back up the trail, which I assumed would be easier since I wouldn’t feel like I was falling. I will just say that I was mistaken, it was definitely not easier. At this point I still can’t say that I enjoyed the hike itself, but when I look back on the picture and remember everything that went into getting there, I definitely don’t regret it.
When I get back from India, I hope that the experience of coming to India in this manner and the experiences I have amassed while here will shape the way I approach life. I am not saying that I want to suddenly become a daredevil and challenge dangerous situations. I will still harbor my fears and act responsibly, but I never want to miss a potentially great experience, like this internship has been, because I am not confident enough.
Since the beginning of my time here at Samaj Pragati Sahayog, I’ve had flashbacks to working with the Agaston Urban Nutrition Initiative* at Penn. Both organizations have the ultimate goal of making sustainable change in the communities they serve. By sustainability, I mean setting up a system where people can self-advocate, teach each other, and eventually phase out the need for the organization itself. With the understanding that community members learn better from each other than outsiders, the SPS Community Media Program runs village screenings of documentaries featuring local people who have profited from building farm ponds or accessing loans through Self Help Groups. The women in SHGs hold leadership positions in the SHG clusters and federations. Similarly, when AUNI runs adult nutrition workshops, the youth employed by AUNI are the ones demonstrate recipes, discuss healthy habits, and explain the key components of a nutritious diet. The food used in these demonstrations is often sourced from the farm where AUNI youth grow food. When I volunteered at Fruit Stand at Huey Elementary School, the students cut fruit and sold it to their peers, learning about healthy snacking, marketing, and math in the process; my job was simply to facilitate.
However, coming as an outsider to help a community is not always well-received. At first, both SPS and AUNI ran into conflict when establishing Kumbaya and Bartram’s Farm**, respectively. When the Neemkheda Sewing Center was first built for women who wanted to make a living sewing patchwork pieces instead of laboring in the fields, men who disapproved of women leaving their homes and tailoring burned it down. After they realized the value and financial benefit of women learning to sew, the men rebuilt the center. In the first growing season after Bartram’s Farm was cleared from a baseball field, boys would come at night to smash watermelons and ruin plants. Yet, once they formed relationships with the farmers, some of these same teens were employed to work at the farm. Initiating programs that empower communities is often the product of trial and error.
It’s not a coincidence that both organizations work to promote my particular interest, food sovereignty. Food sovereignty goes a step further than food security, meaning people should not only have access to enough food to meet their daily caloric intake, but should be able to choose what they eat. They have the right to eat foods that are nutritious and culturally relevant to them.
SPS builds farm ponds, which allow a farmer to collect water for irrigation while raising fish to eat and sell whenever she wishes. The agriculture program encourages farmers to grow nutritious, drought-tolerant crops they can eat, such as millets, sorghum, and pulses (dry grain legumes like black eyed pea, mung bean, chickpea, pigeon pea, and lentils) instead of cotton and soy, which have high water requirements and are not eaten. On a field visit to Deonalya Village, we handed out packets of various bean, squash, and spinach seeds to women at a meeting for the water sharing agreement. These seeds were for the kitchen gardens the women had agreed to start. Because vegetables require too much water, it is not advisable for even the farmers who have access to irrigation to plant them. However, to supplement household nutrition, SPS encourages farmers to grow “kitchen gardens” next to their houses. If a few vegetables are grown where the washing and bathing is done, they are watered with greywater (there is no plumbing, so wastewater is dumped on the ground) and the grower will not need to buy vegetables at the market. In a similar vein, at Bartram’s Farm, there is a community garden where people in the neighborhood can grow produce to eat at home. I’ve also heard plans for students to build home garden box starter kits.
Last summer, a nutritionist named Salome Yesudas came to the Baba Amte Center for People’s Empowerment (the campus where we live) and conducted a traditional and wild foods workshop with local women. She cooked sample dishes made of millets and sorghum, which everyone ate for lunch, just like at an AUNI community event. After lunch, the women were asked to look around the campus for edible plants they recognized. They found twenty-two. Hearing about this reminded me of our wild foods walks at Bartram’s Farm, where we walk around the premises identifying wild edibles and learning their uses. I was amazed to see one of such plants, purslane, growing outside of my room at SPS. I haven’t yet figured out whether it’s one of the wild plants the tribal people eat here, but I plan to ask Sukhram “Kaka” about it when we walk around campus identifying wild foods a few days from now.
Sukhram Maharaj is one of the original villagers to help the SPS founders get established. His father, Ghopal Maharaj, whom we interviewed about traditional foods last week, is one of the oldest inhabitants of Neemkheda. He remembers what uncultivated foods were consumed back when his family cleared the forest and settled here. My interviews here have also reminded me of the farm in Philly. Each summer at Bartram’s Farm, the youth give final presentations about food ways. Their projects are based on interviews with community elders, usually senior citizens who have garden plots at the farm. At the end of last summer, I chaperoned a trip with a handful of students from AUNI’s summer program to North Carolina. On the trip, we visited a group of women who have written a book about uncultivated plants once used by enslaved Africans. They documented these plants to preserve their culture, which is what I’m trying to work on here at SPS.
Of course, there are a multitude of differences between SPS and AUNI—their location, the people they serve, their employees, to begin with. Thus, their approaches to food sovereignty are unique. While AUNI is concerned by Philadelphia’s alarming rate of childhood obesity, SPS holds nutrition camps for mothers and their severely undernourished children. AUNI sends children home from Cooking Crew with recipes higher in nutrients but perhaps lower in calories than a McDonald’s meal; SPS helps implement government schemes to send malnourished children home from school with milk, bananas, and extra grain rations. Another fundamental difference is that AUNI works to bypass the mechanized, corporate U.S. food system to connect people with their food. Children and teens are taught how to grow food; the produce is then used in school programming or sold to the community at an affordable price. People here are farmers, so they are already directly connected to at least some of their food. The rest (rice, oil, salt, sugar) is purchased from government ration shops or the local market (vegetables).
*The Agatston Urban Nutrition Initiative is a program under the University of Pennsylvania’s Netter Center for Community Partnerships. Its mission is “to educate, engage and empower youth, university students and the community to promote healthy lifestyles and build a just and sustainable food system.” I volunteered at Huey Elementary School in spring 2015 with the AUNI Fruit Stand and am on the AUNI Student Leadership Team.
** The Farm at Bartram’s Garden, directed by Ty Holmberg and Chris Bolden-Newsome, was part of AUNI until about a month ago. The farm engages the community in promoting food sovereignty. It trains and employs youth from Southwest Philadelphia at the Farm, where 12,000 pounds of food were grown last year to be sold to the community and used in AUNI programming. Last summer, I worked in the farm youth development program, supervising and working alongside the high school interns. In the fall, I volunteered at Bartram’s Farm as part of the Politics of Food ABCS (Academically Based Community Service) course.
I don’t speak Hindi. Even though I’ve picked up a few important phrases since being here, I still have the same apologetic smile when I nod my head and say “Mujhe Hindi nahi athi hai.” The women here usually respond by saying that I should learn Hindi immediately, but more importantly, a larger portion of these women have volunteered to teach me. They usually smile and say, “You teach me some English, and I’ll teach you Hindi” (in Hindi of course). I never thought about it too much, but I’ve never really asked someone who doesn’t speak English in America to teach me her language. Rather, I feel as Americans, we think worse of someone who struggles with English in America, look down upon anyone who speaks with a thick Indian accent, and are embarrassed when our immigrant parents pronounce words differently with “American” people there. Even though I myself wish I knew Hindi, never have any of these women patronized me for not speaking their language. With English as its only primary language, America is partially paralyzed from accepting the slightest deviations from the norm, whatever that may mean.
A week ago, about ten high school students, part of the Chinmaya Mission’s international branch, arrived at CORD to learn more about rural development and women’s empowerment. Rhea and I, as we usually do with any new human being that enters our otherwise quiet campus, greeted two girls who were apart of this group with our usual: “HI HELLO! WHO ARE YOU? WHERE DO YOU COME FROM? WHY ARE YOU HERE?” It probably sounds more obnoxious in person. Anyways, we started talking to this pre-college frosh and 10th grader about religion and Indian culture in the USA, as they are both were of Indian decent. Rhea asked them if they were very religious and cultural. They gave the usual response: “Haha, I mean we go to the Sunday Balavihar class and stuff, but we’re not like VERY religious.” As soon as they said that, I was reminded of me when I was asked this question in America. I had (maybe sadly still have?) the same fidgety feet and nervous hands trying to clearly establish the fact that, although I may seem very Indian, I am not in fact TOO Indian. Sigh, as someone who definitely felt awkward fully grasping this question, I wondered what this force was pressuring the young children of immigrants to feel uncertain about embracing our own histories.
However, in India, America is still revered as the ultimate workplace, the dream of all dreams. One of my supervisors, Munish (who also let me attempt to ride an Indian scootie for the first time in a mostly empty field minus a few cows), asked me if marriage was required in America. Trying to understand where he was coming from, I explained how I did not think it was required anywhere; but, maybe compared to the Indian culture, American culture was more accommodating of people’s choices to remain unmarried. Later in the conversation, he explained how he had desired to work in America or Canada; but now that he is 29 years old and recently got engaged, thoughts of starting a brand new life abroad seems almost impossible now that he is “tied down” (his words) with marriage now. However, he has high aspirations for his younger brother, who has studied Sanskrit to become a priest. Even in the middle of the incessant strife internally bounding our country, America is still revered as the universal melting pot where all its residents can attain their wildest dreams.
Immigrant families in America fought tirelessly with their own individual hardships to end up where they are. Yet, in a country brimming with so much diversity, such a rich history, and heterogeneity, we are left trying to become one standardized people and even demeaning those who may be a little different. No one wants to stand out as “un-American,” whatever that may mean, in a country that champions individualism. So sometimes we find ourselves being condescending towards other’s accents, even though every modified intonation represents years of personal struggles; we dissociate ourselves from our individual cultures or religion, forgetting how delicately it was transported overseas to comfort our ancestors in this daunting land. I know that I am personally guilty of this.
But what if we all had that attitude? What if we could all strive to understand one another, our positions, our attitudes, our feelings without judgment or condescension? If we could look at our fellow immigrant Americans and WANT to learn about their culture, their history, their story without jumping to conclusions? Maybe it’s time we unapologetically embrace our own cultures and stand up for those battling to do the same by demonstrating a little sensitivity. America is hurting, for sure; yet she still inundates the dreams of millions aspiring to become a part of her culture everyday. It’s inspiring honestly how far a little tolerance, love, and respect goes when women here tell me to teach them so they can teach me. I hope to bring some of that willingness to learn back with me.
“Go ahead! Explore God’s Own Country” was the response that we got from our boss when we asked for time off from work to go to Kerala. I was very interested in going to Kerala because it would very different than most of my other travels (Mysore, Chennai, Delhi and Agra) which had been cities. There many reasons why Kerala is God’s Own Country. I suspect it’s mainly because of it’s natural beauty.
Tina, Elizabeth, Sarah and I embarked on our trip along with two other co-workers (Rahul, Ekta and her mom) from Jana. We took an overnight bus to Kodaikanal (which is in Tamil Nadu but borders Kerala) and began our adventure. We spent two days in Kodaikanal with it’s charming views, delicious home made chocolate and excellent eucalyptus oil. Then we were on the move again to Munnar in Kerala.
The journey to Munnar from Kodaikanal was about 10 hours. We went on three different buses from one mountain town to another. The last bus from Theni to Munnar was about 4 hours. This might have been of the most beautiful bus ride I have ever experienced. We wrapped around the beautiful mountains that were filled with tea plantation in the rain and could see the view getting ever more beautiful as we climbed up the mountain. It seemed that we were not the only ones amused by the beauty as other Indians on the bus were also recording and taking pictures of the view (I can’t imagine that one would get bored with such beauty). After we arrived in Munnar, the rest of our transportation was via Jeep (which I must say was pretty cool).
Munnar was a world away from Bangalore. The monsoon was unpredictable and our hotel sat on a valley. I felt so much more in tune with nature and my surroundings. It was super helpful that Rahul could speak Malayalam (the main language spoken in Kerala) to help us get around. So much so, that people continually asked him if he was our guide. In general, it was so different (and much easier) to travel with Indians than to travel as a group of foreigners. From waterfalls, to tea plantations, to mountains, elephants (totally one of my peak life experiences) and massages, my trip to “God’s Own Country” was incredible mainly due to the people who I spent the time with and the beauty that surrounded us.
Updates on my project: “All work, no play makes Jack a dull boy”.Will resume work after the holiday.
Last week I went to see the movie Gentleman with my co-interns Meghana and Mallory. All in all the movie was great, but what I noticed were the antismoking videos that were shown before the movie and during the interval in between part one and two of the movie. It was a straightforward video. A father was watching TV with her daughter and decided to light a cigarette. On the TV there is a scene playing out of a doctor treating a patient who has developed symptoms from smoking. The daughter looks disapprovingly at his father for smoking. The dad then puts out the cigarette and the video ends with statements on the dangers of smoking. The video made me think about how laws on smoking awareness are more progressive in India than in the United States.
While watching the movie, whenever there was a scene in which an actor was smoking, the bottom right hand corner of the screen would say, “smoking kills.” This is required for all films screened in India. I think this is extremely important, given that different venues of media, particularly movies, tend to characterize smoking as a character trait that exemplifies “being cool.” According to the World Health Organization, the pairing of good guys in movies using tobacco or smoking has actually gone up to 53% since the 1990s. Within the U.S. there are similar efforts to make the dangers of smoking more visible within the media. The Smoke-Free Movies project is currently leading an effort to require that all movies that have a scene in which a character is smoking be given an R rating when screened in theaters. Supposedly, this type of rating would push parents to more often speak to their children on the dangers of smoking. The goal is to continue the social awareness of the dangers that smoking brings. India’s success in increasing the visibility of these dangers is something the U.S. should model its efforts after.
Pictorial warnings are also required on the labels of all packages containing tobacco sold in India. The law requires that these pictorial warnings take up 40% of the package. I first noticed this when we went out to lunch with our boss, Chitra. After lunch she suggested we try this snack that was being sold right outside the restaurant. The guy selling the food had a small booth set up outside. In the booth I noticed that each packet of chewing tobacco had a picture of grey lungs, damaged by the carcinogens in tobacco with the caption, “tobacco causes cancer.” The picture was unsettling, which is exactly what the point of the pictorial warning is. You’re supposed to see the damaging effects of tobacco every time you purchase a product with it. I think its effectiveness is in the shock value, something the required labeling on U.S. cigarette packages lack. Although the United States was the first country to require health warnings on it’s labeling, passing the law in 1966, the visibility requirements of these health warnings are very minimal. Health warnings are usually placed in small print on the side of cigarette packaging and there isn’t a requirement of an image, such as damaged lungs, that demonstrate the harmful effects of tobacco. Usually, these warnings are printed in a way that camouflages into the normal packaging of the tobacco product.
The U.S. should follow the precedent set by countries, such as India, that utilize clear and large visuals that accurately demonstrate which risks the act of smoking carries. In the past, companies that sell tobacco products in the U.S. have done little to ensure this. In fact, tobacco companies such as R.J. Reynolds Tobacco Company were actually accused of using its famous mascot Joe Camel as a marketing technique that was actually reaching children rather than its adult user customer base. The U.S. should begin to consider enacting laws that increase the responsibility of tobacco companies in alerting customers of the risks that come with using their products.
Doctors are gods. That is the sentiment that I have been overwhelmed with since I got here. Whenever an important doctor walks into a room, all the MLOPs and administrative personnel stand up out of respect. Patients look up to and defer to doctors to the point of not even being involved in their own care. At first I was surprised that none of the patients were seriously reading consent forms or participating in conversations about their own health. In a sample demographic survey I gave out, one of the questions (shown below) asked what kind of written information the patient would like to receive. I added option “g” in because I knew that some people must think that way, but neither I, not my bosses expected anyone to choose it. We assumed that they would check all the above boxes, because having as much information as possible never hurts. But when I got the five Tamil-translated surveys back, four of them checked “g”, and the fifth one seemed to misunderstand the question. It surprised and actually scared me to think that none of the patients wanted to understand their disease or treatment; they just wanted to blindly follow the doctors. But then I thought of my experience regarding my own health.
Demographics Survey Question
I consider myself to be a relatively informed person, and I do read up about any condition or diagnosis that I receive; however, I cannot recall a time when I have seriously questioned the validity of a doctor’s suggestion or diagnosis. Even though I am on a pre-veterinary track in college and am interested in medicine, I still unconsciously believe, “Who am I to question the opinion of someone who went to medical school”. Unlike the patients I surveyed at Aravind, I do want to understand my diagnosis and treatment, but I still do not converse with my doctors about it. And I can even see where that affects my own compliance and adherence to medication. If someone like me, who is aiming to become a medical professional in five years, cannot converse about my health and treatment with my doctors, then how can I expect that of patients in Aravind, who may be less educated, and whose doctors more often than not do not even speak the same language?
Shared-decision-making is a popular new concept in medicine. “Medical noncompliance has been identified as a major public health problem that imposes a considerable financial burden upon modern health care systems” (Donovan JL), and shared-decision-making helps to increase adherence. Both the doctor and the patient are considered to be experts on the patient’s health, and they are meant to collaborate in order make decisions that the doctor approves of and the patient will follow. By doing this, the patient is empowered and is more informed as to the importance of his/her role in the treatment process. And since the patients consider their own “beliefs, personal circumstances, and available information”, they are able to better determine whether they will be able to adhere to the treatment plan.
So far all of my interventions for patient information had been concentrated on bridging information gaps using multiple mediums, from smartphone apps to information on discharge forms. But now I believe that it is not only important to bridge gaps in information, but to also get patients interested in obtaining that information and discussing it in counseling. For now I have made an information sheet that is given by the doctors at the time of diagnosis for the patients to read before counseling. Once it is approved I will try to get the counseling sisters to discuss the sheets with the patients in order to get a dialogue going so that a patient can feel free ask questions and hopefully become involved in his/her own care.
Jenny L. Donovan (1995). Patient Decision Making: The Missing Ingredient in Compliance Research. International Journal of Technology Assessment in Health Care, 11, pp 443-455.
I have been at Aravind Eye Hospital in Madurai, India for over six weeks now, and our projects have really begun to take shape and approach completion. I can’t say it was an easy start though. I am used to relying on myself to complete tasks or run experiments, but after working here for a few weeks, I learned that in order to really affect any change, I would have to work closely with the employees. I have never experienced the administration side of a hospital, and being introduced to it at Aravind has certainly been unique. The hospital operates like a machine, always moving from the second it opens its gates at 7:00am until past closing time (supposed to be at 5:30pm). Within that machine, my project is to get a quantitative analysis of patient information in the retina department and to propose ways to close any gaps.
The biggest problem so far had been getting that quantitative data. I spent a week generating and testing eight surveys (general and disease specific) only to find that there were very few patients who were able to fill it out themselves. I would receive surveys that had the first box checked for all the questions and others in which many questions were left unanswered. When I pointed these problems out to the patients, they went on long explanations in Tamil. Now the issue with this is that even though I look the part, I cannot understand a single word of Tamil. Although I don’t get the stares that the other Aravind interns get as they enter the hospital, on the flip side, all the patients and MLOPs (Mid-level Ophthalmic Personnel) assume that I am a local, or that I am at least able to understand the language. Not only do I not speak any Indian language, but even if I did, it would most likely be my parents’ mother tongue, Hindi. So I stand there and repeat the word “English” until the patient realizes that I don’t understand anything he/she is saying.
But even though this method had its difficulties, I was determined to make it work. I would sit in counseling for hours to come out with one or two poorly filled surveys. I would then try to sort through which answers seemed real, and which ones seemed to be the result of a lack of understanding. I thought that I would be able to fix it without getting help from my boss, but one week later, it became apparent that this method was not working.
Discouraged by my failure, I assumed that when I talked to my boss, she would not understand why I could not follow through. We had discussed my methods before I began developing the surveys, and she seemed to think they would work. But I was surprised to find that she understood why it did not work and suggested that we move to a more qualitative approach. I was assigned someone to help me run more open-ended focus groups. It was then that I realized, much like in lab work, there was going to be a lot of trial and error when it came to collecting the data. There is no perfect method, especially when dealing with people from whom you are separated by culture and language barriers. In the last few weeks I began to rely more on the people of Aravind who know the hospital and its patients. Every time I came up with a new idea or new version of something, I would run it by my boss, or the doctors and counseling sisters of the retina department. And even though I sometimes felt like I was holding back the flow of the clinic, I stopped hesitating so much when asking for help. As a result, I am now on my way to designing a smartphone app for the hospital, as well as developing information sheets pre- and post-discharge in order to stimulate shared-decision-making and dispense more tangible information.
At the organization I am working at this summer, travel is a constant part of our lives. We change cities every few days—sometimes Delhi, sometimes Yamuna Nagar, and sometimes day trips to Ambala or Karnal. Add on the pleasure travel I do when I have free days, and it adds up to quite a lot of moving around.
Constantly being on the move has been a rewarding challenge. At first it was exhausting—carrying luggage, worrying about housing, feeling like half my time was spent in a bus or train. Now that the travel schedule has become somewhat fixed, I’ve had a chance to reflect on how this amount of travel can change one’s perspective, both positively and negatively.
I’ll start with the challenges. In some ways, constantly traveling can make you quite self-centered–“How am I getting to the next city,” “Where am I staying,” “Where will I eat,” “Where can I find an ATM,” “How will I get around”—travel can make you focus entirely on putting one foot in front of the other, and in the process you forget the others around you. Relationships are also hard to form when you are never in one place for too long a time.
On the other hand, just as they say that “absence makes the heart grow fonder,” travel makes you appreciate the different places you come back to. When I arrive in Yamuna Nagar, I am excited for the amazing food, the great people, chit-chatting with the night guard or the Canteen cook, and the relative calm of a small city. When I arrive in Delhi, on the other hand, I am relieved to have my own personal space (I stay in a guesthouse in Delhi and a hotel in Yamuna Nagar) and access to all the conveniences and shops that such a big city provides. Both places have their pros and cons, and going back and forth illuminates these in a way that a single daily routine would have masked.
I still am unsure whether this amount of travel is something I would look for in a long-term career. In any case, this summer it has been vital for keeping my ideas and thoughts fresh and challenging me to adapt to a different kind of lifestyle. All of these are skills I will be happy to take forward.
The monsoons have finally arrived and all of the land around us has transformed into a multitude of wonderful shades of green!!
When we first arrived to Madhya Pradesh, everything seemed to be a variation of brownish-tan. The fields were dry and dusty, the trees had no leaves, the grasses were yellow and the mountainsides looked like they could use a nice big sip of water. Now, almost eight weeks later (and ~2 weeks into monsoon season), the land has completely changed.
Everywhere I look I see a new shade of green; the grass outside our room literally looks neon (I swear none of my photos are edited!!) since it’s all so new. The hills surrounding our campus have turned from dry, dead to green and luscious. All of the empty fields are suddenly filled with rows and rows of growing crops; some have grown to be over a foot tall in the past two weeks! It’s amazing just how many different varieties of green there are all coexisting in the painting-like landscapes.
Besides bringing life to the dry land, the monsoons have brought about a completely different climate. Before it was dry and HOT, for the first few weeks we never experienced a day with the high below 100 degrees Fahrenheit. Now with monsoon, the temperatures have dropped substantially, rather than an average high of 105, the mid-day temperature sits around 80 degrees. However, the air is no longer dry; when it’s not raining (which is honestly a majority of the time as rain seems to come down in sparse pockets/at night) the air is heavy and extremely humid. Unfortunately the humidity causes the “feels like” temperature to climb 5-10 degrees on average, thus I still wouldn’t exactly describe our days as “cool.” Finally, we’ve experienced the most beautiful thunderstorms; at night when the sky is covered in clouds, the lightning literally looks like a camera flash has lit up the entire sky.
The only downside of monsoon is the bugs; they have finally come out in full force. As someone who has always been a mosquito magnet, this has not been a welcome shift. The other day my 1-hour sunset yoga session left me with 11 new mosquito bites. On average, I think I’ve been receiving 8+ new bites a day (but don’t worry, I’ve been taking my malaria pills!). In addition to mosquitos, the rains have brought out enormous beetles, moths, ants, flies, freshwater crabs, frogs, snakes and more. We’ve developed an entire routine for entering our room at night in a way that minimizes bringing in unwanted insect guests.
Nevertheless, this wonderful, colorful weather shift has made me so happy that I think I’ve gone a bit crazy. As I wander around campus or look out the window of the car I’ve been constantly singing parody songs about the greenery in my head. Right now I have one stuck in my head to the tune of “Huurah, Huurah,” the Penn fight song. It goes, “Hara, hara, hara, hara. Hara for the plants turning gree-ee-nn.” (hara=green in Hindi)
To truly capture the essence of this shift I’ve created a series of ~transformation~ before/after pictures for you all (and keep in mind that we considered the SPS campus a green oasis when we arrived; the rest of the land transformation is even more stark!):
DelhibyCycle – Started by a Dutch biking enthusiast who believed the best way to explore the sights, smells, and sounds of the city was by bicycle! I love sightseeing, and I love trying new things, so I was convinced. I registered for the tour, and at 6:20am the next morning, I awoke, brushed my teeth, and went to Delite Cinemas, the meeting point for the tour.
It was 9 of us: 3 men from France, 1 from Scotland, 2 girls from Delhi, me, 1 tour guide, and another employee whose job was to keep us all safe. We were given our bikes, no helmets of course, and within a couple minutes, we were led, single file, through one of the most crowded streets in Old Delhi.
I had opted for their most popular tour: a tour of Shahjahanabad, the original name for Old Delhi. The same Mughal emperor who had contracted the Taj Mahal established Shahjahanabad as a capital that he deemed worthy of his vast kingdom. And it was. Shahjahanabad was a beautifully and carefully planned city. Jama Masjid, the largest mosque in South Asia, was at the center. The four major streets of the city all led to the masjid. The Red Fort and a thick wall protected the city.
Two hundred years and fifty years of unplanned urban capitalism have transformed the city. It quickly became established as a trading hub for hardware, which then expanded to dry fruits and herbs, and now, it’s a major wholesale market for every type of good imaginable: engineering parts, flowers, books, spices and more.
It took a trained eye, or at least knowledge of what to look for, to separate Shahjahanabad from the Old Delhi that exists today. This was the first contrast I encountered: the contrast between old havelis turned into shops, courtyards turned into shops, and historical streets turned into….shops. The carefully planned Shahjahanabad transformed by frenzied capitalism, where the only rule is to sell, sell, sell.
After about 30 minutes of clumsy cycling, nearly running into auto rickshaws, and almost making a wrong turn, I finally gained my footing. Soon I was cruising through the gullies, streets in between buildings that were only wide enough for two people at a time. I was weaving through the traffic with confidence. But as soon as I mastered bicycling through the most crowded market in Old Delhi, we entered a new neighborhood: quiet, green, and void of all the chaos I had just grown accustomed to.
After a revolt in 1857 against the British, The British in Delhi migrated out of the old city and established a residential area they named Civil Lines. In true British fashion, this neighborhood has large, gated mansions and an upscale hotel. Now, it is home to several of Delhi’s government officials. This was second contrast: the contrast between posh residence and urban slum. Shahjahanabad slowly crumbling. Civil Lines standing pretty. But I can thank the British for the delicious chai we had in Civil Lines (the British brought tea to India in the early 1800’s).
We reentered Old Delhi and rode past Jama Masjid and the Red Fort on Chandni Chowk Road, the most historic street in Delhi. It has experienced all of the history of Shahjahanabad. Towards the end of the street is a Baptist church next to a Sikh gurdwara next to a Hindu temple next to a Jain temple and all nearby Jama Masjid. And we couldn’t help but notice the sixth religion represented on Chandni Chowk road: McDonalds. The architecture, the city layout, and the few remaining structures point to a capital city fit for a king in the not too distant past. Over the years, Shahjahanabad has had to accept the chaos of the free market. It has learned that unplanned, urban development, though chaotic, can work just as well as carefully laid out streets. It has seen dynasty, colonialism, and democracy. And thus, Shahjahanabad lives on.
ཁོང་ཚོའི་ལག་པ་ནང་ལ་གསེར་ཡོད་ཡིན་ན་ཡང་ཧ་གོ་གི་མི་འདུག “They have gold in their hands and yet they do not even know it”
About 10 kilometers outside of Leh, beside the main Tibetan refugee settlement in Ladakh, is the area of Choglamsar. The landscape is stark: rock faced mountains, clouds of dust, and beating sun. In this desolate backdrop is an important center for Buddhist learning, the Central Institute of Buddhist Studies. It has one of the most extensive Bhoti (Tibetan language) libraries of the Himalayas and every year educates hundreds of Himalayan and Tibetan students in the literature, philosophy and arts of the Buddhist Himalayas.
The institute was founded by the most important Ladakhi of the 20th century, Kushok Bakula Rinpoche. Bakula Rinpoche, like many monastics from the Indian Himalayas, was educated at one of Tibet’s great monastic universities prior to the Chinese occupation. He returned to Ladakh from Lhasa in 1941, having been awarded a Geshe degree, the highest degree in the Gelukpa tradition of Tibetan Buddhism, requiring nearly 20 years of rigorous training in Buddhist philosophy. In 1949, when Ladakhis held their first democratic elections, they elected Rinpoche as their leader. In 1954, he visited Tibet again and witnessed the deteriorating situation under the newly arrived Chinese overlords.
For nearly a thousand years, Tibet served as the spiritual center of Ladakh and the Himalayas, providing indispensible instruction in the Buddhist scriptures and meditation. In his far-sighted wisdom, Rinpoche knew that the Tibet he knew as a student was being irreparably changed under the communist regime; Ladakh and other Himalayan Buddhist regions could no longer rely on their neighbor to the north for teachings. Recognizing the conditions in Tibet would become more repressive, he petitioned Prime Minister Nehru to establish a Buddhist institution in Ladakh. The Prime Minster was reluctant, hoping that the situation between the Tibetans and Chinese would improve. In March 1959, when an exodus of nearly 100,000 Tibetan refugees fled to India, Nehru was forced acknowledge the validity of Bakula Rinpoche’s fears. By October, with support from the central government, the Central Institute of Buddhist Studies was established, with an initial class of only 10 monks.
The Institute has expanded immensely since its humble foundlings. Beginning in the 1970s, CIBS began offering modern subjects such as math, science, and political studies, in addition to their offerings in the traditional topics of Buddhist philosophy, Bhoti language and literature, and Buddhist arts. There are currently 750 students, including more than 300 laypeople. In January of this year, it was gained official Indian university recognition, now offering degrees from B.A. up to PhD. Geshe Konchok Wangdu, a Ladakhi educated in an exiled Tibetan monastery in south India, is the current Director of the Institute and is deeply invested in perpetuating the Buddhist knowledge of the Himalayas. We had a long conversation, switching between our shared languages of Tibetan and English, about the work of the university as well as the state of education in Ladakh more generally.
“Bakula Rinpoche was so very, very important for our Ladakhi people, and so very kind. He cared a lot about our traditional language and Buddhist philosophy and Bhoti literature,” Geshe-la explained. In 1954, Bakula Rinpoche composed and edited a series of Bhoti textbooks for the Ladakhi primary and middle schools, versions of which are still taught in the government schools. However there are major impediments to developing high proficiency in Bhoti. Geshe explained that all government schools use English or Urdu as the medium of instruction; Bhoti is only taught as a single subject. He quoted the UNESCO studies showing the benefits of mother tongue instruction, expressing his frustration none of these facts were taken into account when designing education policy. In addition to greatly improving Bhoti literacy and cultural knowledge, students would perform better in all subjects if they were taught in their mother tongue. He lamented that these findings fell on deaf ears in the J&K Department of Education.
He identified three main problems preventing the development of Bhoti language and literature in the schools. The first is from the students themselves. Many of the younger generation do not see the benefit of Ladakhi language, regarding it as a provincial language with no use outside of their region. Hindi and English, on the other hand, are seen as the languages of opportunity and social mobility. With an increasing desire to move from the villages to Leh, from Leh to Delhi, from Delhi to the west, young people do not see the use of developing high proficiency in their own language.
The next problem comes from the educational policy J&K Educational Department, whose views are similar to those of the students. Urdu and English are regarded as the essential languages of success, while Bhoti is more of an afterthought provided to Ladakhi students. Furthermore, Ladakhi literature, history, religion and culture are only included in the Bhoti class, which is only offered as a single subject. These rich traditional subjects of learning are generally neglected in favor of the general Indian curriculum, based on the colonially inherited Macaulay system, which had expressed goal of creating English minds in Indian bodies.
The final problem comes from the lack of qualified Bhoti teachers. As the current generation of Ladakhi teachers has all gone through the same K-12 education with minimal emphasis on Bhoti language and culture, there is a dearth of teachers with this knowledge. If the teachers do no have high proficiency in Bhoti language, if they are not knowledgeable about the 5 Buddhist sciences of Himalayan culture, how can they teach the students?
In the face of these challenges, Geshe Wangdu is dedicated to providing a traditional Himalayan education. In addition to his directorship of CIBS, he is also the president of the Spituk Kamzang Education Society, responsible fro writing and publishing a complete pre-K through grade 8 Bhoti textbook series. These are the preferred textbooks in the private schools throughout Ladakh that emphasize Bhoti language education and traditional Buddhist learning.
Geshe-la spoke of a moral crisis facing Ladakh that only education could address. Growing up in his village outside of Leh, he said he could drink from any stream; there is now no stream he would risk drinking from after “development” has created unprecedented pollution in the valley. When he was a child, elders were respected as the holders of knowledge and tradition; now, the younger generation thinks of them as ignorant and stupid. As a youth, he never heard people talk about depression; last year alone, 35 Ladakhi students committed suicide. For Geshe-la, these are not anecdotal occurrences; they are deeply interrelated and point to the deterioration of the values that once defined Ladakh. Ultimately, Geshe-la believes education is the only possible solution to rapid transformations that are fundamentally altering Ladakh. The inevitability of change is a core Buddhist belief. The question is how to manage this change while still preserving what is most essential in Ladakhi culture.
At the conclusion of our interview, Geshe-la graciously asked to me stay at the university for 10 days. I expect this will be hugely beneficial for my research, allowing me to study Bhoti curriculum development as well as the traditional courses taught at the school. I also hope that my exchange with students will develop into a helpful dialogue about the nature of education, and how to incorporate the desired modern subjects while also perpetuating traditional Ladakhi ways of knowing.