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The Center for the Advanced Study of India provides funding and support to undergraduate and graduate students at the University of Pennsylvania to conduct independent research and volunteer internships in India.
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Breaking the ice

Mon, 08/03/2015 - 17:07

As I described it in my previous post, empathizing with Shahi workers (especially incoming migrant workers) and establishing proper communication with them is often challenging. When I came into this internship, I had thought that, somehow, the proximity of our ages would strongly play in my favor, that it would enable the girls and me to relate to one another and establish some kind of proximity and complicity.

However, I soon realized that being and looking the same age and being as smiley and friendly as I could was not enough to erase the terrified -sometimes even glaring- looks I would sometimes get when I made them come to me for interviews. You could make a point that being the same age is not enough to outweigh the other fundamental differences in our upbringing, the cultural and linguistics barriers that exist between us. However, I think that, in this case, it is first of all the fundamental nature of the setting that created the communication barrier: a setting in which I am the interviewer, I have the power to ask the worker what I want, but in which she knows nothing about me. Intimidating for her but also a little awkward for me, because I am aware that the fact that I am the one who is sitting in the interviewer’s chair today -and not her- is the result of pure hazard. Fundamentally, I do not deserve this position any more than she does.

Hence, once a girl is sitting in front of me and I am about to ask her questions, it is usually hard for me to overcome the communication malaise created by the situation. When in such a situation, I try to make my interlocutor feel more empowered and informed about the situation by presenting my objective and myself first or by asking her if she has any questions about me. But really, I feel that nothing has been more effective than hostel/village visits and good old icebreakers!

When we were conducting hostel visits during the weekend with our boss Chitra, we found that the girls were generally more lively and opened to talking. I think one of the main reasons for this was that we were interacting in an environment in which they were our hosts, and us, their guests (as scenario almost opposite to the interview setting we used in the factory).

Moreover, we found that scenarios in which the workers would be the ones teaching us something or leading the activity were also favorable to good interaction and trust. While visiting one of the training centers in Orissa, a few girls we met mentioned how much they enjoyed dancing. (After a little pep talk), these girls performed a dance number for all of us. Somehow at some point, I was dragged onto the “imaginary “ stage, and encouraged to copy their dance steps. I was then integrated in a frenzied spinning polka dance circle and then summoned into a waltz with one of the workers. The energy level of the room reached its peak; everybody was clapping and laughing. I was having a lot of fun and began feeling more at ease… and so did they, it seems.

understanding the steps…

… before getting in the groove

Which brings me to topic of icebreakers: at Shahi, people know that there is no best way to start a meeting than with a fun game which preferably involves jumping around or running. As part of the buddy system scheme I have designed for new incoming migrant workers, supervisors get introduced to junior and senior buddies during a formal meeting on the second week of the scheme. During the meeting, junior and senior buddies can also raise concerns and questions with their supervisors. To make the atmosphere more relaxed before the Q& A session (new joiners at Shahi often perceive their supervisors as an intimidating figure), we had all of juniors; seniors and supervisors play a game of “protect your balloon”. Every player ties a small balloon to one of his ankle and must run around and try to pop everybody else’s while protecting his. I had not suspected that these shy looking girls would be able to play so fiercely…

To get a better idea of what I am talking about, you can look at this video I took of the game. I know it is quite long (so feel free to skip parts of it), but my favorite moment is on second 56 when a junior buddy sneaks in and attacks a supervisor from behind. (btw: in this video, all the men who are playing the game are supervisors)


Travelling Alone as an Extrovert

Mon, 08/03/2015 - 01:25

It’s hard.

Okay, fine I know I can’t leave it at that. As an extrovert, I crave human interactions as a way to energize myself. Being alone too long leaves me restless and deflated. Another thing that I guess is interesting about this experience for me is that I’m used to talking through my experiences with other people. It helps me process. I know it sounds dumb. Like, Kendra you can’t just look at a mountain and understand that it’s a mountain? Well, yes. I guess I just thought that witnessing beautiful scenes alone would give me profound thoughts or lead me to the meaning of life, but my mind is coming up blank. Everyone always talks about enjoying alone time and here I am constantly pinching myself: Are you enjoying it yet? Being alone is fun, right? RIGHT?!

Part of it is that I spend so much time being careful and worrying about my safety when I’d rather be meeting people and making friends. Yesterday I walked from Mcleodganj, where I’m staying in the Dharamsala area of Himachal Pradesh, all the way to the Bhagsu Waterfall. I noticed on the way that it was mostly couples and men or groups of men. A few men tried to join me on my way up. I was really careful about this and moved away from them. Finally, when I reached the popular Shiva Café at near the top of the mountain I stopped to go in. There were only about 4 tables and cushions on the ground to sit but three out of the four tables were occupied by groups of men smoking hookah. The café was really cool and I wanted to spend time there but was conflicted by the intimidating male-dominated vibe. I ended up ordering food and eating it quickly (sitting at the least occupied table I could find) and leaving.

Shiva Cafe

On my way back down the waterfall I ran into two women and two men who asked me where Shiva Café was. I pointed them in the right direction and asked where they were from. Delhi. One of the women said I could join them after I explained why I left so quickly. I went back up the mountain with them and chatted for a bit. The mist came down hard and it looked like it might rain. I did not want to be stuck on the mountain for long and one of the men who had tried to join me had also just reached the café. I was desperate for people to talk to, but decided to head back to town just to be safe.

Because I do not like to be out alone in the dark I have a lot of time to myself in the evenings at my hotel. Saturday night I spent a good hour or two attempting to wrap my saree. The Internet helped get me close, but I’m still missing something and get tangled up at the end every time. Last night I looked through old pictures on my phone. I look so different now from how I did during the school year. While in India I cut down on my (already pretty small) makeup routine and now that I feel like I’m in the middle of nowhere alone I have stopped wearing makeup or putting in contacts at all. It’s kind of nice, but I’ll be happy to go back home to all of my cosmetic products and a shower where I don’t have to put on the boiler 30 minutes before I need hot water. Mostly though, I’ll be happy to be reunited with my friends.

NO MAKEUP OMG. Taken by a nice couple. The man was taking pictures of his wife so I offered to take one of both of them in exchange for this.

There are some positives though:

  1. No one can judge me for how many momos I eat
  2. No one can judge me for how often I buy coffee/cappuccinos
  3. No one can judge me on how much I eat or buy souvenirs that I don’t need
  4. I can pass as Indian here thanks to my slightly melanin-enriched ambiguous skin color
  5. I can take as long or as short as I want to do things. The Bhagsu waterfall has many paths and detours and at first I felt like I had to go down every inch to prove I saw everything. When I realized I didn’t it was really freeing.
  6. Sometimes when you sit alone at a family-owned Tibetan restaurant they’ll offer you some of the food they’re eating for dinner and let you play with their dogs and show you videos of their band on an iPad. Check out JJI Exile Brothers here.

Fried momos and thukpa. Dharamsala and specifically the Mcleodganj region where I’m staying are known for being home to a large community of Tibetans in exile as well as the Dalai Lama. It is not uncommon to see Buddhist monks sitting in cafes drinking tea and browsing iPads.

One of many coffee drinks consumed.

In some ways I almost wish I had just gone straight from Bangalore home. It would have been an easy way to cap my experiences. To say “that was India” and call it a day. But as you may have gleaned from my last blog post, I had a huge support network in Bangalore. Adjusting to life in one of India’s more cosmopolitan cities was no huge deal when I had coworkers looking out for me and five other Penn students to hang out with on the weekends (s/o to Bengalu-cru if you’re reading this).

Bengalu-cru on Kevin’s birthday in June (before I stopped wearing makeup completely)

My best friend from home and I have a sort of running joke about how I’m not very mature. Compared to Maddie, who spent three months in Peru before starting college on the opposite coast from where we grew up, I haven’t done many things in life completely independently. Before I left for the summer she said she thought this trip might help me to grow out of that child-like feeling I had. In Bangalore I felt like I was always cared for and looked after. But after a SNAFU trying to get to my bus in Delhi (that included riding in the non-women’s-only metro carriages and a ride on an actual manual rickshaw at night) and a few days alone in the Himalayas, I do feel a little different. If I had just gone home after Bangalore, my goodbye to India would have been like leaving summer camp. Bye to all my old friends, and please keep in touch. But now I’m saying goodbye to strangers and acquaintances and a place I conquered myself.

All that being said, I think I’m ready to come home now, which is perfect timing since I leave in less than three days.


Finding Something Beautiful

Sat, 08/01/2015 - 10:09

It has been ten weeks. My internship at Aravind is over, and I am on the verge of leaving India for home. The time has flown by. The first day of this journey, when I met Olivia at JFK and caught an Air India flight to meet up with the other CASI interns in Delhi, does not feel like 10 weeks ago at all. The question that I am left with is what really came of those ten weeks? What have I done, what have I learned?

My projects are now essentially complete. If you will recall, I was working on two projects, one related to patient safety and one related to patient satisfaction. I helped to compile a patient safety manual with all protocols of all departments and some presentations to help with raising awareness about patient safety among staff. As a second project, my work with the patient satisfaction data has yielded some insights about the Aravind patient experience that have been compiled into a report, and in the final weeks we may have hit upon a way to better score patient satisfaction, that uses some of the methodologies of the Center for Medicare and Medicaid Services (CMS) in the US.

As I write out the results of my projects, I cannot help but feel that there was more to be done.  With more time, I could have done more to push the installation of new patient safety initiatives; I could have included several additional forms of analysis in going through the patient satisfaction dataset. And it hurts, feeling that there may have been rocks left unturned and knowing that much more work is needed to address patient safety and satisfaction.

I think that those thoughts are mostly a product of the fact that these projects are part of work with an extremely long arc. Patients don’t just become safe or satisfied in two months. The work of protecting patient health and meeting patient needs is constant and perennial. The challenge in this context is in making iterative improvements and refining parts of the system each day so that care can improve over time. Yet, even understanding the nature of long term projects, I think that in the world of development and service, this sense (that your impact was not fully felt or made) is something that can be difficult to reconcile. We all want that striking before-and-after picture which can allow us to quantify our impact. We all want to know that we made a difference.

And this, I think brings me to what I have learned this summer. Of course I have gained a lot in terms of learning about some of the technical issues of running a hospital, i.e. how do you bring down costs in the developing (and, frankly, the “developed”) world, how do you generate revenue to sustain a hospital when many don’t have insurance, how do you measure quality effectively. But equally important as these technical insights has been learning about what it means to have an impact and make a difference more generally. What does it take to meaningfully improve the lives of the people around you? There are two ideas that I think I will remember forever relating to this issue, and they both come from the vision of the founder of Aravind, Dr. V.

The first idea has to do with McDonald’s (of all things). Dr. V saw McDonald’s as a key model in creating Aravind. The goal of Aravind was to be the McDonald’s of eye care. Aravind was supposed to be able to deliver eye care at prices that anyone could afford using a standardized process that ensured a certain level of quality. Extending this analogy further, the idea was that in the same way that McDonald’s is able to use franchising to sell big Macs in every corner of the earth, it should be possible to design a blueprint for a high quality, standardized process that can be franchised and used beyond Madurai. One of the underlying notions is that if you want to cure blindness all over the world, you need a structure where it should be possible to slot anyone, anywhere in the world, into the system and have that system function. Of course, Aravind uses doctors and nurses instead of fry cooks and cashier managers, but the concept is the same. The key to making a difference across the world at scale on the order of global health is not superstar individuals, but rather processes and structures that allow ordinary people to do something extraordinary. This is fundamental, and it harkens back to the incredibly simple, Kindergarten-level, adage that teamwork at its best is incredibly powerful. A well-functioning team is infinitely more capable than the sum of its parts working individually.

This sounds great and undeniable, but if you are an individual in such a system, what is your psychology? Do you personally matter? Or are you a fry cook, who can be replaced? (please know that this is not intended to be a pejorative slight at all to the McDonald’s fry cooks out there; I am a big fan of their potato-fried work!) My sense in working at Aravind is that when you are a part of an institution that is working towards something consequential (like eliminating needless blindness), you don’t worry as much about your place. You sacrifice the self-assuredness that you personally are an essential part of making a difference for the assurance that you are part of something that is making a Huge (with a capital H) impact. I am leaving Aravind realizing that the biggest challenges and the greatest positive impacts can be sustained when a system of people work towards something. You can’t be afraid to be the fry cook if you’re working at the McDonald’s of eye care.

The second big idea comes from my favorite quote from Dr. V. In his words, “Intelligence and capability are not enough. There must also be the joy of doing something beautiful. Being of service to God and humanity means going well beyond the sophistication of the best technology, to the humble demonstration of courtesy and compassion to each patient.” The quote can be found written in places all over the Aravind Eye Hospital, including on a small sign in our office for the summer. The quote is so simple, and yet it is the most powerful thing that I take away from the summer. When I walked around the hospital and observed doctors, nurses, and administrators, I really felt that behind every person, there was “the joy of doing something beautiful.” People at Aravind are not shy about goals. The hospitals at Aravind and the many departments within the hospitals receive constant feedback through parameters and measures of quality. Everyone is trying to beat some mark, and across Aravind, the very tangible goal is to reach 100% of the patients in Tamil Nadu.  What I have realized, though, is that there is more to the work than achieving the goals. There is more to Aravind than the goal of eliminating needless blindness. Embedded within the culture is an appreciation and love of the pursuit of that goal. In a way, just the fight, just the challenge, just the struggle for something that you believe in, can be enough. Moreover, when you love that struggle, you really have an edge in overcoming all of the obstacles and achieving something. These past two months were fast, and I leave knowing that there is so much more to be done. But for a few months, I felt “the joy of doing something beautiful,” and I move on, understanding that I can find that joy again and in finding it, make a difference in the world.

With that, so long to India, and so long to a summer of adventure and discovery. It is time to find something “beautiful” back in the US.


In workers’ shoes

Sat, 08/01/2015 - 06:00

Two weeks ago, Amy, Chan, Kendra, Anant and Chitra (our two bosses) as well as doctor Leena (who looks after various factories in Shahi) flew to Orissa, a lesser-developed rural region North East of India. During our few days there, we visited local villages where migrant workers come from, as well as training centers, where new, young, female recruits receive sewing and soft skills training prior to integrating into one of the Shahi sewing units in Bangalore. After forty days of training and a two daylong bus ride, these women finally arrive to their hostel, their new home for the time they work at Shahi.

Our aim during this trip was to observe and learn about the living and training conditions of the Orissa migrant workers in their home state, and to pay special attention to certain features. For example, Amy, Chan and Doctor Leena’s focus was to investigate these women’s perception of heath, as well as their nutrition and hygiene habits. Upon joining Shahi, many of these women indeed suffer from moderate to severe health issues, (one of the most prevalent being anemia). These health issues damage their wellbeing as well as their productivity and have a strong impact on attrition. On my side, I was conducting a more holistic observation. I am designing a buddy scheme (partnering incoming migrant workers with a more experienced workers to help overcome adaptation problems – see previous posts), and I was intending to use this Orissa trip to get a general sense of the discrepancies that exist between their living and training conditions over there and their living and working conditions in Bangalore. This would help me further answer certain questions such as “Which aspects of living and working are more/less difficult for them to adapt to?”, and thus “In which respects/ domains would a senior buddy be helpful to the junior buddy?”.

In the first training center we visited, Anant, Docteur Leena and I were trying to interview a group of 20 girls and have them answer a couple of questions about themselves: What do you think you will miss the most when you leave Bangalore and come to work to Orissa? What aspect of your future life are you worried about…? etc… But we encountered the same difficulty that we had already so often encountered in Bangalore: getting answers!   We arrive with a list of questions, ready to get grand answers. But, the girls in front of us act shy and will not open up. They will answer with one word. If we are lucky…with a sentence. It is tiring and frustrating.

However, having these emotions and acting so impatient also makes me feel a bit conflicted. I am aware that these girls also have it hard but I am still overly demanding. Most of them are barely over 18 years old, they have just left leave their village and their family for the first time and are now training for a job they have to learn from scratch. They are about to leave the rural region of Orissa were they lived in mud houses for the cosmopolitan city of Bangalore. I cannot speak for the upbringing and education they have received, but I do know for a fact that these girls’ education does not make them accustomed or comfortable to think and speak about themselves. In fact, a lot of the girls in Shahi were brought up this way. Survey’s conducted on a large sample of workers show that many of them place their family’s wellbeing in front of their own.

Furthermore, we have observed that women, in particular from rural regions, are subject to many cultural expectations, and are brought up to follow certain behaviors such as being reserved, obedient and hard working…

Maybe repeating these facts to yourself and trying to mentally visualize their upbringing can help you empathize with them and understand why many of them are so afraid to talk to us when we summon then on personal facts? It does help for me …but for about 3 minutes, (the time it takes me to mentally run through all these facts plus 2 minutes (not quite enough for me give myself credit for !).

This is certainly not the most interesting or original example I could have given, but it is certainly little experiences like these that have made the following well known idea pop frequently back into my mind this summer : It is impossible/ extremely hard to get into someone’s shoes unless you yourself get to experience what they have experienced. Most of them time in the Shahi workplace, we as interns have to take all these decisions which we think will improve the wellbeing of these girls. Making these decisions is hard. We will never be able to fully empathize and therefore must rely on interviews, observations, lessons learned from past welfare initiatives, and sometimes even on intuition… I myself have had to use similar sources of information to design the buddy system. I have done my best to understand the needs of the junior buddies but my assessment will probably still be a little off.

I am grateful to have done this trip to Orissa and to have visited these training centers as well as villages where employees live. I figure it is one extra step towards empathizing fully with these girls. An individual is composed of infinitely different facets, but grasping yet another one of these facets is always an improvement…

Here are some photos of the village in Orissa where a few Shahi workers live

young girls just coming back from school


“The sweetest dream would never do”

Sat, 08/01/2015 - 04:59

This is basically a play-by-play of my last day in Bangalore so it’s long. I’m actually posting this now from Dharamsala because my WiFi previously was not good enough.

Throughout the summer I’ve been trying this exercise of attempting to describe Bangalore in one word. I can never pick just one. Of course every city is multifaceted but I was hoping I could think of something that could describe the essence simply. Busy was definitely true when you looked at the streets, but considering the terrace tea breaks we had daily against all-nighters masked in the “Penn Face” I wasn’t ready to settle. Full would be good except I figured that one was more for India as a whole. Though Bangalore’s population has grown by 9 million in just a decade it’s still growing. There’s still room for migrants like the ones in Shahi’s factories and foreigners like me. Same with crowded. Noisy may have worked if not for all the businesses closing at 11 p.m. leaving late night car rides past the Bellandur Lake feeling quite serene.

As I wait for my flight to Delhi here at Kempegowda International Airport and reflect on my last day in Bangalore one word just keeps coming to mind. Charming. Yes, I’ll admit it’s extremely clichéd. But honestly I couldn’t think of a better way to spend my last 24 hours in the city. Unfortunately I missed a few goodbyes, but the ones I got to say I made count.

9:00 a.m.

Chan and I went to Shahi to see off our coworker Prem who was doing a day trip with Chitra so we could say goodbye. We ate breakfast in our hotel and shook the hands of the waiters who eagerly bring me filter coffee every morning.

11:00 a.m.

I walked down Sarjapur Road (where we stay and where Shahi’s central office is) to a little alleyway unknown to me before this week. I pick up photo prints – pictures of PACE-trained workers we met our first week, a picture of the Shahi interns from May, a photo of Chitra in a saree, and some photos from the day before when the Shahi interns treated Chitra, Gini, and Prem to lunch. On the way back up the alleyway I stop by Kanti Sweets and pick up a box assortment. I wish I had done more errands in places like these where things are cheap and transactions are personable. I also pick up half a dozen flowers from a stand on Sarjapur. They cost 90 rupees but I give the guy at the stand 110. He thinks I’ve misunderstood. “Ninety. Nine, zero.” I insist he keeps it and go on my way.

Back at the hotel I write notes on the backs of photos for Chitra, Gini, and Prem.

This photo was taken on a different day, but same flower stand

12:00 noon

I return to Shahi for the last time, gifts in hand. I go to the third floor where the OD Department – Chitra’s team – works. Luckily I find Gini and Sahana, both of whom I give flowers to. I set up a mini shrine on Chitra’s desk with the framed picture of her, a flower, and the other pictures I have printed.

How I left Chitra’s desk

Gini helps me arrange my bus to Dharamsala and gives me the contact for Shahi staff in Faridabad who will help arrange my airport pickup.

12:30 p.m.

Very tearful goodbyes to Gini and Sahana. In Gini’s note I wrote that she’s like an elder sister to me and thanked her for helping me pick out a saree and keeping me from almost buying way-too-expensive silver jewelry earlier in the week.

1:30 p.m.

I am meeting a friend in Jayanagar but have no idea where the restaurant is. I get out of my cab and just assume I’ll figure it out. I end up asking for directions from a security guard who doesn’t speak English so he sends me inside the building he is guarding to ask. I go upstairs and ask for directions. I’m pointed in  a direction and go on my way. I realize I may have gone the wrong way so I turn back and consult Google Maps. Once I’m fairly certain I’ve got my bearings I realize I’ll pass the security guard again after assuring him I’d figured it out a few minutes ago. I’m on the other side of the street so I hope he doesn’t notice me. To my surprise the man I’d asked for directions on the second floor of the building is calling to me from a window telling me to go the way I have now realized is correct. I am embarrassed, but my heart swells to see how much people actually care here.

Even when we were in Mysore, asking for directions wasn’t an invasive thing. As we drove around, one of our Indian friends or the driver would shout out to people every couple of hundred meters to make sure we were headed in the right direction and it was totally normal. No masculine ego conflict in being lost here I guess.

2:00 p.m.

My friend Spoorthy and I eat the most delicious biryani. I eat it with my hand and impress myself with the skill I’ve acquired. It’s spicy but I manage it – another skill wielded in India. We talk about school and foods and her brother who went to Penn (and the reason we linked up in the first place).

After lunch we went shopping for a bit and continued to catch up. She buys some mehndi and draws a design on my left hand. The whole time she draws we have a good old-fashioned girl talk. It’s so nice I lose track of time.

6:00 p.m.

I return to the hotel and go to pick up the saree blouse I’d dropped off for tailoring the day before. Again I go down that alleyway and wait a bit for the finishing touches. The woman at the shop is very kind and shows me some of the traditional wares they sell and wishes me safe travels. I try on the blouse, pay, and take it home.

7:00 p.m.

Chitra brings her two sons over to the hotel to say final goodbyes to me and Chan. She helps me wrap my saree and I’m not sure I can do it myself. Chitra takes pictures of me though some of them have the blurry image of her toddler walking around in them. This is the second time we are meeting her sons and seeing Chitra as natural as she is as a mother is so calming and heart-warming.

8:00 p.m.

We say our final goodbyes to Chitra at KFC (next door at Total Mall) where her son wanted to go eat. Chan and I go and get our final round of momos, sugar cane juice, and schwarma wraps. We get back to the hotel around 8:30 and I leave Chan to wait for her cab while I pack.

9:00 p.m.

I get a call in my hotel room. It’s Saahil from the front desk. He’s been so good to us for our entire stay. Notably on the first night we went out to meet Spoorthy, when we had no clue how to do anything in Bangalore, he saw us getting into an auto-rickshaw and came running out. He told us not to take that auto and called us another trusted driver. He’s been nothing but professional but now when he calls it’s just to tell me that Chan has left and that he’s sad seeing us all go.

Saahil on the right

10:00 p.m.

I arrive at Take 5. In our first week in Bangalore our coworker Zafiyah took us here for Thursday night karaoke. It’s actually ridiculous to realize how far that has taken us. We came to know her karaoke family and would get recognized randomly when we’d go to other pubs around the area. Everyone was sad to see that my co-interns had left but glad I came to say goodbyes. I drink my last Kingfisher beer with Anish, one of the regulars we came to know first. I belt “Drift Away” along with most of the people in the bar. I stand with Zafiyah and pretend to sing back-up vocals when she closes the night with Jeff Buckley’s “Hallelujah.”

Last time at Take 5, photo taken by the owner, Sunny

12:30 a.m.

I arrive back at the hotel to pack and sleep.

6:00 a.m.

I wake up to shower and finish stuffing my bags. “I Don’t Want To Miss A Thing” is stuck in my head from karaoke last night. To my surprise I have several messages from friends wishing me a safe journey and telling me that if I’m ever in India again I should let them know. One friend sends a couple of pictures from Take 5 (one pictured above). I almost cry reading the messages.

7:00 a.m.

I check out of the hotel for the last time and get into a cab to the airport. It’s ironic: I remember when we arrived in Bangalore and I was wide awake for the entire two hour car ride to the hotel, even as the other interns slept. I was so intrigued by all of the sights and sounds and traffic. Being the sentimental person I am you’d think I would do the same for this last time. Especially since “Don’t wanna close my eyes, don’t wanna fall asleep” is playing on loop in my head. But I’m tired and decide that making time to see as many people as I could on my last day was my way of ensuring I didn’t miss a thing. So I sleep on the way to the airport.

9:00 a.m.

I am sitting at Kempegowda International Airport at my gate writing this post.

I promise this is my last picture of a dosa


Stethoscopes and Statistics

Sat, 08/01/2015 - 04:19

What do air-conditioned offices and open air livestock sheds have in common? Well not much, but both have been integral locations for my work thus far. After finishing the data collecting portion of my research here, I have moved on to nutritional analysis and report writing while sitting in a desk chair and staring at a computer screen. It has been an interesting week of sorting through the challenges and possibilities for the development of the dairy industry in the Karimnagar district of Telangana state. It is easy to look at my excel spreadsheet and get lost in the cells of imprisoned data, but when I glance back through my many photographs of water buffalo, farmers, and experiences thus far, I am reminded that the data cells represent a much larger goal. The information collected reveals many barriers to water buffalo milk production; lack of green fodder in the dry season,  underweight body conditions, and unavailable or misused medicines among many others. Yet instead of becoming frustrated by the dearth of resources, I have been finding it more beneficial to focus on improving the techniques used by a select number of progressive  farmers in the villages instead. Gathering parameters on buffalo weight, diet, health status, and management was key, but talking with farmers in the midst of a field or over a cup of chai is where I gathered an even richer array of qualitative data. On one such evening of collecting data, the sun had inconveniently set, so I quickly completed my physical exam under the beam of my LED headlamp.( It was a last minute decision to bring that light and I am so glad I did!) Two children intently watched me work and were very interested in my stethoscope as they had never heard of or seen one before. For the next few minutes, I showed them how to listen to their own heartbeat and smiled at their enthusiasm and joy over their new discovery. It is times like that which motivate me to continue my struggle of defining statistical p values and chart types.

Measuring a the girth of a water buffalo for weight estimation

Performing a physical exam on a water buffalo

In between moments like sharing a stethoscope or struggling to take a rectal temperature of a buffalo, some farmers explained their hesitation to try new technologies and conveyed traditional techniques that they were uncomfortable stepping away from.  Others were excited about trying new methods of feeding their livestock and potentially increasing their income from buffalo milk. These perspectives have been quite useful as I think through future studies and development efforts that are viable for the future.  Unfortunately, many development efforts in this area have failed due to improper implementation or even things as simple as the inability to fix the broken machinery. Other efforts struggle to become sustainable because farmers do not have the financial or educational means to adopt them. To avoid repeating these mistakes, I have tried to involve a variety of organizations, researchers, and farmers in my surveys to better direct future projects from PennVet. There is much to tell, so stay tuned for my final report and results in a few blog posts!


Saying Goodbye

Sat, 08/01/2015 - 04:01

It’s hard to believe that I’ve spent over 70 days in a foreign country. Between finishing projects and having our final meals at our favorite restaurants, I lost track of time and my departure time creeped up on me.

India has really grown on me these past few weeks. It has taught me how to increase my spice level, master the head nod, and effectively haggle.

Since I knew this day would come– the day of goodbyes–I have been taking lots of pictures to remember our time in India.  Even though some of our favorite moments were captured on camera, the beautiful voices, laughter, and Tamil language that filled our everyday lives were not. In the last 3 days of my stay in Madurai, I tried to document the warm and friendly environment I felt at Aravind. I made a short video of the wonderful people I’ve had the pleasure of working with and seeing every morning.

[Click here for Aravind Video]

On the last day of my internship, I walked into Aravind Eye Hospital like I would any other day. However with every step, it dawned on me how I would never be able greet the MRD sisters walking with their case sheets, or be able to smell the morning Horlicks across the low vision center, or be welcomed by the smiles of the children in the waiting area. But this time, there was a slightly different presence on my walk to the office.

The pediatric waiting room on the first floor greeted me with an upbeat tune. I walked in as the parents and children watched the colorful images play on the television screen. After 10 weeks of collaborating with the pediatric opthalmogisits, my videos were finally finished. Yet, seeing them for the first time on the TV had completely caught me off guard. Soon I was surrounded by doctors who also wanted to view the new addition to the clinic. One of the doctors I had worked closely with over the summer walked up behind me and softly said, “what you’ve done here, this is high impact.” Her words coupled with the parents’ keen attention to the videos brought a lot of joy to the last day of my internship. While I am sad to leave…sad to part ways from the people, the food, the routine..I am so ecstatic and grateful to have been able to leave something positive and beneficial behind.

I’m not the best with goodbyes so I’ll keep this short: Goodbye to the morning heat and tuk tuk honks. Goodbye to the samosas and nightly ice cream runs. Goodbye to the “aunties” and “sisters” of Aravind. Goodbye (for now) to two of my favorite trip planners, trekkers, comedians, and models –Vivek and Olivia.

Goodbye India.

 

-B


On Leaving A Place Behind

Thu, 07/30/2015 - 19:51

As I sit in the airport waiting for my flight to Viet Nam with my eyes half-closed, this is what I’ve managed to remember after having traveled pretty often:

  1. I can pack lightly and quickly. I learned how to fit a week’s worth of essentials into one backpack and still have room for a package of dates.
  2. Some things just need to be let go. Like the pair of boots that finally fell apart after a night out. There will be other boots. Tangibility does not necessarily mean that I’ll remember the memories with a particular item.
  3. Always carry snacks. Preferably your favorite chocolate that your friends got you for your birthday.
  4. Always carry headphones. Super useful when you want to drown out your surroundings or when you want to perfect a moment with a carefully selected track.
  5. Always arrive to the airport early. Don’t show up for an international flight half an hour before the flight leaves and expect to make it past the 50 people waiting to get through security in front of you.
  6. Always dress comfortably. Bring a jacket, scarf and pillow. Don’t forget socks. Sweatpants are ideal except if your mom requested that you dress up to impress your family members that you haven’t seen in 10  years.
  7. Don’t rush to try and be the first person to get on the plane. There’s no point because people will just literally overlook and step on you. Might as well chill as long as you can.

Things that I never manage to remember despite having traveled pretty often:

  1. You might not love every place you travel to. You might not love every experience you have, even if it feels like you’re supposed to love them.
  2. You also never know when you’ll fall in love with a place. It just hits you in a random moment, and then you can hold onto that moment forever. It hit me today when I took my last auto rickshaw ride back to my hotel after meeting a friend for lunch. I had my headphones in and was singing really loudly, watching Bangalore pass me by. Everything just seemed so endearing to me during that ride. I wish I had taken rickshaws more often.
  3. You can’t try to get work done when you have limited time in a place. I still have a 10 page research paper to finish by tomorrow. I’ve been trying really hard this week to work on it, but there were always people to spend time with and to say goodbye to. Tomorrow’s going to be a long day.
  4. I suck at goodbyes. I’m either super emotional or super cold. I can express myself much better in writing especially when it comes to emotional stuff. But even then, more than anything, I wish I could just give people my emotions because words are completely inadequate when you’re trying to thank people for opening their homes and hearts to you, a complete stranger.
  5. Sleep is important. You can’t fully enjoy things when you are sleep-deprived, even if there’s this mindset that you’ll only have this moment once.
  6.  “Home” is a very significant word. You know it’s serious when you refer to your hotel as “home.” As in, “Are you headed home to nap now?”
  7. You never really leave a place behind. You never realize just how many people touched your life until you are about to leave. You take with you the smells, sights, sounds of the city, the traffic that doesn’t give a damn about lanes and signs, the raw honesty, the random cows that own the streets, the evening rain, the friendships you’ve made, the things you can’t remember and the things you’ll always remember.

Heading Home

Thu, 07/30/2015 - 11:54

I’ve again found myself scrambling to write my last blog post in India right before I board my plane, just as how I wrote my first one in the terminal before boarding my plane to Delhi. I justify this to myself by claiming it will be written after everything I’ll experience on my trip in India will have already happened. Even sitting in the airport, it still hasn’t fully hit me that I won’t be taking the very familiar ride to work tomorrow morning, won’t get tea with my coworkers, won’t see the same faces at the gym, and won’t be in India anymore. Who knows when or if I’ll get to do what has now become a comfortable routine for me again. Only after realizing I’ve done these things for the last time am I starting to realize how much I’ll miss it. 

The people in this city have been nothing but good to me. I think my favorite part of the Indian culture I’ve experienced has been just how welcoming and hospitable everyone seems to be. Maybe we’ve just been lucky in who we interact with, but from those at work to those we’ve struck up conversation in pubs, the whole trip has been a constant stream of invitations. These invitations have ranged from sharing a homemade chicken biryani lunch on my birthday to joining a friend we happened to meet playing pool (who’s apparently famous for being on an Indian reality show?) for strange food adventures including camel (incredible) and lamb brains (not bad) to getting out of Bangalore and exploring how beautiful India is outside of the city with our coworker. 

Having said this, I think I’m ready to head home. Despite everything I loved about India, there were always the lingering thoughts of home— who I was missing, what I would be doing, and what I would be eating (I can’t handle spicy food, I’ll admit it). It’s hard to say exactly what the impact of my summer in India has been, but it’s definitely there. I think it will be best to reflect on this in my final blog post after returning home and having had time to look at my trip from the other side. 


There is no love sincerer than the love of food

Thu, 07/30/2015 - 08:47

George Bernard Shaw said that apparently. He also co-founded the London School of Economics. A fellow economist and food enthusiast? I appreciate that.

I think anyone who knows me knows how much I love food. And I think oftentimes the best way to immerse myself in a culture starts with food. I studied abroad in Italy last fall, and all of my money was spent on either food or transportation to get me to food. All I knew of Indian cuisine before arriving here was that there was curry and there was… more curry. Come to think of it, I had only ever been to one Indian restaurant my entire life before this trip, and it wasn’t even that impressive. But Indian food has been more than wonderful to me on this trip, even if my stomach hasn’t been. Here are just a few snapshots.

Butter chicken is a North Indian dish that is absolutely to die for. I think it was the first real Indian meal that we had during our time here. Not a single drop of the creamy, sweet, tangy, spicy sauce is wasted because there’s always a basket of parathas – round, flaky flatbreads – at hand. The first time we had it was at a restaurant in Delhi that our boss recommended.

Poori is a North Indian bread, deep-fried to golden, flaky perfection. It’s become very popular all over India apparently and with good reason. The canteen at work always served them on Wednesdays and Saturdays, so I always eagerly looked forward to those days when I could clog my arteries to my heart’s content. Heh. Poori is made from wheat flour and a bit of salt. I guess it’s true that the most delicious things are often the simplest.

I often had some kind of curry with my pooris. We’ve had everything from aloo (potato) to ladyfinger (okra) to gobi (cauliflower) curry at our canteen. In addition, they usually serve some sort of biryani (rice cooked with spices, veggies, and/or meat), sambar (a tamarind-and-lentil-based stew), and rasam (a tamarind and tomato based soup often mixed with plain rice for flavor).

People here only eat with their right hands – left hands were reserved for other dirty work – and we rarely saw utensils being used. The first time I fully used my hands for a meal was at a worker’s canteen in one of the factories. I was so surprised by how hot the food felt in my fingers; normally it’s fine enough that I can just start eating. I also was very aware of how much I hate getting my hands dirty, especially when stuff gets under my nails. But it was definitely a fun experience and by the end of the internship I was pretty comfortable eating with my hands.

I mentioned momos in my last blog post, but I just had to mention them again because they’re so good. And cheap. And good. I’m going to miss my momo guy. Saying goodbye tonight will be quite difficult. He’s even started giving me extra since I go there so often.

My favorite meal was in Mysore. We had taken the weekend to travel with some of the guys’ friends who were very nice to plan our trip and show us around. It was a very standard South Indian meal, with the usual rice, sambar, rasam served to us on a banana leaf, but I had also ordered a side of fried fish. It was the most delicious fried fish I’ve had in awhile, super fresh and flaky and perfectly seasoned with a dash of lemon. Ugh.

The tropical fruit scene here is pretty awesome. Cartfuls of ripe, orange mangos line the streets here, and we would almost always have one for breakfast every morning. Custard apples are very expensive and nearly impossible to find in Philly. You can imagine my excitement when I found a guy who sells them right outside of the factory unit. They’re soft to the touch when ripe and the skin just peels right off, leaving you with a sweet, creamy fruit. It’s a little frustrating to eat if you are an impatient person like me because there are a million seeds in each fruit, but it’s more than worth the effort. Why can’t we have fresh coconut stands in the states? If I could only eat one thing for the rest of my life, it would definitely be fruit.

My absolute favorite South Indian dish is the masala dosa. It’s half crepe, half pancake and 100% addictingly delicious. Super buttery, golden and crispy on the outside, piping hot and fluffy on the inside with a generous portion of spiced potatoes, this is probably the most popular breakfast item around. The dosa batter is a fermented mix of rice and lentils, soaked overnight and ground into a fine paste-like consistency. I actually really disliked dosas the first few times I had them, but the one we had in Mysore won me over for good. Dosas are typically eaten with chutney, rasam and sambar. So addicting. The best one I had was probably at MTR, a chain of restaurants here, and I was ecstatic to find out that they sold their dosa mix. I can’t wait to go home and try making them!

Living in a city meant we also didn’t have to give up other cuisines, so enchiladas, burgers, baos, pizza, amazing desserts, KFC, and even pho still made their way into my diet. I’m not ashamed. And even though we tried our hardest to add some variety to our diets, these dishes always ended up tasting a little bit of India with some extra spices added to them. One of the guys was not amused, but it was almost endearing in a way. When I was in Europe, I always tried to seek out the most authentic restaurants, the hole-in-the-wall-family-owned-secret-recipes-local-hangout spots. Trip Advisor was my best friend. After having been here though, I definitely have come to appreciate food simply for what it is rather than what I think it should be. Not even the dosas that I love so much follow the true form that they originally had when they were first invented — they were apparently thicker, less crispy and more pancake-like. Authenticity is such a tricky concept because things are always adapting and drawing inspiration from other places, and to be as open-minded as possible when you’re experiencing a new culture — all aspects of that culture — is a valuable lesson I won’t forget.

(I’ll update with photos later — internet is being quite stubborn here)


Visions of Victimhood in PSAs

Thu, 07/30/2015 - 00:44

Content warning: This post is a discussion of anti-violence ad campaigns as well as sexual assault and rape culture with pictures of victim-blaming Public Service Announcements. The issues are mentioned without graphic details. 

At Penn I do a lot of advocacy work against interpersonal violence. By this I mean dating violence, stalking, abuse, and assault (including rape). Last year I was the Advocacy Chair of Penn’s V-Day Movement – the group of women who produce Eve Ensler’s Vagina Monologues each year to donate money to the only rape crisis center in Philadelphia. (For more information on Women Organized Against Rape, see their website here). I have been trained about how to respond when a friend or acquaintance discloses a violent experience and all of my Facebook friends know that I am constantly sharing articles and information about rape culture.

The term “rape culture” describes the dominant cultural attitudes that exist about sexual assault. It’s the fact that when someone has been sexually assaulted we often ask if they were wearing revealing clothing or if they’ve been drinking rather than questioning the perpetrator of violence. It’s that we’re often more likely to worry that someone is being falsely accused of rape than to ensure that the person accusing feels safe and can access help.

Feminist movements have pushed back against rape culture for years in various ways. Many ad campaigns in the Western world that are meant to combat rape and assault can actually contribute to rape culture. They encourage women to be careful, to look out, to never drink. Many feminist movements have sought to override these campaigns and replace them with education aimed at those who could be perpetrators (anyone/everyone).

What I’ve noticed in Bangalore is that there are a variety of anti-rape billboards and posters. And all of them are aimed at potential perpetrators of violence against women. The slogans are “When you kill a girl child, you kill many others. Save girl child,” “She is a Child, Just a young Girl, Don’t rob Her innocence” and “She is a Woman full of Hope and Power. Don’t take that away from her; Save her Honour!”

My reaction was first one of surprise. It hit an awkward chord to address someone in their moment of considering such a violent crime. We often write off people who are serial killers or rapists as someone with mental illness for whom a rational appeal wouldn’t work. This is obviously widely problematic as it stigmatizes mental illness and makes it seem as though appealing to the potential perpetrator is futile.

Still I wonder, are these posters effective?

What I do know is that these approaches, while a breath of fresh air from the victim-blaming slogans I’ve seen more at home, still meet me with some not-so-nice feelings. If one has experienced sexual assault, they have the liberty to name that experience for themselves or not. What I mean is that these posters imply that anyone who has survived an assault has lost their honor or power. Or that killing a young girl is bad because her worth lies in the potential of her womb. These posters perpetuate harmful myths about rape and sexual purity. They paint anyone who has had this experience as a victim – as if that should define their life (notice I have chosen to use the word “survivor” when possible).

So there’s that. After writing this post I found an article about locals in Bangalore and feminist activists poking holes in the signs. Some of the concerns I have are given mention, but even more it seems as though people are upset that the posters give Bangalore a bad name and will discourage tourism. I think it’s true that these signs feed into the “rape in India” hysteria that has not been extremely productive. Still, it’s been quite an exercise of mental yoga to consider the ramifications of addressing potential perpetrators so openly and bluntly – and I’m hesitant to denounce it completely.


Learning and Re-learning Abroad

Wed, 07/29/2015 - 02:20

After I travel abroad (or have any big, perspective-altering experience), it usually takes me months to fully process what I’ve learned. I usually don’t even bother reflecting on big takeaways until weeks after returning home. However, the impending blog post deadline is a great way to speed things up, or just a good excuse to reflect on some of the realizations I’ve made over the last ten weeks. Here are a few:

-Patience: I’ve been here since mid-May, and our intervention (deworming tablets, iron supplementation, and free fruit in the morning, along with heath and nutrition training for all migrant workers) was just rolled out about 10 days ago. While it’s frustrating in some ways to only see the beginning stages of the culmination of our work, I’m elated that we accomplished even what we did. I’ve had to be patient with people who take weeks to email me back, with accessing the resources that I need like translators or transportation, with the iron capsules that were supposed to be ready weeks before they were, and mostly with myself. I have high expectations for myself and what I can accomplish. Especially when traveling to a completely new place, I have to recognize that my own lack of rapport, cultural understanding and language skills will provide set backs and challenges.

Waiting forever for staff to show up at a government office. The sign says “Government’s work is God’s work.”

…and that brings me to flexibility: This is one that I learn over and over whenever I go abroad. The more rigid I am with my schedule, the more unhappy I’ll be. In India (and wherever you are in the world), things very rarely go as planned, and we often have a choice in how we deal with these situations. The quality of wifi connection does not adhere to my need. I won’t always be able to get to factory unit 12 on time to conduct my interviews. Or, maybe I’ll arrive on time after the 45 minute trip and have no translator to help me conduct them. There are countless potentially frustrating moments, but this summer has given me invaluable practice in embracing them and adapting myself and my own plans instead of taking out my frustration by blaming uncontrollable circumstances.

-Focusing on people’s admirable traits: Doris, one of the HR staff from factory unit 12, successfully consoled 153 terrified workers while they received blood tests. Prem, another HR staff from unit 7, is the only man I know who can lead a training session for female workers on menstrual hygiene. Dr. Leena is incredibly loving, and cried with me when I was sick. She continues to buy me brownies on “doctor’s orders” so that I fatten up. Chitra, our supervisor, only has one day off per week (Sunday), but spent so many of those helping us do hostel visits or other work. This Sunday, she invited us for brunch and woke up at 7 am to prepare it. I don’t know how I’ve deserved this stroke of luck, but I’ve been surrounded by some of the most generous, loving people that I’ve ever met.

Breakfast at Chitra’s!

-The limits I set for myself will become real: During the beginning stages of researching anemia and nutrition amongst migrant workers, I don’t think I really believed we would be able to accomplish anything. Without the incredible support and push from the Shahi staff, I am almost sure that this idea would have become a reality. The work has helped me to realize how real these self-placed limitations can become, and how trusting in myself to push beyond my previously conceived boundaries is incredibly important.

The enormity of Shahi’s working population was very intimidating when planning any kind of training or project

And a few less important things that I’ve learned:

  • How to eat chicken with many bones in it
  • How to cross the street
  • How to eat rice with my hands
  • How to tear a chapatti with one hand
  • How to pick out a decent mango

Mango vendor near our hotel

  • The exact spot in our hotel’s hallway where I can sit for the best wifi
  • KFC is great in India, but beef burgers are generally not
  • Bangalore restaurants and pubs ALWAYS have awesome lights


Likho Apni Kahaani

Tue, 07/28/2015 - 02:55

Growing up in NYC, I was constantly surrounded by new faces. On my commute to and fro school, I used to create backstories for people I would see on the subway. It was nothing harmful; it was just a way to cure my boredom and test whether or not I still had an imagination since my high school was essentially a mind-crunching sweatshop. The young woman wearing a neatly ironed blue blouse and pencil black skirt sitting in front of me bobbing her head back and forth to the music coming out of her white, Apple earbuds — she went to a pre-professional college in hopes to become a career woman but now holds small pockets of regret because she actually has a burning passion for horticulture. The middle-aged man sporting a nicely pressed blue-striped suit standing near the door reading a book on interior design — an actuary who has absolutely zero artistic ability but is trying to surprise his wife with a newly modeled kitchen. Exercises like these would help my early mornings pass by, especially when my friends were slumping over each other due to fatigue on our way to Chamber Street.

But now, thinking back, I wonder if this mindset was too presumptuous. I guess there’s nothing wrong with letting your imagination run for some self-amusement, but it’s important to recognize when assumptions are exactly just that — assumptions. During my high school days, I was definitely guilty of taking assumptions of people I barely knew and shaping their entire character based on the few pieces of their identity that I gathered either from firsthand experience or gossip. This would then affect our interactions and my perception of the person. And this is extremely unfair. Many times, we fail to recognize the fact that everyone’s actions and aspects is connected to some inner workings that is fully invisible to all but that person. By not realizing that each person has their own unique backstory, their own struggles, and their own battles, it’s very easy to judge whether or not something he/she does right or wrong. And by not staying open-minded, we fall prey to a tunnel-visioned mindset that our own code of ethics or way of reasoning is superior to those around us, which further fuels this need to judge. This is no new human phenomenon, but with the onset of social media and the anonymity of the internet, it has become far too rampant. Note, I am not saying that it is wrong to carry your own opinions and you should definitely have your own idea of what is right or wrong, but I don’t believe it is our prerogative to impose our ideals onto others and then judge them for doing something that is alien to our world of morality and boundaries, especially when the entire story is yet to be heard.

Now what does all of this have to do with India? Nothing, thanks for reading.

Just kidding!

This idea is deeply woven into my experience in India this summer. This mentality to not judge others under any circumstances is a practice that I tried to undertake last year and it was truly tested the past two and a half months. From the day I received my acceptance e-mail, I’ve been told India is a very undeveloped nation, portrayed by my peers almost in a barbaric light compared to the “first world comforts” of the Western world. So coming in, a part of me expected the worst and I couldn’t help but point out all of the things that were outside my understanding of the world, a.k.a. what I considered “wrong.”

There are no streetlights or road lanes here? Pedestrian-first is not a thing? Wait, I’m pretty sure there should be a sidewalk here. Wow, that’s a lot of trash on the street. Goats, cows, and dogs roam freely — casual. Okay that guy just spat at my feet, thanks.

But over the several weeks I have been here, I have taken the time to consider that a lot of these happenings can be explained and that I should not judge how people here live. I’m not saying I’m perfectly void of these thoughts; I still cringe my nose from time to time at some of the scents that linger in the air and question life. But by recognizing that the world is multi-faceted, I became more receptive to the beauty that this country holds: an amazing sense of community, a diverse array of ideologies, and a meticulous love for home-crafted beer, among other aspects. And if I had gained anything from my summer (besides gratefulness), it’s a sense of respect for the people here. Even with living conditions that many of us would deem unfavorable, people here are happy. After worrying less about what I might be stepping in and observing the things happening around me, I’ve noticed a lot of people smile and laugh, which to me was a living testament that happiness is not contingent to one type of living or only connected to material possession. This brings me back to my original point that there is by far more than two sides to a coin. Who am I to judge whether one’s way of living is worse off when in fact that person can be happier than I am (and my peers at that, considering the recent NYTimes article on campus suicide)? And isn’t that the end goal — to be happy and share that joy? Maybe, maybe not. Nonetheless, I think it’s important to remember to not only not judge a book by its cover, but also not judge the author for the words he/she has written. Or I guess in our day and age, don’t judge a Tweet by its hashtags..? (Sorry, I tried)

For those who are curious, “likho apni kahaani” is the motto of Janalakshmi Financial Services / Jana Urban Foundation, and it means to “build your own story.” Pretty dope, isn’t it?


Dear India

Mon, 07/27/2015 - 04:17

Dear India,

Before hopping on your luxurious (lol) national airline in May, the extent of my knowledge of your complex and varied culture was from restaurants, a handful of friends, approximately 2 actual Bollywood movies, and Slumdog Millionaire. I can confidently say that after spending 10 weeks wandering through your chaotic streets, enduring your heat wave, and meeting your incredible citizens, I’m going to be extremely confused when I return to American culture. I’m already terrified when I see the occasional white person walking around. I don’t know what I’ll do when I cross a street without fearing death by motorcycle/tuk tuk/auto. I can’t remember what it’s like not to smile at every single person I make eye contact with. I am definitely unprepared for the weather to go under 80 degrees Fahrenheit at any given time. Why wear shorts in the summer when you can wear kurtas and leggings? Why wear shoes?

My favorite part about spending 10 weeks here has been the individuals I’ve met, especially at Aravind. A day never passed when someone (ahem, Hepsiba) didn’t say, “you look like you need a snack” before handing me biscuits, carrots, cookies, etc. I started with a project team and ended up with a personal team of Tamil teachers who beamed with pride every time I attempted to speak with one of their friends or colleagues in their ancient language. Nithya and Sakthipriya notified me whenever a temple elephant strolled down the road and took pictures/fixed my hair like older sisters when I wore my sari. Sister Lakshmi taught me the basics of Indian culture my first few weeks here; how to eat with your right hand, the proper tea/coffee customs, how to speak to patients that came to the hospital. The younger MLOP sisters of the free hospital constantly made me laugh, told me about their lives, and included me in their daily routines. Dr. VPR, an eccentric, brilliant ophthalmologist, generously offered multiple books about his favorite philosophers and yogis. Vivek, Busra and I had the privilege of working under Ms. Dhivya, a disciplined and intelligent leader of Aravind’s administrative staff. Most of all, I am thankful for meeting the legendary Hepsiba Jawahar. This woman has more sass than I knew was possible. She has put me in more hilarious situations than I have time to discuss and served as my fearless mentor the entire summer.

Unfortunately I have one issue with you, India; your food has left me with severe trust issues. I never anticipated eating lamb’s blood and intestines a few weeks into this trip (or at all for that matter). I also didn’t realize that EVERYTHING has the potential to make you sick. I would like to take this time to thank the creators of Pepto Bismol/similar medicines, as my life would be a miserable place without them. The best part about living in a world where you’re constantly looking for hygienic bathrooms is that there usually are none when you need them. As one could imagine, being extremely carnivorous in a place where most dishes are made from lentils/rice/vegetables left a lot to be desired. In your defense, the meat dishes that I did consume while here were amazing (shout out to Spice Garden), and I don’t remember any of them making me sick. Parathas, or as I call them, the Croissants of India, could comprise an entire food group in my diet. By the end of this trip I expanded my horizons to lentils and vegetables, but still tons of rice, yogurt, and bananas. You definitely win the prize for Best Coffee, Best Tea, and Best Butterscotch Ice Cream (sorry America). Next time I’m here I’ll give North Indian cuisine a try.

India, you are geographically like the California of South Asia. There are beaches, mountains, forests, deserty areas, etc. I’ve never seen anything like the Western Ghats in my life. Every time we hiked or drove through them I could not fathom that something so beautiful existed, untouched by humans in many parts. It was a huge contrast from the scorching beaches of Rameswaram, the lush forests of Kodaikanal, the charming city of Pondicherry, and the jungles of Thekkady. I didn’t anticipate strolling along a sandy beach, plundering up windmill covered mountains, and getting eaten alive by leeches within the course of a few weeks. Your wildlife is magnificent, but I still get most excited about the goats, cows, and stray dogs that we encounter multiple times everyday. I think the U.S. would be a much happier place if there were puppies at the end of every trip, like our trek at Yanaimalai. I’m so glad I had people like Busra and Vivek along for these trips-two of the best people that I know and love (to harass).

Before embarking on a long-term journey like this, people always say that it’ll be the “adventure of a lifetime.” To avoid stringing together a million clichés about ‘broadening my horizons’, I’ll put it simply. India changed me, and in a way, I think I changed a tiny part of India too. I would be happy if I left an impact on the people around me in the way that they affected me. This experience has taught me to laugh at myself in countless strange situations. I’ve made friends from all over the world, and I learned that despite cultural differences, everybody still loves to talk about their pets, kids and favorite foods. I’ve learned little snippets of a language that’s thousands of years old, yet still proudly spoken by the citizens of Tamil Nadu. I’ve been forced to break free from meticulously planning every single thing that I do. I’m inspired by the work that I was able to do here, and I will absolutely transfer what I’ve taken from this experience into my future pursuits. I’ve been pining over this internship since I stumbled upon it on the IIP website in the fall of 2014, and I could not be more grateful to have spent 10 weeks in this extraordinary country. Romba nandri to Penn, the International Internship Program, the Center for the Advanced Study of India (CASI)/Aparna, and the Aravind Eye Hospital. Poittu Varén, India. Until next time.

Anbudan,

Olive Chinna Pappa

One last trek to Yanaimalai, which means “Elephant Rock” in Tamil

Vivek: Please let me pay you back sometime. Your ‘pay it forward’ philosophy won’t work if you never let anyone else pay you back. Thanks for introducing me to the far superior India Dominos pizza and for counseling me about my neurotic academic/career concerns. You’re very wise (also a genius), but most importantly a flowing stream of hilarious quotes. Busra and I both love you for being a good sport when we take modeling photos of you. You will always deserve “the throne.” Rest assured that we will show up at your door and sit on the floor until you invite us in because “it’s awkward.” I’m very sad we aren’t traveling home together; the flight definitely won’t be a 9.5/10 without you. I look forward to our retirement in Auroville.

Busra: Shra Shra Shra. What would I have done without your 24/7 presence in my life? Probably would have eaten way less ice cream, that’s what. I am grateful I got to join you on your Ramadan journey (“Azan sounded, time for dinner, let’s go, it’s prayer time!!”) I was/am in awe of your discipline; if I could survive for that many days without constant food/water it would be a miracle. I’m so glad that we developed such strong telepathy over the course of this trip; it makes communicating so much easier. It was great having a partner to antagonize Vivek with. You’re also brilliant and underestimate yourself almost as much as Vivs. I am very much looking forward to our Turkish breakfast that you’ve mentioned (and in typical Olivia fashion I’ll talk about it 100 times until it happens). We’ll keep the Jay-Shawn spirit alive during the school year with ice cream/French fry dates, gotta maintain the “Fat American” stereotype. Can’t wait to see the five trillion (beautiful, photogenic, well posed) pictures you’ll have from Turkey. Peace, love, and Meat&Eat.


Who are you?

Sun, 07/26/2015 - 18:13

According to a recent talk at Aravind by Mindtree co-founder Mr. Subroto Bagchi, an individual can be defined with the following six criteria:

  • Education
  • Experience
  • Network
  • Networth
  • Family
  • Health

Adding these criteria together forms an individual’s platform. It is through this platform that we follow our dreams and goals in life. However, two individuals with the same platform may have vastly different outcomes in life. Why? Because we are highly influenced by our desires/purpose.

Mr. Bagchi says it all comes down to the matrix.

A. High platform, Low purpose

Individuals are very motivated by money. They desire consumption. Their biggest mistake is the belief that they are indisposable. For instance, they may fail to acknowledge the line of qualified people in line for their job.

B. High platform, High purpose

People who fall in this category desire legacy. They wish to leave something beneficial for the next generation. These people tend to hold a lot of power and are highly respected. Consequently, they rarely receive negative feedback.

C. Low Platform, Low Purpose

People who land in this category are motivated by existence. They make sure to attend every single wedding, birthday, and funeral. Their biggest fallacy is comparison. By constantly comparing themselves and others, they fail to recognize the intermediate steps and obstacles individuals face to get from one point to another.

D. Low platform, High purpose

And last but not least, these individuals desire innovation. Their mistake stems from a fear of scale. They worry of losing quality if they increase the scale of their work.

Note: Purpose is defined by impact over time. High purpose means impacting a lot of people over a long period of time.

In an ideal society, equal ratios of each category would provide a nice balance of innovators, money makers, event planners/attenders, and power holders. However, this is rarely the case. What’s more important, however, is that we are not tied down to one category. Depending on our desires and life circumstances, we have the potential to move through these categories.

Dr. V, founder of Aravind Eye Hospital, exemplifies someone who was able to move through this matrix. He started off in low platform, high purpose by serving in the Indian Army Medical Crops. After being diagnosed with rheumatoid arthritis, he was bed-ridden for nearly 2 years, leaving him crippled and unable to continue his career as an obstetrician. He shifted to low platform, low purpose. While most people might have given up, Dr. V decided to pursue his interest in medicine through a field that would allow him to operate with his condition. By switching to ophthalmology and constantly training himself to hold a scalpel, Dr. V became one of the most well-recognized cataract surgeons. While most people might sit back and enjoy retirement, Dr. V worked even harder to develop a system of eradicating needless blindness. He saw the problems associated with access and cost to eye care so he strived to create a system of treating patients for free.  These pursuits moved him to the low platform, high purpose quadrant. Unlike people in this category, Dr. V was not afraid to scale his innovation. Working hard to develop his 11-bed hospital to a full 600-bed hospital and to open Aravind hospitals in other regions of India, Dr. V created a legacy. His remarkable eye care system has been studied by business schools all over the world, attracting curiosity in its ability to provide free eye care while still sustaining a profit. The current Aravind ophthalmologists follow in Dr. V’s footsteps, thereby also identifying with this rare category—high platform, high purpose.

After a nice run through the park with Dr. Tulika this morning, our conversation led to how we define success and how it changes with age and culture. She brought up Mr. Bagchi’s matrix and we had an interesting discussion about which category to strive for. As my internship comes to an end, I could not imagine a better way of thinking about my experience at Aravind. I’ve had to recognize my platform and reflect on the motivation behind my goals. The matrix offered a new perspective to understand my role in India and as an intern at Aravind.

Where do you fall in the matrix?


Money On My Mind

Sun, 07/26/2015 - 14:31

McDonald’s was something of a treat for us when I was growing up. We rarely ever went out to eat because it simply wasn’t economical. Every Friday afternoon, my dad would pick us up from school and our whole family would drive half an hour to the nearest mall. My sister and I would spend the afternoon dreaming our way through racks and racks of clothes we could never afford, and we’d all go to McDonald’s for dinner. It’s funny, but since I’ve gotten chances to try so many different restaurants in college, it’s my mom’s Vietnamese home-cooking that I constantly crave.

My parents worried about being able to send me to college. They could help me memorize my times tables and made sure I had enough to eat and buy me notebooks, but college was a monster that they couldn’t help me fight. It taunted them endlessly and initiated many arguments between the two of them, probably even more than I’m aware of. I’m not sure who was more relieved, them or me, when I found out I was accepted as a QuestBridge Scholar to Penn. Most of the people I interact with don’t really know what my financial background is like. Due to my generous scholarship, I’ve been able to fit in well enough among my peers.

Momos are Tibetan dumplings that bring to mind Japanese gyoza; they’re pretty popular here in India. There’s a guy that sells them pretty close to my hotel, and we often grab some after work or dance practice. Five chicken momos cost a mere 30 rupees. 50 cents. 10 momos for a dollar.

We interns spend about the same as we would in the states whenever we go out to eat. Back there, paying $10 for a meal wouldn’t be unusual. That’s like a Chipotle burrito bowl with a side of guac and some change. That’s like almost 10 dumplings. That’s like 600 rupees (Rs).

The average salary for a tailor at Shahi is about 6000 Rs, or $100, per month. Talking to many of the girls during our time here revealed that they only allow themselves about 1000-1500 Rs per month for food, opting to send the rest back home to their families. The money is very important in helping fund their siblings’ education and ensuring the general family welfare, which is why many of these girls were encouraged by parents to find employment in the first place. It is therefore essential that they are able to save and to send back as much money as they can.

Let’s take a moment to think about these 1500 Rs though. That’s less than a dollar per day. It’s one thing to be told that 20% of the world’s population live on less than a dollar per day, and it’s an entirely different thing to see that reality in front of your eyes and hear it over and over again every single day for a couple months. There were many different factors that Amy and I encountered while trying to piece together the overarching issue of malnutrition, and money was definitely a huge problem. Perhaps a potato and rice diet was due to habit, but there’s no denying that it’s also the most economical option. Even back in the States, eating healthy is particularly expensive and impractical for those who belong to the urban poor, as Gwyneth Paltrow failed to fully understand earlier this year. There is very little room for these female migrant workers to escape this negative feedback loop of malnutrition and long work hours. They cannot hope to continue working at their best if they do not take better care of themselves, but this would mean sending less money home to their families every day, a duty of which they would not deprive themselves.

So whenever we go out for dinner on the weekend and drop as much money in two nights as they do in a whole month on food, I can’t help but feel guilty. Again. I know, there was a lot of guilt in my last post and there is more in this one, and one could make the argument that I can’t feel guilty about living within my own current means, but that doesn’t mean that these things don’t cross my mind every single time I make a purchase here. This monetary facet of the malnutrition issue is one that we couldn’t come close to addressing despite Shahi funding the intervention — deworming tablets, iron tablets, and fruit — for its entirety of 30 days. We designed a supplemental training module in which we encourage the girls to think about their own health and allow themselves to spend more money on nutritious food, but the sense of familial loyalty and responsibility seems to run deep here. Amy sometimes points out that I’m a bit pessimistic, which is completely true, and that we are helping them move forward with the information we give them and the points we can address. It’s a matter of balancing out my critiques about what we haven’t been able to do versus focusing my energy on what we can do at the moment, and as far as money goes, I hope that our final data analysis and report will be able to convince Shahi to scale up the intervention for the benefit of all its workers.


Pearls, But No Swine

Sun, 07/26/2015 - 13:10

Pigs were a commonplace road-side decoration in Mulukanoor Village where I had collected my research data, but now as I am back at the International Crop Research Institute for the Semi-Arid Tropics (ICRISAT) for data and sample analysis, swine  are few and cattle seem to rule the highway medians leading to downtown Hyderabad. I suppose I am intuitively drawn to notice livestock and new animal species anywhere I travel. This past Tuesday, I sat packed like a sausage up against a bus window on the way to shop at the markets and bazaars surrounding the historic Charminar monument and mosque. I couldn’t help but notice the water buffalo walking lazily past a crowded tea stand, yoked zebu waiting under the shade of trees growing out of sidewalks, and monkeys gleefully raiding a pile of coconuts on a wooden wheeled cart.  When my cohort Maureen, a PhD student from Cornell, and I finally arrived at the bazaar after a few additional rickshaw rides, we entered upon a different kind of zoo. Although the Charminar market has slowed significantly after the passing of Ramadan when large crowds come to purchase goods and clothing specific to the occasion, the streets are still bustling with a an amazing array of people flooding textile shops and our target for the trip; pearl vendors. Hyderabad pearls are plentiful and inexpensive in many areas of the city, but if you feel the need to tour over 40 jewelers and pearl artisans in a row, this market is the place to be. It is also a good location to learn some bargaining skills. I often feel uncomfortable demanding lower prices and theatrically getting up to exit until vendors lower prices, but Maureen takes to the bargaining scene naturally. One vendor jokingly told her that she should switch her PhD from Animal Science to Marketing and Business. As we sat and looked at the variety of colors and designs, vendors also displayed the authenticity of their pearls for us by holding them under a flame and describing their slightly uneven but natural surface. I felt slightly more at ease this time in the market after travelling through the crowds of people and climbing the Charminar towers a few weeks prior. It was at that time that I paid a small fee to climb up narrow, twisting stone steps with strangers closely in front and behind to reach the views from the Charminar balcony. Just before mild claustrophobia set in,  I emerged from the dark, pillar steps with the massive crowd to overlook the bustling streets below.

A view from the Charminar balcony

Approaching the Charminar Mosque through the Market

On the same day as my first visit to Charminar, I was also able to visit the historic Golkonda Fort in Hyderabad, Telangana. Although the current remains of the fort were constructed beginning in 1506, the fortified hill has been a coveted spot in the hands of many kings starting in 945AD. It is famous for its surrounding mines of gemstones and its impressive architecture. There are sets of outer and inner walls and many, many (emphasis on many) steps to reach the mosque, Hindu temple, and towers at the peak of the fort. With the sun beating down on us at noon, I attempted to race a 10yr old boy up the steps while his mother laughed at us from behind. I did ‘lose’ the race to the delight of the boy, but we both won a fantastic view of the ruins and the city beyond:

After taking in a sufficient amount of pearl shops and bargaining deals, I made my way back to the research institute to work on searching out more jewels (jewels of knowledge that is) in my data analysis. Although studying water buffalo milk production may not always seem as glamorous as searching out ancient ruins, I am excited to compile my results and refine the next steps for the improvement of livestock and livelihoods in this area which is certainly a different, but valuable treasure.


Saying Goodbye

Sun, 07/26/2015 - 05:49

I can’t believe it’s my last blog post in India. I think I’ve been avoiding writing this one. I hate summing things up. (so I should lead by promising that this doesn’t cover a tenth of what I really have to say about this summer). And even more than summing things up – I hate endings and goodbyes.

I’m thinking back to the end of this past semester. It had been a really crazy, exciting, fun-filled, and incredibly stressful semester (as I guess most are at Penn). And If I’m being perfectly honest, when it was over, I don’t think I felt ready to come to India. After two years in college, I felt like I’d finally settled into my groove: I had my friends, my clubs, my major(s) – everything was falling into place, it felt like home.

I remember my last night in school, wondering why I was going so far away from a place where things felt so good.

But then I remembered a quote I’d heard somewhere once:

If change is frightening it’s a good thing because it means you’re grateful for what you have.”

 And I remember having a really profound minute (profound moments hardly last longer than that), in which I reflected on how far I’d come in the last two years, and how lucky I was to have so many things – both at Penn and at home in New York City – that I was afraid to leave behind, if only for 10 weeks.

But of course that’s not the whole story. Because I wasn’t just afraid about leaving Penn, I was nervous about my first visit to a developing country

And I can’t pretend the lack of certain simple creature comforts haven’t been challenging:

I miss having a sidewalk to walk on so that I don’t have to worry about being run over whenever I walk outside.

I miss being able to stick my head under the faucet and drink when I’m thirsty.

I miss Mexican food.

I miss fast internet.

All of these are small, first world problems. But I’d be lying if I said they’re never on my mind.

And then there are bigger things.

I look forward to being back in a place where I’m not confined by gender-specific expectations. It gets tiring to feel like a second class citizen.

I look forward to being back in New York and not having to worry that the cab driver will stop at some warehouse stuffed with expensive goods where a smiling, sycophantic salesmen will endlessly try to sell things I don’t want.

I look forward to understanding what’s going on when I’m traveling.

Which brings me to the double-edged nature of traveling in a country like India. On the one hand, it’s exhausting – you never really can know 100% what’s happening, because all the directions and instruction are being shouted in a foreign language and things can change inexplicably in an instant.

For example, last weekend I traveled to Amritsar with Bill. We bought our ticket online beforehand, got to the station an hour early, everything as careful as possible. We asked someone for the bus to Amritsar, we boarded the bus and settled down. And then we showed our ticket to a man sitting near us to double check, and we found out that the bus we’d bought tickets for had been cancelled and we had to buy new tickets.

No had one bothered to tell us. or if they did, they said it in Hindi and we had no chance of knowing.

And yet – on the other hand – this kind of traveling is so exciting. You learn how you can manage on so much less or in such strange or different circumstances. You never know what to expect wherever you go. How the people there will react to you, what the landscape will look like, what crazy driver will be driving the bus – it’s certainly far more exciting than my usual bus ride from New York back to Penn. And I do think I’ll miss the excitement. Often there’s nothing harder than simple, predictable routine.

That also goes for the work I’ve done here. Sometimes it may have felt here like I was working pretty hard for summer vacation. And yet I was recently filling out some paperwork for school in which I had to describe the various projects I’d worked on this summer, and I was suddenly filled with a sense of accomplishment. LEAP’s mission is to prepare Indian students for their career, but I think interning here has in many versatile ways prepared me for mine:

I’ve had the opportunity to: write official statistical reports, work on designing classroom curriculum, spend hours researching about pedagogy and classroom management, think about effective ways to build an alumni base, try my hand at designing a promotional video, write promotional material for a website, and also conduct various workshops for teenagers, college students, and adults.

Laura and I running a workshop on improvisation and classroom presence

It’s been a true start-up summer, giving me experience in a wide variety of fields and especially in the one I’m quite interested in: education.

And it’s given me a lot to think about – vocational training (LEAP’s main focus) is not a field I’ve ever thought about much, because it’s nowhere near as glorious as the way we like to talk about education and empowerment in America. But it’s very reflective of the reality of a country like India.

It goes without saying that I will miss my co-workers at LEAP: so warm and welcoming, so passionate and hardworking, so eager to share their food and their experiences of Indian culture, so quick to offer their help and advice, so excited to learn more about us and our lives back in North America.

A going away party for two of the trainers

It is strange to realize that I don’t know when I will see them again.

And to end off: I want to return to the last piece of that quote from above for a second, that part about being grateful for what you have.

Because all other complicated feelings about India aside, I hope I return to America with a profound sense of gratitude for what I’ve been given in life.

I’ve missed my friends and family: I’m endlessly grateful to have had them supporting me from a far and to know I’m going back to be among people who care about me so much.

In the grand lottery of the seven billion people living on this Earth, I’ve pretty much hit the jackpot. Sure, there are plenty of people in the world wealthier than me, but the truth is that I’ve never lacked for what I need in life: I’ve always had a roof over my head, never had to worry about never had to travel in unbearable heat, always had a clean way to shower and relieve myself, always had nutritious and sufficient food, never lacked for a solid, well-rounded education.

Working away during one of many power outages

And that brings to my final point: what I’m most grateful for is knowing that I’ve been given the tools to essentially do whatever I want in my life. I’ve been given the power to shape my life as I wish and, even more than that, to shape the world around me – or at least have a small impact on it. That’s a lesson that India has taught me – and I hope it’s one I never forget.

P.S. the big thing I’ll miss about India: the food. hands down.


Workers, Staff, Faculty and… Healthcare?

Thu, 07/23/2015 - 12:21

Since we arrived at Shahi Exports, we’ve witnessed the stark differentiation between “staff” and “non-staff.” The staff includes the company’s management, the HR team that we work under, us, and all of the other marketing and design groups that help a garment company function. The people who do the actual labor – cutting fabric, washing it, sewing pieces together, adding buttons, dying jeans, etc.—they are non-staff or workers. While everyone works within the same building at unit 7, the staff and non-staff are mostly segregated by floor. There are also separate cafeterias and restrooms for the two groups. Often, these separations make sense because of the structure of the factory floor, but the distinction and the salary gap are both very real.

A worker sanding jeans — one of the most physically taxing processes involved in garment production

Back in my hometown (Kutztown, PA), the same phenomena is easy to see. My dad is a professor at Kutztown University, where a very similar “faculty” and “staff” division exists. The two groups differ in education, salary, and benefits. When I asked my dad if he knew any specifics on the differences in faculty and staff health care, he said he wasn’t sure since they operated under separate unions. Back at Penn, race, dialect, and local West Philadelphia residents vs. non-locals often (but not always) enforce the faculty/staff division even more. While I’m curious to return to both Kutztown and Penn to better understand more about similarities or differences in benefits and healthcare, I was lucky enough to experience both worker and faculty heath facilities in the Shahi context.

Shahi provides all of its workers with a health insurance program called the Employees’ State Insurance Corporation, or ESI. ESI is a government-run program for individuals who earn less than 15,000 rupees, or $250, per month. The health insurance is immediately effective as soon as the worker is on payroll, and is paid for in part by the government, worker, and employer. This service is enormously important to many workers, as it covers both them and their families and services are usually free of cost.

ESI covers over 75,800,000 individuals across India, which puts tremendous strain on the facilities. We got to visit one of the nearest ESI hospitals, and found it packed with people. People were sitting on the floor and on windowsills, and there were lines to see general physicians that snaked outside in the hot sun. Many people would stand for hours just to be turned away after closing hours. The hospital was also over an hour away from the factory unit where we work. The hospital is not open outside of normal working hours, so workers have to take off full workdays in order to go. If workers are sent due to severe anemia, they will likely have to go first to an ESI dispensary (small, but more numerous pharmacies) in order to get recommended to the hospital, then travel to the hospital, stand in line to see the doctor, and be recommended for blood tests. However, the blood tests are only available until one o’clock. So, in almost all cases, the individual will have to return the next day to wait yet again for the blood tests. The results can take time to obtain as well.

A worker getting her blood pressure taken before her blood is drawn for a hemoglobin (anemia) test. This is part of the initiative that Chan and I have been working on.

When I later needed to see a doctor for my own stomach troubles, my supervisor, a member of the “staff” of Shahi, recommended the doctors’ office that she and her family used. It was a private hospital that was about 10 minutes away from the factory unit where I work, and I was able to sit down in an air-conditioned waiting room as soon as I arrived. After my appointment, I inquired about hemoglobin tests, and was told that I could get one right then and there if I visited the labs downstairs.

These discrepancies in services and care are difficult to witness from afar, but becoming part of the system myself was much more impactful. It also forces me to recognize that I am part of such systems of inequality back home, but their familiarity renders them much less visible. I know that broadening my understanding of the intersection of class, education, and health will not stop when I hop on my plane to Newark.


Aiming for Teaching Eyecellence

Thu, 07/23/2015 - 10:24

(My apologies, that couldn’t have been cornea if I tried. Okay I’m actually done now.)

I haven’t really accepted the fact that I’m coming back to the United States in a matter of days. This week has been filled with excitement and activity, furthering my denial about leaving a country that I’ve grown surprisingly accustomed to over the period of 10 weeks. I’m not sure how ready I am to walk down streets that aren’t oppressively hot, dusty, and teeming with goats and cows.

Starting this Tuesday, Aravind continued to prove its strength as a model institution with well-established teaching methods by hosting the 8th Eyexcel conference that included physicians and teachers from 16 institutions in 6 different countries. Eyexcel is dedicated to “expanding the global eye care workforce through excellence in training”, a philosophy that Aravind adheres to through the development of courseware that will eventually be shared internationally. I had the privilege of helping the facilitators of this conference and interacting with participants from Peru, Bangladesh, Malawi, China, Nepal, and different parts of India. Course faculty includes Dr. Suzanne Gilbert of the Seva Foundation, Dr. Kathryn Hecht formerly of the American Academy of Ophthalmology, Dr. Karl Golnik, President of the Joint Commission of on Allied Health Personnel in Ophthalmology (JCAHPO) and Professor of Ophthalmology, Neurology, and Neurosurgery at the University of Cincinnati and the Cincinnati Eye Institute, along with various other leaders in eye care and educational development that made this conference possible.

Serving as an excellent culmination to my summer work, the conference was important in reinforcing the teaching philosophies that we actively incorporated in the Aurosiksha lessons. Sustainability, proper implementation, and efficient design were among the key elements discussed when developing course curriculum. The position of Mid Level Ophthalmic Personnel is unique in that the training is specifically focused on competencies that lead to care. It is different than a nursing or physician assistant school in that it is tailored to a particular institution’s workforce needs. JCAHPO is one of the leading international organizations in furthering education and certification programs for ophthalmology, and the idea is to provide a broad range of suggested competencies/relevant training that then allow a hospital to select what is needed for delivering appropriate care.

In addition to providing engaging lectures by experts, the conference was designed to “practice what it preached” by incorporating blended learning techniques into sessions that included group work, discussion, and readings. The participants strengthened relationships with others from their institutions and from hospitals across the globe. “Training circles” from the various geographical regions will be developed in order to maintain these professional alliances and facilitate dialogue on teaching techniques for ophthalmic assistant and residency programs.

The founder of Aravind, Dr. Venkataswamy (Dr. V) was a dedicated follower of spiritual leader, Sri Aurobindo. The conference focused on one of Sri Aurobindo’s philosophies on “perfecting teaching”:

The first principle of true teaching is that nothing can be taught. The teacher is not an instructor or taskmaster; he is a helper and a guide. His business is to suggest and not to impose. He does not actually train the pupil’s mind, he only shows him how to perfect his instruments of knowledge and helps and encourages him in the process. He does not impart knowledge to him, he shows him how to acquire the knowledge for himself.

Dr. Golnik examined this idea in one of his talks on the ‘changing paradigms in eye care training’ by explaining that teaching does not equate to learning. It is especially important to emphasize translational learning throughout the education process in ophthalmic assistant training programs, as the acquired knowledge will quickly evolve into skills that are used with patients. (Fun fact: The weekend before the conference, we visited Sri Aurobindo’s ashram in Pondicherry.)

Everyone at the conference was delightful to interact with. I ended up serving as a sort of liaison between the facilitators and attendees to gauge whether the educational goals of the physicians and trainers were being reached. Taking part in the icebreaker activities, coffee breaks, and meal times allowed me to get to know the participants on a more personal level. My new friends include a pediatric ophthalmologist from Tibet, project managers from China, an ophthalmologist who serves tribes in Gujarat, doctors from Malawi, and hospital directors from Andhra Pradesh. These are only a few of the diverse and talented medical professionals and educators that traveled to Madurai to enhance their training programs.

Though the Aurosiksha lessons incorporated scientific knowledge, clinical skills, and collaborations with medical personnel, this entire internship experience has had an educational, people-centric focus. I previously had no background in evaluating what or how to teach students, especially since I am currently still a student. Hepsiba, Nithya, Sakthipriya, and I have taught and learned from each other, brainstorming new ideas and troubleshooting a process that previously had limited direction. The Aurosiksha department will be expanding in the coming year to accommodate a higher volume of material. This training resource has the potential to reach multitudes of new trainees and will hopefully allow MLOPs to treat patients with a confident and well-informed approach.

Highlights of the past two weeks

-Presenting with Hepsiba to over 250 trainees who had just arrived at Aravind for orientation. It was powerful to see the future audience of Aurosiksha and the new, more innovative training techniques. They also enjoyed our skits and my attempts at using Tamil.

-Receiving free chocolate cake because the kitchen staff recognized me as “the foreigner that loves cake”. (Clearly I’ve developed a good reputation)

-Eating at the same café in Kodaikanal 3 times because their pizza, fries, pasta, desserts, etc. were so good

-Spending the majority of the Kodaikanal trip petting the homestay’s “watch dog”, Bruno

-Visiting Aravind’s beautiful Pondicherry branch hospital

-Falling through the sidewalk into a ditch in Pondicherry, driving by an exploding firework in an auto rickshaw

-Discovering Arun Butterscotch ice cream

A very suspicious Bruno

The whole intern group (and Priya) at the Pondicherry branch of Aravind

Me and faculty facilitator, Dr. Susan Gilbert of the Seva Foundation