CASI Student Blog
Ask anyone at one of India’s Aravind Eye Hospitals and they’ll tell you that their system for eye care doesn’t start at their well-equipped tertiary hospitals. Yes, these exemplars of clinical and operational precision may support the finest ophthalmologists with the greatest efficiency. However, the entire organization is for naught if it can’t receive any of the 12 million blind people sequestered in their homes spotted around the country into their waiting rooms. Aravind begins in the country in its eye camps.
Think of the camps as a traveling circus. They load their handful of materials in a brightly colored van and then begin across the country side to a new place every weekend. When they arrive they immediately unload their few boxes of supplies and pitch their “tent” in a residential school or temple. When everything is set up the casual onlooker is left wondering how so much could have come out of that truck. Like circus each worker has their own booth that they tend to the entire day for their customers.
I got to visit one, waiting in the corner because unlike every other busy worker in this camp I had no role to play. I sat alongside the ophthalmologists as they took patient after patient and performed the same routine. Each patient came with a paper that the doctor took. He asked them to look at his ear then proceeded to shine a light in their eyes. After a few seconds he jotted some notes on the slip, mumbled a few words, and passed the patient on. Of course there were a handful of special cases who required more time, but the work was routine and monotonous. But like any system there was a bigger picture. I followed the paper trail, where did these patients come from and where did they go?
The doctor’s station was one stepping stone to a complete, comprehensive diagnosis. Patients were passed along, completing the most basic sight tests to determine their vision, going to doctors, then getting split to refraction or more diagnosis. Every patient left with a new pair of glasses, or the same paper sheet, completed, a medical record, so they could go to Aravind next week.Click to view slideshow.
The camp was a perfect demonstration of the pairing medical training with a mindset for efficiency. Those tasks that did not require a trained ophthalmologist were led by Aravind’s technician sisters. Each camp prepared with past statistics of their camps and cataracts prevalence to properly assign the roles to the right number of technicians. And while each task could be considered simple and repetitive, the beauty of it was that that was all that was necessary to leave every patient with a proper and complete diagnosis.
After 230 patients filed through the multitude of stations at our camp we began to wrap things ups. 65 patients were to be admitted to Aravind for cataract surgery and we picked up by a large bus. These were all patients who had come to the camp by word of mouth. Either they or a friend had glimpsed a flier on the side of a road to alert them to Aravind’s presence and out of a need for any form of help they brought themselves her. And now they were on a bus to an even bigger system than they could have foreseen.
Interested in a more complete breakdown of the steps and estimate processing times of this eye camp? Click the link below! Pardon the imitation of my professor.
We are entering week 6 in India, and I can hardly believe how much time has passed. This past month has been a whirlwind of adjustments, new experiences, and realizations. I find myself more attuned than ever to the value society places on physical appearance and, more specifically, color.
Particularly for women, the idealization of Western expectations of beauty are everywhere you turn. Billboards, posters and tv ads market whitening treatments. “Tan removal” facials and scrubs are widely advertised at spas. We’ve walked into several beauty stores, both at malls and stand-alone locations, and the emphasis on “fair” skin tones is impossible to ignore. In Bollywood movies, television shows, and commercials, actresses (and many actors) appear whiter because of lightening techniques. And those with preexisting lighter complexions are given preference in the industry over their darken skinned counterparts.Click to view slideshow.
There is constant pressure to meet the unrealistic beauty standards set forth by society. I fall victim to it in the United States, but it must be understood in a different context here because of where the standards are derived. That I, as a Western woman with lighter skin, am treated with extra care is for a reason long preceding me. The impact of colonialism manifests itself in a subsisting inferiority complex within Indian society. Despite the physical removal of such authority, the undertones of white, Western superiority are deeply ingrained after nearly a century of British rule. These themes are unfortunately recurring in society today, especially for women, and it would be wrong from me to ignore it.
The perpetuated notion that being lighter skinned equates to enhanced beauty, and self-worth, is toxic. But there are those who are actively working to counteract wrongful degradation. The founders and supporters of campaigns like “Dark is Beautiful” and “Unfair and Lovely” aim to combat the underrepresentation of people based on color and strip away various systems that perpetuate oppression. These empowerment campaigns send the message that any given person is enough. Regardless of where you come from, what you choose to believe in, who you love, what you look like, differences should never be reason for disparagement. Differences should always be embraced for what they truly are: beautiful.
I am a white, upper middle class, American. I acknowledge my inherent privilege in this world and people absolutely have the right to say I will never truly understand what it means to be marginalized in this manner. But I know that despite this, I want to play my part in preventing the so-called “drivers” of societal standards and norms from dictating any given human’s value. I want to be part of a society in which everyone is safe to accept, encourage, and embrace their diversity…a society in which we are not “fair and lovely” or “unfair and lovely” but just human, and lovely.
Hello readers! I arrived in India a few days ago and am excited to begin my research and start blogging for CASI as the recipient of their Travel Funds for Research Award. I am a PhD student in the department of Anthropology at the University of Pennsylvania in my third year. I am a Wisconsin native. However, I also feel a strong connection with Delhi, as I did my Masters in linguistics from Jawaharlal Nehru University here and have been back and forth between Philly and Dilli (Delhi in Hindi) many times since I started my dissertation project. My sub-field of study is Linguistic Anthropology, which is the study of how language shapes our social worlds. Specifically, I research accents of Indian English and the accent training industry in the National Capital Region of India.
Delhi is an exciting place to be studying language. They have a saying here: “दिल्ली किसी की नहीं है” (dilli kisi ki nahi hai ‘Delhi belongs to no one’). Everyone you meet in Delhi comes from somewhere else. There are migrants from all over India here, each with their own linguistic repertoire, though the languages you hear most often are Hindi-Urdu, Punjabi and English. Many of those who live in Delhi have come here from every corner of India seeking work, and many them end up in the Business Process Outsourcing and Information Technology (BPO-IT) industry, working for third party companies that service international clientele. The BPO-IT industry is a huge employer in India (3.7 million jobs) and is the largest contributor to Indian exports out of any other sector (38%). The Delhi area is one of the biggest hubs of the BPO industry. In particular, Gurugram (formally known as Gurgaon) has shot up as a hub of call center activity since 1991.
One of the results of the demand for English speaking employees is an ever-growing voice and accent training industry. In this industry, trainers attempt to deal with the challenges in communication that companies face when moving their phone bank operations to India. For this reason, new employees go though a training process where they used to learn to speak with foreign accents (most commonly American Standard English and Received Pronunciation. One of the interesting things that has emerged over the past decade, however, is a new standard of accent training which is neither British nor American: the Neutral Accent. In my research, I investigate the social implications of this accent and its features: where it is used, by whom and for what purpose. I am partnered with a skills training company and will be observing their training over the next couple of months, but I will also be following them outside of the office to track their accents in different spheres of interaction. I will be keeping my ears open as I watch news shows and interact with different people in Delhi, seeking to discover new patterns in how different people speak! So, follow me this summer as I follow the accents of Delhi!
Imagine you’re driving home late at night. You’re minding your own business when suddenly, you’re startled by another car’s high beams as the driver zooms around a corner. While grumbling to yourself about the other driver’s lack of consideration, you return your focus to the dark road ahead of you. You’re disoriented for a few moments and experience difficulty perceiving details. If you’re an individual with relatively healthy eyes, you will gradually “dark adapt” back to your surroundings when the peripheral photoreceptors in your retina adjust. Rod photoreceptors allow us to see in low light, or scotopic conditions. We have a sensitive pigment in our rods called rhodopsin, which detects visual signals in the dark that can be sent to the brain. When rhodopsin is “bleached” or hit with high intensity light, the rhodopsin is temporarily non-functional and the cones will try to take over. Cones are generally not sensitive in dark conditions, which explains this temporary “blindness.” This delayed transition doesn’t cause major problems when you’re walking from a sunny parking lot into a movie theatre, because your rods have some time to adapt to the darkness. When you’re driving at high speeds, however, you don’t have 15 minutes or a half hour to allow your rods to fully adapt after being exposed to a bright light. Herein lies a problem with driving at night. The transition from dark to bright to dark again occurs rapidly with passing cars, and your rods don’t have a chance to catch-up after becoming bleached. In someone with a retinal degenerative condition, vitamin A deficiency, or other deficit, this transition might occur very slowly or not at all. These individuals are identified as being nyctalopic, or night blind.
You might have been able sense my excitement about a test called FST in my last post. To recap, FST stands for “Full Field Stimulus Threshold Testing”, and it’s a psychophysical measure of someone’s visual threshold in scotopic conditions. The premise of the test involves dilating and ‘dark adapting’ someone for about 40 minutes, meaning they sit in a completely dark room so that their rods grow accustomed to the dark conditions. A full field flash of light is administered at a wide range of intensities, and the built-in algorithm uses forced-choice responses to calculate a probability of detecting a certain threshold of light. Although it sounds simple, this ‘subjective’ test is able to detect responses from the most sensitive parts of the retina. While FST does not provide a spatial assessment of vision like ERG does, its distinct advantage is that it can pick up responses in low vision individuals or patients who have severe rod dystrophies. Additionally, it is not uncomfortable for the patients and it’s faster than other methods. The examiner can use different wavelengths of light (which appear as red, blue, or green) to test rod and cone sensitivity in greater detail. Aravind had the necessary equipment in place but lacked a program and tools needed to complete the test, something that I have been able to work with them to implement using my research funds.
Aravind is a particularly special place to be able to use FST due to the magnitude of patients with nutritional, genetic, and disease-related retinal abnormalities. Patients regularly come to the retina clinic with Retinitis Pigmentosa, Leber Congenital Amaurosis, and Stargardt’s disease, among many other diseases. The seemingly most common condition patients present with, unsurprisingly, is diabetic retinopathy (DR). DR is a leading cause of blindness, affecting 93 million people across the globe.¹ The Times of India referred to India as the ‘diabetes capitol of the world’, with approximately 50 million people living with Type 2 Diabetes. Poor disease management is the norm as shown by many of these patients, and uncontrolled blood sugar is a major contributor to worsening ophthalmic health. Although excellent research has been completed over the past few decades in order to describe DR pathogenesis in animal and human models, the results in some areas are incomplete. One such area is dark adaptation. There is a small yet interesting body of literature pertaining to dark adaptation studies and DR, and I am hoping to contribute additional characterizations of photoreceptor function in different cases of DR using FST.
In the introduction to this post, I talked about driving as one specific danger of dark adapted deficits, however night blindness can affect an individual’s quality of life and safety in other ways. Because patients with DR experience peripheral retinal changes even early on in disease progression and they undergo procedures that can salvage day vision and harm night vision, they are an ideal population for FST testing. In addition to clinical outcomes, it is important for patients to be aware of diagnosed dark adapted deficits in order to avoid high risk activities. I’ll talk more about our specific studies in my next post!
This is the first time I have been able to conduct research with real people using my own ideas. I love doing clinical research in the U.S., but my role is different in that I am executing the protocols and ideas of my superiors, not my own. Although it is exciting to have autonomy over a project, it comes with a new set of elevated responsibilities. Luckily, I have excellent mentors in India and in the U.S. to guide me through these challenges. I’m working with the chief of Aravind’s retina department, Dr. Pankaja Dhoble, an inspiring and passionate physician. As someone who has extensive research experience, she is showing me how to push the research process forward in a country where punctuality and deadlines are sometimes neglected. The IRB and patient recruitment processes are also quite different from what I have grown accustomed to in the U.S., yet some of the challenges of clinical research appear to be universal. I was warned that following up with patients in India can be difficult and time consuming, something I am all too familiar with in our studies back at home. Despite these obstacles, human research is incredibly rewarding and offers the unique opportunity to connect many demographics of patients with innovative diagnostic tools. I cannot wait to move forward with our work over the next few weeks and I’m even more excited for our collaboration that will continue over the next year.Global prevalence and major risk factors of diabetic retinopathy.Yau JW, Rogers SL, Kawasaki R, Lamoureux EL, Kowalski JW, Bek T, Chen SJ, Dekker JM, Fletcher A, Grauslund J, Haffner S, Hamman RF, Ikram MK, Kayama T, Klein BE, Klein R, Krishnaiah S, Mayurasakorn K, O’Hare JP, Orchard TJ, Porta M, Rema M, Roy MS, Sharma T, Shaw J, Taylor H, Tielsch JM, Varma R, Wang JJ, Wang N, West S, Xu L, Yasuda M, Zhang X, Mitchell P, Wong TY, Meta-Analysis for Eye Disease (META-EYE) Study Group Diabetes Care. 2012 Mar; 35(3):556-64.
When I tell people in the US that I am originally from Bangladesh, I am often met with confused and surprised looks. Some will ask me what part of India that is, some will ask where in the Middle East it is, and others won’t even bother trying.
When I tell people in India that I am originally from Bangladesh, I am still met with confused and surprised looks. People ask how I know Hindi, how I ended up in the US, and most importantly, what I’m doing with three American peers in India.
As a Hindi speaking brown girl in India, I have numerous privileges. To start with the obvious, I appear local. My skin tone protects me from half the stares that my non-brown co-interns face. I only say half because any young woman in India is susceptible to stares, brown or not. My next enormous privilege is being able to speak Hindi. I can get by almost anywhere as a privileged North Indian. I have already avoided the foreigner fee at various tourist sights and bargained my way down to reasonable prices. I have also made several local friends with whom I am able to hang out without seeming like an outsider. Another big one is my fluency in English. I was speaking to a waiter recently who was very amused by how “I speak like an American, look like an Indian, but am neither” (referring to my Bengali origin). In Bangalore, knowing only about ten words in Kannada, I always take a brief second before each interaction to determine whether it would be wiser to use Hindi or English. They seem to have the same success rates but usually Hindi takes me a bit further. In addition to these I can’t ignore the fact that 90% of the time here I am walking around with three American non-brown friends. This gives me all the luxuries of being a foreigner while still holding the privilege of looking brown.
At this point, it may seem like I’m enjoying the best of both worlds here in India, and in some ways I probably am. However, being a brown non-Indian has just as many downsides as it does up. I often find myself having to take charge of our group while making plans, travel arrangements, finding places to explore, etc. I am pushed to become the spokesperson for the group within work environments but especially outside of work. Sure, some part of this may just be my Type A personality but it’s undeniable that a big part is also that it’s simply expected of me. As a South Asian, I am more familiar with the way things work here than the rest of my co-interns. But this responsibility can easily become a burden. Given that it’s my first time in India, just like my co-interns, it can be frustrating to constantly have to play host and be explaining things. This isn’t necessarily my fellow interns’ fault – regardless of whether we are with coworkers, uber drivers, or vendors, it’s expected that I know certain concepts or am somewhat familiar with why things are the way they are. While it’s true that there’s similarities across South Asian countries, I grew up watching way too many Bollywood movies, and I am practically fluent in Hindi, I find that people around me often forget that I am just as much a foreigner in this country as the other interns. When one of my co-interns asked me what a Puja was for example, I referred to a scene from the movie Kabhie Khushi Kabhie Gham (which we had just watched together), and explained that given that I am Muslim, I had never actually been to one so I wasn’t the right person to ask.
I knew before coming to India that my experience would be unique. As a South Asian from one country in another, I definitely would not be local in India, but I wouldn’t be 100% foreign either. As I reach the halfway point of my summer in India, I look forward to seeing whether my non-Indian brown experience continues to be more positive, negative, or a mix of both.
Hundreds of millions of Americans from all walks of life do the same exact thing each day, a careful ritual that they have done every morning since they can remember. They walk over to their dressers or drawers and put on the clothes they need to start the day, all without thinking too much about it. Sure, we think about what to wear for the weather or occasion, or about brand and style, but so often we forget the simplest thing about what we wear: where the clothes came from, or who made them.
I’m sure everyone is different, but I know for sure I’m guilty of this—it’s so easy to imagine that, rather than people, a bunch of automated devices in a warehouse far away are churning out one garment after another. Rolls and rolls of fabric into one end, millions of pants and jackets and scarves out the other. Knowing I would soon be on my way to work for Shahi, one of the world’s largest garment exporters, I knew I had to throw out this convenient misconception in my head. It’s possible to forget it (or ignore it), but each and every thing we wear—whether it’s from Walmart or J.Crew—was not created by a machine, but by a human being with his or her own life, a unique set of hopes and struggles and stories.
Before I left for India, I wanted to get a better picture of what life is like for those working as tailors in garment factories so that I could know what to expect. This proved to be harder than I thought it would be. A quick Google search on the topic often led to more horror stories than anything else. Whenever I told friends at home that I would be working for a garment manufacturer, they seemed to always respond with reflections on the latest exposés of the industry that they saw on the news–fires and forced labor, among other atrocities. While at first I would shake these stories off as poor representations of the garment sector, I later started to question myself. What if they were right? No matter what, I decided I had to focus on my reason for going to work at Shahi. I would not be perpetuating the problems of the industry, but actively working to make them better.
I kept this all in mind as I made my first trip to the factory floor with my interns. The floor was exactly the opposite of what you might see on the news–it was brightly lit and the enormous fans kept the temperature in control. The colossal room was completely filled with the active hum of machinery and with the vibrant colors of the cloth of hundreds of brightly patterned saris. Even though I tried to prepare myself before I arrived, I still found myself awestruck. You can think as hard as you would like about the source of your clothing, but nothing prepares you for seeing it in person, for coming face to face with those who labor over and create what you wear every single day.
As I saw more and more factories while traveling all throughout the south, this scene became less surprising, almost commonplace to me. I often had to remind myself that while the conditions were fairly good at Shahi, the company like any other is far from perfect, and that workers in other less regulated companies were facing conditions that were unthinkable in comparison.
Every day I tell myself not to let the hundreds of people I see day to day fade into the background, like they used to be in my mind before I came to India. This is why I decided to focus on developing the counseling system in the factories. In a company with thousands of workers, it becomes important to remember the humanity in each person. It is impossible to fully understand what any individual is going through, but perhaps by improving the scope and reach of the company’s counseling services, each individual can at least be offered the attention and open ears that they deserve. If I succeed at improving the program in any way I can, it would be only one small step towards progress in the scheme of things, but one I would like to think could make a difference for many people. As my project continues to develop and take shape, I look forward to sharing more about both the barriers and successes I face.
But before then, I hope that those who read this blog pause next time they reach for their shirts in the morning. Think about who made them, who might have played a part in getting them to where they are today. It may be hard to fathom, but it is so incredibly important not to forget the lives behind what we wear.
Today, I woke up late enough to miss breakfast. Then, thanks to either the pressure of an empty stomach or the good 9-hour sleep I had last night, I started reflecting on what being an intern entails. I quickly realized that words such as intern, internal, inward, inside, in, …seem to be connected. And that is because they actually are. Indeed, the word “intern” has its roots in Latin, internus, meaning internal or inward. In the same logic, being an intern alludes to being inside something.
Before I go any further, some preliminary understanding needs to be grounded. Let’s understand that everything has two main parts: an inside and an outside. The two parts are somehow linked and their relation is vital. In fact, as an intern, I ultimately have to ensure a decent relationship with the extern. Put otherwise, my task in Aravind is to help the system reach out to the external world, or patients in this case, while solidifying the inside. For example, my first project has been on patient education, designed to raise patients’ awareness about eye diseases and what they should expect at Aravind. The main challenge in my project is to translate the material on patient education from a science-rich language into a patient’s preferred and understood language, devoid of scientific sophistication. Not fun at all!
Furthermore, there are many layers that can define in and out, as the inside in one context may be the outside in a different scene. While I am inside Aravind, I still have a self that needs to be nurtured. That’s why I want to maintain a healthy two-way communication between myself and the internship. I complete my assignments as an intern, and in return, Aravind’s unique inspiration fuels my personal growth. Working from Monday through Saturday, from 9 AM (or earlier) to 6 PM (or later), everyone here is firmly committed to their work. I had never seen such hard and loyal workers. Some of the doctors don’t even take a day-off on Sundays. I had to ask a doctor from Mozambique when I met him on a Sunday after work, and my questions were fairly predictable: “How does Aravind make doctors stay despite the incredibly huge amount of work? Are they better paid here than in other places?” In yet simple words, he gave me a very profound answer and roughly said: “It’s not about money. It’s about being passionate about our work and loving what we do.” Lesson learned!
Not surprisingly, everything was not very clear during the first few weeks. Besides, working abroad brought about greater confusion since things as simple as eating the local food were challenging. Yes, I experienced culture shock. Nonetheless, the more days I spend in Madurai, the more comfortable I feel. I came to believe that my new expertise is in working in an environment where I feel younger and less professional than almost everyone else. Developing self-confidence, exploring, making connections, and asking questions have been my secret for a smooth adaptation. And so, I enjoy being an intern.
I remember when I used to hear about Economists when young. I was pretty sure they dealt with money, and that their aim in life was to make people earn as much money as they could. Little did I know I was going to choose this ‘money maker’ career later in life, and that it was going to become so much more than that.
The thing about Economics is that it is a science, plain and direct. Like other types of science, an object of study is needed – and Economics happens to focus on the most complicated, convoluted and sophisticated of them all: human beings. These objects of study are not only different and unique in every way, but also constantly evolving. And one would ask, what is the best way to tackle these objects of study, these unpredictable and dynamic beings? India offers a scenario where many samples of human beings can be found, and during these past weeks, I’ve been able to test one of the best techniques to study human beings, and at the same type, arrive to some economic realizations.
Taylor and I were meant to find out if Naandi’s coffee project was guilty of murder. Not any kind of murder, but one of the most tragic kind: cultural murder. By introducing tribal farmers to the international market and by selling their organic coffee abroad, was Naandi taking them away from their Adivasi culture? Away from their native languages? From their customs? From their values of caring and sharing with each other? Away from the type of community where neighbors know each other stories, or where children are not fatherless, but fathermany (or is it fatherplus?), because children are taken care of by everyone in the village? Was Naandi taking them towards the mainstream culture? That one where individualism triumphs and were people don’t look at each other’s eyes anymore?
Was Naandi slowly killing the Adivasi culture?
The best way to get to a verdict was by immersing ourselves in these objects of study’ usual setting: the villages. After spending some days in the office planning our visits and building quantitative analysis based on coffee procurement information, we headed to the field to start our ethnographic study (and to observe our objects of study closer).
We had already visited their working places – the coffee plantations up the hill- so now we wanted to see them in their living places. We visited two villages, where we had long conversations sitting in
straw rugs by the cattle sheds. Sitaram, a Naandi employee, helped us in these endeavors by translating from English to Telugu, while other farmers helped him translate from Telugu to Oriya – the original tribal language.
Curious minds asked about the US and Peru – my home country-: about our crops, our food, and our marriage system. There were some instances where Taylor and I needed more than a few minutes to build a solid answer, especially those inquiries about race, skin color, the tax system and the education process. We spoke Spanish, French, Chinese, and even showed Sign Language, so that the farmers could hear and see how different languages can be. At the same time, Taylor and I asked about their families, their perspective of Naandi, their new opportunities, their desires to send their children to school, their clothes, their food, and more.
We toured some of the houses and admired their kitchen fueled by wood and their many shelves of tin pots. While eating mango with chili powder, we continued our relentless inquiry: we asked about their Bibles, their books, and their stored food; we asked about their traditional nose rings, about their wedding celebrations, their homemade cigarettes, and about their favorite TV program.
Although we still have more work ahead, Taylor and I got an initial idea of the final verdict by observing and listening. What is more, I realized that my numerical pre-conclusions did not show the whole picture. Based on calculation of a low average income, I expected a certain village to have no recent purchases; opposite to my pre-conclusions, this village turned out to be going through a “golden period”. Numbers had failed, while personal interaction hadn’t.
I realized that the most numerical side of Economics lies only in its name, and that the rest of it is centered in the complicated objects of study that humans are, and who are the ones that give sense to the science.
I also realized that lots of knowledge is acquired and is given through direct interaction between the scientist and the object of study, between us (although I wouldn’t call myself a scientist just yet) and the coffee farmers. Ethnography is a tool that requires the vanishing of any levels of separation, and turns the scientist into the object of study, and the object of study into the scientist. And this is the secret behind its effectiveness.
I realized this.
And that I choose my career well.
que estás en el cielo.
Our Father, who art in heaven, why on earth is it raining so hard??
Yes! The monsoon arrived this morning. It has been a bit late getting here, causing some havoc for the farmers around. For Alexa and I, a delayed monsoon meant more triple-digit heat days, so when the rain started coming down while we were at breakfast, it was a wonderful temperature relief.
That is until we had to walk back to our room in it.
In approximately four seconds, we were entirely soaked. The rain was coming down in sheets, and so we gripped our water bottles, hiked up our pants, and ran down the gravel road, trying to avoid snakes and puddles in our sandaled feet. The good news? When we got back to our room, we were cold. Let me explain the gravity of this: I have never had a minute go by here where I haven’t been covered in sweat. Being cold? That was a fantasy. And now…
Santificado sea tu nombre.
Hallowed be thy name! or rather, Hallelujah for the rain! This does mean more bugs, snakes, scorpions, and, of course, mosquitos, but for the time being, the cool air is so refreshing, I could care not.
Venga tu reino.
Hágase tu voluntad en la tierra como en el cielo.
Thy Kingdom come, Thy will be done, on Earth as it is in Heaven.
Please God, let me start working. The good news: our prayers were answered. This week (week 5), we finally started working on a project. This means no more sitting around all day! Yipee!
My job is conducting interviews of women in financial groups called SHGs (self-help groups). The SHGs bring rural women together, where they save money, can take loans with fair interest rates, and learn financial literacy. The farmers in the rural areas around here used to get loans (to buy seeds and farm equipment) from extremely corrupt moneylenders, who would charge upwards of 100% interest rates. Because most women here are illiterate and did not have any means of becoming financially literate, SHGs formed to teach women how to save, take loans, and go to the bank. Now, families are freed from the confines of taking loans from corrupt moneylenders and have learned enough reading and writing to get loans from the bank. To put it in perspective, the women in the SHGs had never been to a bank before joining, so the ability to even go inside the bank, more-or-less interact with employees and take a loan, is a major achievement. Many of the women never leave their homes, but now they are going to SHG meetings, traveling to the city to get to the bank, and are in charge of the finances of the household, which has been a huge confidence booster for them.
I have been (attempting to) interview some women in the SHGs to write up their stories about their lives before and after joining. However, with the language barrier, whoever comes with me to translate does 99% of the talking and then translates a bit of whatever the women say. So, I’m not quite sure how much of the story I am getting, but it is something.
I’m not actually sure what SPS wants me to do with the stories I collect, but I’ll let you know as soon as I find out! I’ve had things to do 3 days this week, which is a massive improvement. So it’s still slow around here, but things are looking up!
Danos hoy nuestro pan de cada día.
Give us this day, our daily bread… I take that back. No more bread!!
I thought I would lose weight in India. (Not because I wanted to, but just because of being vegetarian and getting sick.) But alas, no. What I’ve learned is that eating vegetarian doesn’t necessarily mean that one is eating vegetables. So, as of yesterday, Alexa and I are on a diet. 90% of our meals are pure carbohydrates, mix that with sitting all day, et voila! On top of it, we wear super baggy clothes, so it’s easy to hide… new rules:
- Rice or roti (tortilla like bread), not both!!
- No potatoes
- Small helping of dal (lentils)
- As many cucumbers as possible
- If they have it, some type of vegetable
- No sweets (although I must say I wasn’t eating any before because to say they liberally use sugar is an understatement…)
- Only snack if “work out” the night before
Pray for us.
Food in Indore that I won’t be eating again for a while…
Perdona nuestras ofensas,
como también nosotros perdonamos a los que nos ofenden.
And forgive us our trespasses, as we forgive those who trespass against us. Or rather, forgive me for the snack I just ate that totally broke the rules outlined above.
No nos dejes caer en tentación y líbranos del mal.
And lead us not into temptation (but those cookies look so good!) but deliver us from evil (please snakes don’t come into our rooms, please please please).
[Inspiration for this blog post: whenever I am terrified here, I start saying the Our Father in Spanish. For me, it acts as a meditation, like a chant almost that calms the mind and focuses the brain. Instead of concentrating on the actual words, I think about the rhythm of the poem (I see it more as a poem than a prayer). Why in Spanish? Who knows… Probably because I can’t remember the French version. Oopsies.]
And here is a *beautiful* poem I wrote about the bugs. Enjoy.
Be gone bugs!
Don’t make me throw these jugs
There are bugs in our bed
That I’m trying not to whack
But it’s driving me insane
Because I can barely sleep in my sack
I squish hundreds of them with my shoes
If you were here, you would too
They come in from under the door
And scatter all over the floor
My food is not safe
I’m trying to hide it now
My suitcase is stuffed
With enough food for a cow
We got a bottle of Raid
But I’m not sure it’s made
For the amount of bugs that come through
If only you knew…
I used to follow the ants
Around the room
With a bottle of soap in hand
Wishing I really had a broom
Oh yes! How can I forget?
The other day, there was something new we met
It scurried around
Not wanting to be found
It can up the mosquito net
And onto the curtains
Please don’t be a recurring pet
My eyes are now trained
And ready to maim
The crickets and termites and ants
That have all came
This poem is pretty bad
Please don’t be sad
We’ve learned great protection skills
That I guess I’ll use if I ever head to the hills
So goodbye for now
We’ll try to think how
We can survive the next couple days
In myriad ways
This past weekend, I decided to venture off on my own to explore Bangalore’s science (Visvesvaraya Industrial & Technological Museum), history (Karnataka Government Museum) modern art museum (National Gallery of Modern Art), and planetarium (Jawaharlal Nehru Planetarium). With Bangalore traffic this journey took about an hour to reach the heart of the city where all the museums nestled in between the lush greenery of Cubbon Park and beautiful Vidhanna Soudha, Karnataka’s state legislative chamber.
The cab ride started as most cab journeys around this city, with the driver asking where was I from, as usual I answered US. Normally that would be end of the conversation. However, this driver was different, as my being from the US sparked his curiosity. The driver asked me if I knew Kannada, which is the local language for Bangalore and all Karnataka. Knowing that I didn’t much besides the words for no, want, and yes (haudu, which has taken on a special significance for my intern group), I meekly responded, “kannada gottilla” meaning, “I do not know Kannada. This prompted a jovial laugh from my driver. He listed all the languages he knew, Kannada, Hindi, Tamil, Telugu and Malayalam. He admitted that English wasn’t his strongest language. I told him that English wasn’t my strongest either, a joke that caused us both to chuckle.
We started our conversation discussing the traffic. He asked if the traffic in Bangalore was similar to traffic in the US. I told him that we have more traffic lights in the US. From traffic we moved on to cars. We talked about the difference between the cars I have seen in India versus the cars in the US. The mainstays of Indian roadways are Suzuki, Tata, Mahindra, Toyota, Hyundai and Honda. I told him the US also has its fair share of Hondas and Hyundai’s. The US does have nearly as many motorbikes as I have seen here. The biggest difference between these two nations in terms of motoring is the gearbox, or transmission. In the US the majority of the cars are automatic. In India like many other countries manual gearboxes are the norm. It’s fascinating here in Bangalore, as manual transmissions are generally not very conducive to traffic.
We also talked our families. The driver mentioned how proud he was of his two children, both engineers. He asked if my parents were worried that I was so far away. I told him that I keep in contact with them regularly though WhatsApp.
From family we shifted our conversation to politics. The driver gave me a primer on Indian politics. He remind me that Prime Minister is Narendra Modi. I told him that Modi was coming to the US very soon for a meeting with President Trump. We also discussed differences in our currencies. I told him about the uniformity in color and size of US dollars. We also discussed the value of our currencies. I informed him that one US dollar is equivalent 64.5 Indian Rupees. I gave the driver a dollar that I had on hand as a gesture of goodwill.
As the cab pulled up to the science museum, I thanked the driver for his conversation and company. As we went our separate ways I thought about how appreciative I was for the opportunity to talk with a complete stranger and discuss various small topics such as traffic, cars, family that we all can relate to no matter where we live. These topics that we can all relate strengthen the common bonds of humanity. This conversation with the driver only reinforced my belief that people no matter where they reside are more similar than they might think.
Pictured LtoR Lavanya, Anant N.,Anant A., Lawrence, Josh, Gabby, Raisa and Chitra
It’s hard to that I have been in India a little over a month now. It’s been a whirlwind of an experience working with Shahi. The first weeks have been spending time familiarizing with the interworking of Shahi. We have been exposed to the entire process of making garments. After watching the process I can proudly say anyone who believes the garment industry is a low-skilled industry, clearly has not tried any of the various tasks required to make a garment! Shahi in partnership with Ministry of Textiles provides training to people interested in joining the garment industry. The training last for a little longer than a month, afterward the trainees graduate to Shahi employees.
As I mentioned in the previous post, Shahi is one of the largest garment companies in India! As a result Shahi has many factories, scattered across India. As interns we have been shown many of Shahi’s factories around Karanataka by Anant A., Chitra, and the rest of the Organizational Development (OD) team. Visiting the factories often feels like road trips for us. Between the Bengalore traffic and the distance between factories, I’m pretty sure that we Shahi interns must rank high on the most traveled interns. These journeys have provided me an opportunity to read books that have been on my reading list for a while now. It has been eye opening to see the differentiation between both neighborhoods in Bangalore, and differentiation between city life and bucolic life.
OD and me
As CASI interns we have been placed under the guidance of the OD team. Chitra heads Shahi’s OD team for South India. Words can’t convey how valuable she has been in acclimating us to Shahi. After spending a few weeks learning the ropes, I have decided to focus my energy on a few areas, developing a marketing strategy for OD, conducting research on some of Shahi’s longest serving employees and working on a curriculum framework for Shahi’s daycare centers (crèche) with my fellow intern Raisa.
I chose these specific projects because they allow me to both challenge myself with new tasks and allow me to utilize skills I have learned from Penn. Both the marketing plan and research will use skills I have learned at Penn. As a bonus it gives me the opportunity skills I have learned in my marketing classes. I’m really excited about the opportunity use these, as I know my heart and mind is set on pursuing a path in law, rather than business. The crèche project will challenge me most. It’s actually one of the reasons I was most excited about joining Shahi this summer. I know the vital role that education plays in early childhood development. Every child deserves the best opportunity for success, and that starts with daycare. Shahi’s crèche facilitates must provide the foundation for education for thousands of children. I will lean on the assistance of OD, my fellow interns and educators here in India and back in the US to make the best contribution to crèche that I can. I look forward to updating my progress in future posts.
This week marks the fifth of my time in India, and it’s crazy both to think about how long I’ve been here and how long I have left to go. The past five weeks have been filled with Indian food, intense heat, and learning lots about SPS and the interconnectedness of their various programs. A standard day consists of daal with rice and roti twice a day combined with various side dishes including potatoes and okra.
Getting used to a savory breakfast has been one of the most difficult parts as noodles or spicy stews have typically always occupied dinner territory in my mind. This past weekend we took the two-hour drive to Indore, the closest big city, to pick up some American snacks to complement our meals here and watch Wonder Woman. Surprisingly the about fifteen words in Hindi I know meant I could understand Sameer’s plea of dhyanavad (thank you) to the guard while driving Steve Trevor into the estate. Afterward, our friends at SPS took us to a food market nearby and convinced Kameron and me to try pani puri, which consists of hollowed-out dough pockets filled with potatoes and spicy tamarind water. When you buy six, they don’t all come out at once. You’re given a metal bowl and you wait near the cart as the vendor hands one each to everyone waiting like a spicy shot. After overcoming the initial spiciness, I gladly participated and tried not to think about how furious my stomach would be the next day (surprisingly it was alright).
Kameron and I have developed quite a routine for dealing with the numerous pests that get into our room. We have fortunately passed the three days in a row when a mouse visited and agilely was able to get basically everywhere in our room. Our squeegee to clean the bathroom floor became our greatest weapon as we climbed on chairs, threw shoes, and devised plans to get the mouse outside. We have thus far seen two severed geckos, only one of which was able to survive. This particular situation required me to tie a scarf over my mouth and gingerly lift up the severed tail of the battered gecko who had seen the wrong side of our cooler fan with a piece of cardboard to deposit it outside where nature does its own disposal. There seems to be an infinite number of bugs in our room at all times from the infestation of flying termites two weeks ago that wormed their way through our mosquito net after shedding their wings to the crickets that seem to apparate away the minute we get close to the ants, the bigger ants, and the biggest ants that exponentially increase in difficulty to kill. This doesn’t even count the tiny bugs that constantly end up in our bed no matter how many times we shake out our sheets at night. Regardless, the bottom of our shoes are almost permanently stained with bug carcasses and I have used nearly every item I brought here to bring down a bug at this point.
I’ve begun work on my main project that I’ll be working on while I’m here which consists of documenting the effect of an SPS program that provides night shelters for chicken farmers. I go out to villages nearby with my supervisor/interpreter and an SPS employee that knows the village well to speak to families involved in the program to see the effect it has had on their livelihood. I have memorized a short little spiel in Hindi introducing myself, saying my name and that I’m a student from the US. It’s usually immediately followed by their laughter and a repetition with more accurate pronunciation from a native speaker, but it does break the ice and make the situation of talking about their lives to a clear outsider less awkward. I’m excited to continue learning about the Adivasi people of India and all the work that SPS is doing to ensure their livelihoods and empowerment.
What can someone do in 10 minutes?
Run from Leidy to DRL?
Sleep a little more after slamming the snooze button?
At the Aravind Eye Hospital branch located in Puducherry, India, 10 minutes is enough time to perform a cataract surgery.
After reading the articles and case studies about Aravind, I was dumbfounded with how simple yet incredible the hospital system was. Dr. Venkataswamy (known as Dr. V) earned his degree in ophthalmology and following his retirement in 1976, he had one goal: eliminate needless blindness in India. Today, Aravind has come a long way since starting out as an 11 bed hospital. To put into perspective the scope of Dr. V’s achievement, as of 2012, the Aravind Eye Hospitals have collectively treated 32 millions patients and performed 4 million eye surgeries. .
My co-intern Maggie and I were dropped off by our tut-tut driver at 7 am in front of a pathway lined by floral shrubbery that led to a pastel-blue colored building. Exhausted as I was from traveling overnight and being lost for 2 hours afterwards, I was still filled with excitement as I was finally going to be involved in something so inspiring to me. A few hours later, we listened attentively as someone gave us a brief tour of the hospital and some of the unique aspects of it that intertwined with spirituality and the principles of service.
In the days that followed, I had the opportunity to meet with several of the doctors including Dr. Venkatesh, the head chief medical officer, Dr. Kavitha, Dr. Swati, and several others who were incredibly sweet and welcoming. I was ecstatic when I realized how easy it was for me to enter an operating room and observe the different types of surgeries. Eye surgery in the operating room is a lot calmer than I expected — I was naively disappointed it wasn’t a real-life simulation of Grey’s Anatomy or House. In contrast, I felt a sense of calmness as I entered the room and observed the cyclic process that Aravind is famed for.
We have three stages of the cycle
Stage 1: A surgeon performs eye surgery on Bed #1 as nurses escort another patient and prep them on Bed #2, which sometimes is not more than 5 feet apart.
Stage 2: The surgeon finishes operating on Patient #1 and walks over to Bed #2 to immediately begins surgery. Half the nurses usher to Bed #1 to wrap the eye and escort Patient #1 out while the other half of nurses are trained to assist the surgeon.
Stage 3: A new patient, Patient #3 is escorted to the empty bed (#1) to be prepped for surgery. And then the cycle repeats once the surgeon is finished with Patient #2.
The purpose of this cycle is to maximize time efficiency while maintaining surgery efficacy. This goes on for hours, and by the end of the day, countless of surgeries are performed, and countless of people’s visions are improved. Today, I casually timed a cataract surgery that involved breaking up the cataract with a device/technique called Phaco and the replacement of the lense. Everything was so fluid, from the transition from one patient to the next to the surgery itself. It took 6 minutes and 43 seconds to perform the surgery. Less than 10 minutes. As I looked down at my own hands, wondering if they would ever be steady enough to perform such a meticulous surgery, I was overwhelmed with questions about the system and reflection about my own reasons for following a pre-med path.
After about a week, we were briefed very quickly about potential projects that we may be assigned to during our stay here. My first project sounded simple enough: create materials for the counselors to use in the glaucoma clinic so that the information passed on to the patients and circulated through the new influx of counselors is completely standardized. This ensures that the information is accurate and dispersed equally to all patients.
Easier said than done.
Although the surgeons themselves are highly skilled and perform surgeries at an unbelievable pace, the work pace for us interns is slow. I have noticed that I must advocate for my project and what I need in order to get the information and guidance that is required. There are barriers that I didn’t think would cause me much of a problem like the Tamil language and even self-motivation. It is different than how I have experienced other job opportunities in the U.S because I expect most things to be plainly laid out in front of me. Instead, here I am forced to utilize my social skills (haha) to shyly ask the doctors for help and blindly create the materials that I hope will be sufficient. As I Skyped with my sister and her boyfriend, Dan, we talked about how it may be difficult for me to adjust to this pace because of how trained I was to Penn’s environment prior to coming here. At school, I am constantly under the strain that I do not have enough time, that I have too many things to do. My schedule is jammed with studying, extracurriculars, and work that I barely have time for myself. Penn has forced the impression on me that I have to do things quickly in order to get anything done. To some extent, this is true, as seen by the highly skilled doctors at Aravind, but I also think that doing things so fast does not allow time for reflection, thought, or purpose. The unfamiliar downtime I have here is something that I am not used to, which I fill with many reflections that I have not necessarily had time for before (incredulous as it sounds).
Everything is work in progress here, from my current project and my future ones, to my own personal growth. Perhaps as I become more familiar with the environment, more comfortable with the workers and vice versa, my path will be clearer.
Until next time!
Sitting on the terrace looking at the beautiful mountain view of the Araku Valley, breathing in the fresh air and seeing the swaths of children running around during their summer vacation, I know that I made the correct decision in accepting this internship.
A fellow CASI intern and I arrived at the Delhi airport via Lufthansa airlines around 1 AM IST on May 20, 2017, and we were both wide awake. Despite our plan to stay awake on our flight to best adapt to the time difference, we both made the mistake of sleeping a majority of the way. Wide-eyed, we made our way through customs and baggage claim before being greeted by drivers holding signs with our names on them.
We arrived at India’s Habit Centre, the gorgeous hotel that would be our home for the next three nights. Since we were unable to sleep, we started planning our next day’s adventures as we wanted to take in as much of Delhi as possible before starting our respective internships.
After two fun days in Delhi, all of the interns headed to a modern clothing store where an ice-cream social had been organized by the Penn Club of Delhi and UPIASI, the CASI affiliate in Delhi. There we met Delhi Penn students both past and future. It was great hearing their experiences and being able to see the differences and similarities between my Penn experience and theirs.
Early the next morning, my co-intern Gabriela—or Gabs as she prefers to be called—and I made our way to the Delhi airport to fly to our new home for the next 10 weeks, the Araku Valley.
We flew into Visakhapatnam, or Vizag as it is commonly referred. There we were met by our driver Santosh, who took us to meet a man from whom we would learn lots of information from, David Hogg. Over the next three days, Hogg, the Chief Agricultural Advisor for Naandi, would depict the ins-and-outs of Naandi and the specific Coffee Farmer project that was centered in the Araku Valley.
In addition to learning about the projects and coffee agriculture and what Naandi does, we learned of how there are seven mandals or sections that house thousands of coffee farmers who all work with Naandi to produce their increasingly popular Araku coffee, which recently opened up its first store in Paris, France.
This first week has been a whirlwind of sunscreen and insect repellant, hikes to different fields of coffee and mangoes (lots and lots of mangoes), sitting in lecture-style sessions to learn of the inner workings of the Coffee project, meeting and interacting with different farmers and their families, and taking in the natural beauty that is the Araku Valley.
Before starting my internship, I must admit that I was not fully clear on what it was that the organization does, especially in the Araku Valley region. Since coming, I now know that the larger organization has a slew of different projects that help promote the advancement of different in-need populations individuals. These projects include meal programs, girls’ education, water purity, and, where Gabs and I will spend most of our time, a coffee farmer project.
The original purpose of the coffee project was to provide farmers in the Araku region with a better means of income while utilizing the land and resources available to them. Naandi came in and showed the farmers how to properly raise coffee, a crop that was originally planted in India by the government, and taught them how to grow the red cherries needed to produce the best coffee. By teaching the farmers, they have gained the proper skills to take their income into their own hands, which in itself can be considered a success.
The exact project that Gabriela and I are to work on is still somewhat in the air, yet we do know that we are going to be completing some form of socio-economic research to analyze the impact of the increased income received by farmers, especially as it relates to nutrition and cultural norms.
I look forward to seeing what is in store for the remaining nine-weeks of my internship!
I have been wearing the same pants and t-shirt for some days now (of course washing them every night), and I am pretty sure my fellow interns may think I have packed nothing but food on my 50 pound-bag. After my flight to Zurich got delayed 24 hours, and after spending one whole day roaming around the airport like Tom Hanks, I finally arrived to Delhi one day later than expected. I was already excited, looking at the nice Indian decoration in the airport, and as weird as it sounds, I was even happy about the impossibility of charging my phone in one of the Indian outlets (I forgot to buy an adaptor). After a long day of worries, I was finally here. Little did I know that my happiness and relaxation were premature. My bags were taking an unusually longer time to show up in the baggage pick up area… And they never showed up. They had never made it to Delhi!
It was even more difficult because my partner -Taylor- and I were going to fly to Visakhapatnam – our internship site- the next day. After complaining in the airline office and making sure that my bags were going to be send to Visak, I got a traveler’s bag and was off to the exit.
That first day in India went by very quickly. I spent it in Delhi doing some sightseeing with all the interns and getting some clothes.
We went to the Red Fort and the market near it, where I was able to feel the intense heat, see the chaotic street vendors, and admire the colorful saris. After spending the whole day running store from store, bargaining with vendors and seeing monkeys walking casually around the streets, it was time for the Ice Cream social. I got the Upenn special (some red and blue ice cream) and met some people who had been recently accepted to Penn. It was nice to answer questions that I myself wish had been answered when I was a Baby Quake. We played some board games, and I was able to better know some interns. My hotel roommate, Jody, turned out to be a wonderful person, while Kameron ended up being a great “connect 4” player (I beat her though).
I wish I could have had more time to spend with my fellow interns and to acclimatize to India, but our flight to Visak was at 3 am that next day! I was running on adrenaline and excitement. On the plane, I was already looking forward for our first day at our organization.
When we landed and walked to the exit, there was already a friendly face waiting for the people for Naandi Foundation. His name was Santosh, and he was driving a 4×4.
He took us to a hotel in the city to meet David Hodd, who turned out to be our guide for the first week at our internship site -Araku Valley. Located 4 hours away from Visak, Araku Valley was a wonderful sight. Hills of green, yellow plantations and red soil followed us along our trip. I should admit that when I saw the town where we were living, I felt relieved. My coordinator hadn’t explained that it was an active little town where many things were available (I was half expecting a secluded village). To top it off, we arrived to the place where we were staying: a 3 floored-apartment building. It had electricity, battery-powered lights in case of power shut downs, running water, and the most amazing thing: a western bathroom! Again, I had prepared myself mentally and physically for the humblest accommodations, but seeing that they were better than expected made me feel that it was going to be easier to adapt. I was going to stay with Taylor in the second floor, and we would have access to the kitchen at the 3rd floor (which to my surprise, had a brand new fridge).Click to view slideshow.
That same day we went to the office to meet the rest of the team. We met Prakash, Satish and Venkat, who in the later assignments of the week became our go- to people. They were all working in offices located in a big house, that not only had a room for guests with a clean bathroom, but also a well equipped kitchen where the mandatory evening chai tea was to be prepared.
This first week was meant for us to dive into Naandi’s history and activities. Naandi is a much bigger NGO than I expected, and it has wonderful programs dedicated to improve the livelihoods of the tribal communities in the Araku region- the Adivasis. David took us to the Coffee Processing Unit – CPU for short- a complex where Naandi processes the coffee that is procured from the Adivasis’ villages. With a red truck, Naandi goes to every village in the Araku region, collects the best coffee cherries, and brings them to the CPU to be separated, pealed, dried and cleaned. There is big machinery available and a well-established production chain. While David explain every site within the CPU, I could notice that it had every part of a sustainable system I had learned in class. The recycling of water in tanks, the purification of water to avoid eutrophication of rivers, the processing of manure, the manure-powered kitchen, and the organic garden, it all seemed as an annex from my Environmental Science book.
Later that week, David, Prakash and Satish gave Taylor and I an extensive lecture on Naandi’s many projects. We learned that the coffee project is not only about the procurement of coffe, but also about the training of farmers, provision of special compost, provision of seeds and saplings and close examination of plantations. Naandi has also developed a program to provide education to young girls called Nanhi Khali, together with a water management program to make safe water available to Adivasis.
To complement our knowledge about our organization, we went to field trips to Adivasis villages. We visited 2 villages with David and Venkat, where we were able to see the huge coffee plantations in the surrounding hills. David had a chance to explain the biodynamic approach Naandi takes with the coffee plantations; relying on the knowledge that plants are all interconnected, Naandi promotes a natural compost made of leaves that nurture not only the coffee plants, but also all the organisms that participate in the plant’s nutrition – fungi, smaller plants, shade trees. It was a concept I have never heard before, which had seemed to work for the Adivasis farmers. Walking down to the village, we had our first encounter with the tribal people, who seemed very welcoming and interested in us. Women wore traditional clothing, with golden nose rings and colorful saris, while the men wore skirt-like pants, which we learned made farming easier.
By the end of the week, we met Vinod, who was in charge of the CPU production and had a gift for coffee processing (David claimed that Vinod’s palate had been so extensively trained that now he was able to tell if a coffee bean was properly dried only by chewing on it). Also, by the end of the week, I received my baggage! Santosh, who is proving to be such a funny man as days go by, picked them up from the airport and brought them to me. I can change clothes now, and maybe convince the team that I have more clothes than the same blue pants and white shirt I have been wearing so far…
During my application and interview process with CASI, our program coordinator, Aparna, encouraged me to do some research on Aravind. She told me there were a number of online resources like case studies and presentations on the NGO. I ended up watching a 23-minute video on YouTube entitled “Infinite Vision: The Story of Aravind Eye Hospital” and skimming through a couple recent news articles. Both source types recited statistics about the initiative’s history, growth, and success that I’ll get to discussing below.
As I read up on South India’s most prestigious eye center in the comfort of my campus apartment half a world away, I was certainly impressed that to learn that an 11-bed clinic in 1976 had since expanded to a network of hospitals which see several thousand patients each day. But I now know I did not grasp the breadth nor importance of Aravind’s work until a few months and four plane rides later, observing the present-day operations on the ground. Here’s what I can tell you.
Founded in 1976 by their beloved Dr. Venkataswamy (amicably referred to as Dr. V), Aravind’s mission is to eliminate needless blindness. I’m a bit ashamed to admit, as a health and societies major, that prior to researching the organization I wasn’t even aware blindness was a major health issue in India. 39 million are blind worldwide, and 12 million within India alone. Of the 12 million cases in India, 80% fall into the “needless” category—that is, the debilitating condition is preventable or treatable. To combat these colossal numbers, Aravind provides eye care to the people of India.
What makes Dr. V’s initiative so special? The patients themselves decide how much to pay for their treatment. About half of the surgeries done are free or at a heavily subsidized rate. The money made from other half, who pay market price for their care, sustains those who are financially strained. And the people who can pay market price choose Aravind as they provide the best ophthalmology services in the area.
The cost-cutting measures Aravind takes has allowed this system to survive over 40 years. The hospital network produces its own lenses for cataract surgery, their primary operation, at its partner manufacturing center Aurolab. Their surgeons receive a modest pay that is comparable to what they could make at a government hospital (though many could opt for a much higher salary in private practice). Further, Aravind ophthalmologists do nearly 4 times as many operations per year than their counterparts in other parts of India and neighboring countries, meaning the cost-per-surgery with respect to the price of the surgeon’s time is much lower.
But eliminating needless blindness cannot be achieved if all suffering people are expected to seek treatment themselves. Among rural Indian populations live many of the patients who require free care. They don’t often have the resources to a) know Aravind exists and will provide free treatment and b) get to an Aravind clinic. Dr. V recognized this necessity to find patients rather than complacently wait for the blind population of 12 million to come to Aravind by their own means. This brings me to an integral part of achieving Aravind’s mission: eye camps.
The hospital reaches rural areas of Tamil Nadu though eye camps. I’ll continue piecing together the puzzle that is understanding Aravind’s expansive system when I get the opportunity to observe a camp myself within the next couple weeks. A blog post entitled “Interworking of Aravind” would be incomplete without a camp description, so I have but a working description on the interworking of Aravind for the time being.
It’s been three weeks now since I landed at the Indira Gandhi International Airport on May 20th. I arrived with two of my Shahi co-interns, Josh and Gabby (Lawrence had already arrived on a different flight earlier that morning). During the cab ride from the airport to the Habitat Centre, I remember being filled with excitement, exhaustion, and an overwhelming amount of scenery to take in from the early morning streets of Delhi.
Before I continue, I should probably introduce myself! My name is Zeba Raisa Shah, but I prefer to be called by my middle name, Raisa. I am a rising junior at Penn studying Political Science, concentrating in International Relations, and minoring in Spanish. I was born in Bangladesh – for those who are not familiar, that’s a tiny country in South Asia, just east of India also bordering Myanmar. I moved to the United States in October, 2006 with my mom, dad and brother; I was nine years old at the time. Living in Albuquerque, New Mexico (random, I know), it was almost too easy embracing the different sides of my identity as a Bengali Muslim immigrant. I was privileged enough to attend a school that genuinely embraced diversity and over the past ten years, my family has settled into New Mexico as if we were always there. It wasn’t until I arrived at Penn that many other parts of my identity started to become more salient and I struggled to navigate this Ivy League university as a first generation student, a low income student, an Asian American, and a young woman. These identities have become integral parts of my college experience and I can’t imagine being myself without engaging with them both on campus and off.
Now that we’ve established who I am, let me explain how I ended up in India this summer! I came to India through Penn’s Center for Advanced Study of India (CASI) internship program. I am working at the Operational Development (OD) department of Shahi Exports, India’s largest readymade garment exporter. The purpose of OD is to improve worker welfare while still maximizing company productivity. I became interested in this particular internship due to its women’s empowerment aspect. The garment industry has revolutionized the lives of millions of women in South Asia by employing unskilled labor. Given my Bangladeshi background, where the industry is even larger than India, I already had a little bit of familiarity to some of the challenges that this industry faces. The OD department at Shahi has many programs to empower women through leadership, education, and soft skills training.
Each intern at Shahi is working on a specific project of their interest as well as collaborating on some other projects. I, for example, am particularly interested in the migrant workers that come to Bangalore for work and leave their families behind. A huge percentage of Shahi workers come from other parts of India such as Odisha, Bihar, Jharkhand, etc. Not only do they face language barriers, they also have to adjust to the hectic urban life of Bangalore. Shahi has partnered with an NGO called Janodaya to provide hostels for these migrant workers. I plan to look into these hostels and work to create a model hostel standard that can be used in the future by Shahi to ensure quality living conditions. Furthermore, I want to work to design some language classes that can help alleviate the language barriers that the migrant workers face. Lastly, I’ll be working with Lawrence to design a standard curriculum for the workers’ children that use Shahi’s childcare facilities, while incorporating nutrition education and information for both the children and their mothers.
I’ll get into more details of my projects in future blogs, as well as more about my unique experiences in India, but that’s all for now!
“Go with the flow.” That was the advice I was given prior to shipping myself halfway around the world to the Aravind Eye Hospital in Madurai, India. My first question at Aravind was “Where is the flow?” The hospital was like a river basin where all of the “flow” made its way to settle in a pool and come to a rest. I thought this as I squeezed through lines of people standing to register for an appointment and walked past teams of families sitting in waiting areas. Some patients were too busy holding their place in their flow to notice a lanky Caucasian guy walk past, but many others studied me silently as I passed.
We were being given a tour of the hospital’s Out Patient Block. Soon enough, however, I was already lost. I recall my 6th grade project to model a cell as an object; I chose a factory as my model. In actuality I should have chosen an Aravind Eye Hospital. Different floors subdivided different divisions of eye disease which were further split into vesicles of patient counseling, refractory testing, prescription distribution, and laser eye surgery. Large monitors bounced registry information back and forth and young women technicians kindly ushered placated patients up and down corridors to where they needed to be. The hospital was an organism with many moving parts, each self-sufficient but also interdependent. But not all parts moved as shown by the motionless waiting rooms. There was a juxtaposition of action as those who were needed worked tirelessly and constantly and those waiting to be needed were motionless but ready.
I began to see the flow and it had me on edge. Aravind was dedicated to ending needless blindness through high quality care. It took as many patients as possible, regardless of background, to give them the greatest gift possible, their sight. In their mission Aravind was a teacup filling itself, and the kettle was all of India. The hospital balanced precariously on the very edge of perfection to keep the cup perfectly filled as the flow added was compensated by cost-cutting efficiency to keep the same flow going out. I watched a doctor suction the nucleus of a cataract lens out of a patient, insert a foldable new lens, prep the patient to leave, then turn to an adjacent bed for another waiting patient for the same procedure. He did this all day.
We shortly received our projects: conceptually easy tasks. Mine was to revamp a resource website, “Vision2020 e-Resource”. It is a database of management techniques that Aravind has amassed over the years. The hope is that no other hospital need face the same development challenges Aravind faced or, “remake the wheel” so to speak. Nearly everything is archived, from structuring a large tertiary care hospital like the one I toured, to planning outreach programs for surrounding villages. All I have to do is make the website easier to use. However, I soon realized that even the smallest changes to the website would have me climbing through layers of time-consuming tasks. I will have to spend time on the website to determine its deficiencies, present them to other consultants, restructure the page, inform the Information Technology Team of the needed changes, quality check the implementations, then develop a long-term protocol for maintaining the website.
The way they manage work flow is different here. All consultants dedicate themselves to their jobs from Monday to Saturday. For me meeting other consultants is difficult because each is performing their specific task for Aravind. They’re often occupied completing another assignment or off at a conference, caught up in their own flow. Under these conditions it is a challenge to begin the long train of tasks that I must complete by the end of the summer. There are often times when I get stuck sitting at my desk, waiting for the next assignment, because all the people I was meant to meet were indispensable. It is times like these where I remember the flow, the different pace that India follows, and the specific task each person is assigned. I’m reminded of the many moving and non-moving parts in this organism and of the small role I play in this massive cell.
As I zip up my suitcase—filled with Chacos, a jar of peanut butter, and excitement for the impending summer—the realization that tomorrow morning I am heading to India for ten-weeks finally sets in. A mere two weeks ago, I was a college sophomore anxiously awaiting the end of another school year so that my summer journey could begin, and now it is about to start!
The journey to my IIP-CASI internship began a year-and-a-half ago during the spring break of my freshman year. Through the amazing department of the Fox Leadership program located at Penn, I participated in a cultural immersion trip to India headed by Penn professor Dr. Femida Handy. Through this trip, where we visited the cities of Bangalore and Mysore in the southern Indian state of Karnataka, I felt a large sense of personal growth and development through an exposure to the juxtaposition that India offers—the poorest of the poor contrasted with “India shining.” This trip was not only eye-opening, but also left me desiring to see and do more. I learned so much about myself during a 10-day period that I immediately found myself desiring to travel back to India and to see more that this beautiful and extremely diverse country has to offer.
In the fall of my sophomore year, I attended an IIP information meeting, where I learned that not only was my dream of returning to India an option, but it was more possible than ever! That night, following the hour-long session, I spent countless hours searching through the CASI and IIP websites, former student blogs, and researching different organizations that I felt best suited my interests. After I wrapped up my last final in chilly December, I immediately hunkered down and began filling out the applications to two different CASI programs.
Flash forward to early March. I receive an email stating that the CASI program runners had reviewed my application and saw me fitting well into a program other than those that I initially interviewed for, and were reaching out to me to see if I would still be interested in going through the application process. I must admit that I was extremely hesitant. Would this new possible internship fit into what I hoped gain from the summer ahead, a summer in which I wanted to challenge myself in new ways amongst a new culture and unique group of individuals. The answer would be an unwavering yes. From the moment I looked at Naandi’s website and read their mission statement, I knew that interning for this organization would give me the foundation to further explore my interests both academically and personally.
When I received the congratulations email from CASI, I was beyond excited! In that moment, with a sentiment that still holds true today, I gained an overwhelming sense of excitement. My head started to swim with hundreds of ideas and images for what I could and would do starting in late May.
My trip preparations likely differed to some extent from other students participating in international internships. I am a member of the varsity volleyball team here at the University of Pennsylvania, and I suffered from and recently received surgery for a torn labrum in my shoulder. Thus, my biggest concern for this summer was that I will have access to the means necessary for me to continue strengthening and conditioning my shoulder so that come the fall season, I am back playing the sport that I love. To make proper accommodations, when peering inside my suitcase, one will find that some of the “supplies” that I brought involve a jump rope, agility ladder, and a weighted medicine ball.
As I sit and look at my packed up bags, I start to daydream about my long hot days in the beautiful Araku Valley region and cannot help but think that in less than twenty-four hours, these daydreams will be my new reality.
Hello readers! My name is Jodi Marcus and I am an Urban Studies major in the College of Arts and Sciences, Class of 2018. I am originally from Los Angeles, CA. This summer I am working in New Delhi at Leap Skills Academy, a skill development startup that aims to bridge the gap between students and industry.
I can’t pinpoint exactly where my fascination began, but I have pretty much always been drawn to India. The colors, detailed art, flavorful food, lively music and other thrills of Indian culture have always seemed like the perfect antidote for the feelings of monotony I associate with my life in the U.S. Of course, it is an embarrassing cliche— an unfulfilled Westerner’s Eat Pray Love style romanticization of a mysterious country across seas—but it has been my reality. I have always yearned to break out of my routines, to be shocked, scared, excited and thrilled for as much of my day as possible.
I have spent hours day-dreaming about a happier, more at-peace version of myself, covered in henna climbing tall mountains and speaking to beautiful strangers in saris. I have pictured a me who is more stimulated, confident, and excited about the world.
After glorifying India for so many years, it feels pretty damn weird to be here. I have built up such high expectations of India, and of my life in India, that it can be hard for me to take my experiences at face value and appreciate India for who she is, scabs and all. For all the wonders as glorious as I could have imagined, there are realities just as neutral and just as unsettling.
For all the adventures I have had and will have, I am still primarily living my life in a pretty standard routine. I go to work from 10:30-7, eat dinner, get home exhausted (the heat really takes its toll), try to get some things done before I crash for the night, and then wake up and do it again. While each day brings its own challenges and excitements, when all is added up, I spend most of my hours sitting in front of a computer in an office. Even in India, life must go on.
There are times I have felt deep confusion and sadness. For example, about a week or so into my stay, I went shopping for work clothes at Janpath market. I briefly stopped to look at an outfit from a woman who had set up shop on the sidewalk. When she told me the price of the outfit, I lost interest and moved on. The woman then followed me down the street for over 10 minutes, shouting lower and lower prices, even touching me and grabbing my shirt to try to get my attention. What started at $28 ended up being offered for $1.50.
Yes, we could talk about how this woman was prepared to severely rip me off or that she probably shouldn’t have been following/touching me, but more importantly, the incident gave me insight into the extent of her desperation. Here I was with a generous stipend from a fancy university, trying to ignore a woman who was willing to stalk me for $1.50. I think of the little boy I met whose genitals were exposed through a gaping hole in his dirty pants or of the hundreds of dogs lying in piles of dirt, sick and covered in fleas. And yet all I know how to do is continue walking and try not to feel like a bad person for not having the answers. The cognitive dissonance is hard to shake off.
I have felt extremely claustrophobic because of unwelcome stares, wishing I were invisible at times because I feel taken advantage of just by existing. I have become hyperaware of people looking at me and can feel the sexualized undertones creeping over my skin, a sensation that is blatant to me but frustratingly not as obvious to other people around me. I have learned to look down so that I don’t have to confront my discomfort, and while this method works, I feel upset that the boundaries of my gaze are now dictated by others.
And yet, even through India’s (literal and metaphorical) haze, the beauty and liveliness of this country is astounding. The art, colors and patterns are absolutely incredible. Even the trucks are painted in beautiful designs!
How rad is this truck!!!
Walking through the market places, I am continuously in shock at how beautiful and meticulously crafted everything is. No matter how many embroidered kurtas and dangly earrings I see, I seriously can’t get over it. We visited the palace of mirrors at Amber fort in Jaipur and I was literally squealing with joy, overtaken by the textures and craftsmanship.
Amber Fort, Jaipur
Me in the INCREDIBLE palace of mirrors at Amber Fort. This picture doesn’t do it justice
I love the sneaky smile the shop-owners get when I call them out on trying to rip me off, the laughter we share because we both know that bargaining is actually just a really fun game. And then there’s the confused but exhilarated feeling I get when I see cows walking through lanes of traffic like its their backyard, the excitement I feel towards the cities’ relative symbiosis with animals and nature. I have felt so appreciative of my coworkers who come to our table every day to ask how we are and I am almost equally grateful to the samosa guys near work who sell me my favorite Indian snack for a mere 30 cents.
A cow surrounded by monkeys and a pig. Killing it.
I have now been here for almost three weeks. For the times I have felt let down, there have been twice as many times where my expectations have been met and surpassed. I look forward to updating you all on my adventures to come!