CASI Student Blog
Please note that this blog post is to be the third entry in my blog series!
Wow how time flies! Nearly four weeks have passed since the start of my internship with Naandi, and what an experience it has been.
Naandi assigned my co-intern and I our first project: to conduct an ethnography evaluating how an increased income, as the result of partnering with Naandi, has changed different socioeconomic factors of Adivasi farmers’ lives in two specific villages.
Based off of this statement, one might have a few questions. (1) What in the world is Naandi? (2) What is an Adivasi? (3) How are farmers increasing their income? (4) How are you researching this?
Let me start by explaining Naandi. Naandi is a non-profit organization headquartered in Banjara Hills, Hyderabad, Telangana in southern India. Naandi, partnered with several major companies such as car manufacturing Mahindra-Mahindra and yogurt producing Dannon, heads several initiatives all across India to help disadvantaged demographics, such as the girl child, young adults, and, where I am spending my summer, the Adivasi, or tribal, farmer.
These farmers historically faced extreme financial burdens and were in a stagnant mindset where the only thoughts occurring were how to make it to the next day. Mentioned in my previous blog, Naandi partners with farmers and villages throughout seven mandals (districts), and together the two produce and manufacture coffee. Farmers receive all the necessary supplies and teachings from Naandi, procure the coffee, and sell their best coffee cherries to Naandi, who then buys the coffee at the highest market price from farmers. This method has resulted in farmers receiving an increased income, which is where our research comes into play.
First, we conducted preliminary research to learn more about tribal communities and their lifestyle, as well as to see how an increased income has historically impacted traditional communities. Then, we created a series of verbal and observed questions that we sought to answer, canvasing topics from hygiene and cultural norms to financial literacy.
After creating the types of questions to ask, the next step was to determine who the questions would be asked to. In order to get what was perceived to be the most representative response, it was determined that the best people to interview would be those who had received the most “average” income in their respective villages. Calculations were performed to determine who these farming families would be. Then, the interview process commenced.
Throughout the past three weeks, we visited the two aforementioned villages and, through extensive conversations, gathered our information. At every conversation, we were met with numerous warm, genuine farmers and their families. In these villages, we talked with groups both large and small and conducted our interviews as two-way conversations. The villagers were extremely interested in the two young foreigners who had travelled thousands of miles to meet with them; all conversations proved to be not only informative but also extremely enjoyable! Questions of family, food and traditions occurred for hours and the farmers spoke of how they were so happy to meet with us and expressed an interest in or lives as much as we were interested in learning about their lives.
After analyzing the interviews and experiences in both villages, my co-intern and I created a preliminary report and at the moment are preparing to take a train ride to Hyderabad to present to the heads of the organization!
Of the villagers that we are meeting, I must admit that my favorite individuals have been the young children that we meet. These children, so joyful and curious, are often the first to smile at us as we enter their villages and follow us around to see what exciting activities we may be up to! Every time I meet and interact with one of these young children, I cannot help but be reminded that all language barriers can be crossed with a smile, and that these children, with dreams to explore the world, are our future. I perennially feel blessed for the opportunity that I have this summer and cannot wait to see what comes next.
learning about the coffee process
Some of Naandi’s cows
Until I started my internship, I was not aware of the massive scale of the gold industry in India. The company I worked at, MMTC-PAMP, takes raw impure gold dore, refines it to purity, and sells it to vendors and individuals in the Indian market. During my internship, I examined the global nature of the gold industry and pondered on why the metal is so powerful today, especially in India.
An aspect of the gold industry that initially caught my curiosity was how people have gone through great lengths to acquire the yellow metal. Today, it’s not as if gold is simply dug up from the ground; gold mining, and mining in general, is one of the most resource intensive and environmentally destructive industrial activities, as it releases toxic compounds into the air and water, is heavily dependent on fossil fuels, causes damage to the landscape around the mine, and require a large amount of water . In turn, the gold mining process contributes to natural habitat destruction, global warming, societal and cultural displacement, and risks to human health.
However, in today’ model of global supply chains, I think that the end consumer often remains oblivious to the process by which their commodities are created, and the demand for a product is not greatly shaped by its material consequences. Since there are few mines in India, India gets most of its raw gold from abroad, and even despite the harmful consequences of gold production, gold is one of India’s largest imports. The skyrocketing demand for gold from Indian consumers – an average of 895 tons per year from 2009 to 2014, or 26% of the global annual demand, according to the World Gold Council, is a main contributor to the country’s current account deficit, where imports heavily exceed exports .
Talking to people at my company, I learned more about the cultural importance of gold, a key driver of its demand. In Indian weddings, gold jewelry is given as a gift to the bride, and similarly to the marital context, gold also holds significance in the context of religion, as gifting gold is popular during the Hindu festivals of Akshaya Tritya and Diwali. While MMTC-PAMP primarily sells gold bars and ingots, it also sells minted products and coins with designs, many of which reflect the religious importance of gold.
Aside from its ornamental and gifting value, gold in India has also served as a form of currency and financial security, which is a large contributor to the importance of purity for Indian consumers. According to a Federation of Indian Chambers of Commerce & Industry study, almost 77 per cent of respondents cited that gold was a safe investment . Unlike ornamental value, where design matters, the financial value of gold is based almost solely on its purity and quality. During my risk management project, my co-intern Nick and I analyzed the probability-adjusted cost of risk events for each step of the production line, from the moment the gold dore is received from abroad, to the various products the company sells. Although it took a while to adjust to the commute to the company’s gold refinery in Nuh, Haryana, which is located 2 hours away from Delhi, visiting the refinery, along with working in the corporate office, highlighted the meticulous steps that the company takes to ensure the of the purity and quality of the gold it produces.
The idea of investing in physical gold, as opposed to investing in a savings account, or other type of financial instrument, was new to me, but it opened my eyes to the fact that the global financial system has yet to offer its “benefits” to everyone on earth. Gold is not simply a commodity here, but a financial asset for many households. Although my internship focused primarily on analyzing the internal business model, I also found myself learning about the gold in a broader social and economic context. And sometimes, the best things learned are unexpected.
Last week we visited a school that Shahi has partnered with as part of their Corporate Social Responsibility. Shahi provides this school, and several others, with sports equipment, computers, science labs, and other valued resources for children. Part of our visit involved a ceremony of sorts, in which the program was explained in detail and important figures were recognized amongst both parties. As interns, we often receive tangential praise simply for being a part of Shahi, even if we have had relatively little exposure to the initiative at hand. Roses are gifted with lasting applauses as our names are announced in the same breath as the heads of departments and school principals. This attention can feel uncomfortable at times. While it is always well intentioned, and incredibly gracious, I can’t help but feel undeserving.
School officials asked our intern group if we would say something to the room full of students and teachers. In similar, past visits, I remained silent. But I realized that I was sitting up on the stage, receiving praise for a program that provides students with the tools to aspire to high level universities, to skilled professions like doctors, lawyers, teachers, scientists, engineers. And here I was, a student at a high level university, applying to law school, and I was sitting silent, receiving undeserved recognition. Was this really the model to aspire to?
I am a self-proclaimed introvert. Speaking to a large room, in an unfamiliar environment, with limited language capabilities, and limited experience with the program being discussed, would intimidate anyone. But as a more reserved, “shy,” person the expectation that you’ll say anything diminishes even more. My co-interns looked absolutely shocked when I stood up. But that’s partially why I felt so inclined to speak.
Sure, it was a bit nerve wracking. I think the kids could sense that when I walked to the front of the stage, because they broke out into laughter. But a couple words in, and I found my genuine thoughts and feelings about the program overcome those nerves. I forgot about who might judge me, and what could go wrong, and I just spoke because I felt it was a message that should be heard.
To the students I am from a noted University in the United States working at a large company. I am what they’re often told to aspire to. But standing there in front of them, I was just a young woman, speaking to a large room, in an unfamiliar environment, with limited language abilities and limited experiences. One day, sooner rather than later, they might find themselves in a similar situation. Feeling out of place, a little judged, in a new, unfamiliar place. It might not feel natural, or of extreme comfort to “speak up.” But I wanted them to see that the level of confidence, and assurance, and success, that they are told to achieve, is a constant work in progress. Unfortunately, for reasons simply because of the country, class, or skin color they were born into, there will be more barriers placed in front of them. There will be plenty of people, institutions, and regulations that attempt to restrict their growth. But that should never deter them. Who they are, and what others perceive as flaws or weaknesses, should only motivate them further.
Although on a smaller scale, this is something I always try to keep in mind. People who can’t appreciate differences in personalities, upbringings, character molds, origins, try to tear others down. But there is no better way to combat judgment and criticism than by continuing to be you, and using those distinctions to your advantage.
I can’t believe it’s come to an end. 10 weeks felt like 4 weeks. My feeling right now is a mixture of anxiety that I may not finish my project and of pride to have done something meaningful in life. The irony is that the more I approach the end, the better I understand what I should do, and the more I see ways to get things done faster. Now, each hour of my time here is more expensive, and I try my best to make it worthy. I wish I had the same feeling from the first week of the internship, that moment when I looked at my calendar and thought I had immense time to explore everything. Nonetheless, I am very happy to have been at Aravind and in India.
During the last week, my focus has been on making more progress on my project. I met with my supervisors, talked to patients, and built on the feedback I keep receiving. An important aspect of growth I learned from Aravind is the importance of feedback. I believe this is one of the things that keeps the institution moving forward. Every week, they have regular meetings where different staff members present about ongoing projects, in presence of directors. The whole purpose of these meetings is to ensure everything is on the right track and keep everyone updated on what’s happening. During this week, I also presented about my experience. My presentation included my achievements, my failures or challenges, and the lessons I learned (more on this in my next post). Anyway, it was nice to hear the “good luck” wish from the executive director of LAICO (Lions Aravind Institute of Community Ophthalmology) and “thank you” from staff members at the end of the presentation. Now, I am clarifying my last input into the project before I hand it over to Aravind, and I hope my introductory work will be a good basis for future improvements on patient education.
In addition, I did what most people do a few days before a flight: laundry, packing, saying thank you to those I lived and/or worked with, etc. This is the time when you realize the importance of everything and what everyone meant to you. My roommate and I are planning dinners and semi-parties, just to make our last days at Aravind and in India more memorable and maybe longer. But the countdown timer is still on. Our flight on this coming Saturday is quickly approaching. There is nothing we can do at this point to stop it. We just need to get ourselves ready to go back to our old lives. At least, it’s been quite an experience that marked our lives. Over the next few weeks after I leave India, I will meditate on my entire summer experience, comparing my expectations before the internship and what I found. Did I get all I wanted? Is there anything I missed? Is there anything I would do differently if I were to go back in time? What will my first summer in college contribute to my future career? My educated guess tells me that my next blog’s title might be “I learned more than I gave back,” or something similar. And I do believe learning was my priority in any case.
A few pictures from our last days at Aravind and in Madurai.
When I first came to India, I was aiming to evolve and improve myself for the better. I wanted to develop a change in my perspective on the world and begin appreciating the significant things more after my time here. And although 10 weeks isn’t a short period of time, it isn’t necessarily that long either. The answer to the question of whether or not my mentality and perspective has changed since coming here still remains a mystery. Perhaps, it will be answered in the future, or I didn’t even change that much from my first trip abroad. But what I do know for a fact is that I’ve gone through experiences and adventures that I never would’ve expected to have had before.
I’ll never forget about the first few weeks of my stay here. The temperature was over 100 degrees everyday and walking from one block to the next would make me sweat buckets.
I’ll never forget about the time when I traveled to Jaipur with several other CASI interns, and we were able to travel to the monkey temple, a scene that was filmed in Planet Earth II. Peanuts were available near the location to feed the dozens of monkeys in the area, and the monkeys would slowly come up to you to grab the peanuts from your hands.
I’ll never forget about the journeys in the 12 hour overnight buses without a bathroom. They sound horrible, but they were worth it in the end. One of the trips was to a mountain, where we hiked up and were 9000 feet in the air. I literally stood among the clouds.
I’ll never forget about the beautiful appearance of the Taj Mahal. With its exquisite features and bountiful history, it had really earned its title as one of the 7 wonders of the world.
I’ll never forget about going to see a performance right by the border between India and Pakistan. The crowd of thousands of people cheering and being prideful of their country could be one of the most exhilarating atmospheres that exists in this world.
I’ll never forget about the many people that I’ve encountered here who have expanded my horizons. This includes the people that I met while we were staying at a hostel who were traveling from all around the globe, as well as the awesome co-workers in the office that I was able to bond and become friends with.
And lastly, I’ll never forget about my two great co-interns, Hari and Jodi. From our daily interactions in the office and at home to our late night introspective conversations about the meaning of life. I wouldn’t have expected to get along so well with two people that I hadn’t heard of before this internship to the point where they considered me to be their “son” because I was the youngest one amongst us.
There are some moments which we never forget in our lifetimes. The beautiful places that we see, the amazing people that we become acquainted with. However, these moments usually only last for a brief amount of time. They coincidentally happen to be on the same path that we’re on so that we cross paths. And many times, it’s sad to say goodbye to these things because change isn’t always good. But it isn’t necessarily always bad either. The fact that I was able to have all of these experiences and opportunities to meet all of these people will always be a part of who I am. Without me realizing it, everything that has happened to me here will become a memory that has affected me in some way in creating the person that I will be. One thing I know for sure is that the adventures I’ve had in this new world will become a part of the stories that I’ll share with others in the future.
Interning at Aravind has been an honor for me, and it is such an inspirational place. However, my experience is not only about being inspired. It is also about helping Aravind accomplish its mission: “to eliminate needless blindness” through completing my assignment as a project student. When I started my internship nine weeks ago, I chose to focus on patient education. The project was intended to improve patients’ knowledge and management of eye health, and raise awareness about what to expect at Aravind. I noticed that I have been providing very limited details about my project. So, let me share about my project.
Here are the topics that I worked on: Aravind locations and facilities; spectacles; diabetes affecting the eye; glaucoma. The deliverables for the project will be videos and posters to be displayed on different screens inside the hospital. Below, I briefly elaborate on each topic.
- Aravind locations and facilities
Many people, including patients, do not know everything that Aravind has to offer. This impedes service delivery to those in need of care. Aravind has multiple locations for eye hospitals, community eye clinics, and vision centers. Within the eye hospitals are optical and medical shops, general medicine, radiology and chemotherapy departments, prosthetic eye clinic, labs, contact lenses clinic, eye banks, meditation rooms, restaurants, etc. The objective of the project was to clarify where each facility is found and/or its main use.
It is important to educate patients about how to choose the right pair of spectacles and how to properly take care of their spectacles. For example, some patients find wearing spectacles very uncomfortable because they chose oversized spectacles. Other patients’ lenses have accumulated many scratches as a result of improper cleaning methods. Although opticians educate patients on proper eye care, miscommunication or misunderstanding can occur. And so, patients should be warned about the possible challenges and be more educated about spectacles so they can make more informed decisions.
- Diabetes affects the eye.
At one point, India was described as the capital for diabetes. The sad reality is that diabetes affects more than 62 million Indians, which is more than 7% of the adult population. While many patients are aware of diabetes, they usually ignore the worst of its symptoms: diabetes is not limited to high levels of blood glucose. It actually impairs other organs such as the brain, heart, kidneys, teeth, organs, eyes, etc. In particular, diabetic patients’ eyes are at risk of Diabetic Retinopathy. The devil of diabetic retinopathy is that it’s progressive and is only symptomatic in late stage when the loss of vision is irreversible. Thus, a yearly eye examination is recommended to all diabetic patients to track the DR in its early stage.
Notoriously known as a sneaky thief of sight, glaucoma is an eye condition where the optic nerve is damaged due to an increase in intraocular pressure. Glaucoma’s surname derives from the fact that the disease is asymptomatic until vision loss occurs. Unfortunately, it cannot be cured, but only controlled if detected early enough. In addition, glaucoma is hereditary and more prevalent in adult populations. An annual eye checkup is highly recommended for patients who are over 40.
In a nutshell, these are the main messages that Aravind wishes to convey through videos and e-posters. My focus has been to define the scope and content for each subject, as that should be the first step to making sure the right messages are conveyed. This process involves consulting doctors and other specialists in the concerned departments in addition to talking to counselors and sisters (see my previous blog) who are constantly in touch with patients. Last, and probably most importantly, I talked to a few patients to gather their perspective and figure out their understanding of eye health, since this project is aimed at ultimately helping patients.
One billion. Your brain can’t even imagine one billion things at once- the number becomes abstract in its sheer magnitude.
India has over one billion residents.
Sitting in a seminar about tobacco control interventions, successfully causing cessation in 1% of smokers sounds small, nonsignificant. But when India has over 100 million smokers, helping “just” 1% means helping 10 million people. (That’s more people than live in all of New York City)
Public health research has an entirely different context here and entirely new issues to work around. For researchers at PHFI, publication is less important. They are not concerned if the journals they publish in are high profile and are far more invested in clinical results. It is a stark contrast to research mindsets in America, where having one’s paper in Nature or Science is considered the ultimate achievement. As one speaker puts it at the 2nd Annual NCD Consultation- “It’s about health improvement, not CV improvement”.
At PHFI, I am working towards developing resources for diabetes education, but any classroom activities conceived cannot involve any additional materials. Rural schools do not have access to the art supplies, wifi and computers, etc. that many American teachers rely on for effective lesson plans.
More so, because of the immense cultural diversity that exists in India advocating a healthy diet means completely different things in different parts of India— our resources must account for this. North Indians eat paranthas for breakfast, where south Indians
eat idli, vada, and sambhar.
I experienced the range of diversity myself on a visit to Bangalore. The last weeks made me comfortable in North India: I became used to calling drivers “bhaiya”, walking in 100 degree plus weather, beggars knocking on your window attempting to sell you balloons. Even trips to Jaipur felt similar- a pinker, more history focused version of a city I was used to.
But now, the signs around me were no longer in familiar English or Hindi- in fact, English was much more of a language asset than Hindi was. Going to a typical South Indian restaurant, I felt completely out of my depth as the waiter kept placing unfamiliar food on my banana leaf plate.
One billion people means one billion individuals. Logically, I knew that people spoke hundreds of languages in India, that each state was a cultural hub of its own. But regional differences in India extend far beyond how you pronounce “coffee” and what you refer to soda as.
Whenever I pictured India, I have always envisioned Delhi- it was the only India I ever knew. Now, working on national diabetes interventions or researching about adolescent health problems in Assam, I have begun to view India as a nation rather than a singular city.
I watched my first Bollywood movie when I was 8. Only ancient movies were available on that cheap bus that was taking me north of Lima to see my grandparents. After looking at the scratched CD’s for “Tiburón” (or “Jaws”) and “Misión imposible” (ok, that may be an easy one), the hostess decided to put the very last movie everyone was expecting: “Billu, the barber”, with Spanish subtitles.
It was love at first sight.
I fell in love with the pressing need of the director to include a song every 5 minutes, of course accompanied with the energetic group-choreography, the continuous outfit change and the rhythmic melody. I fell in love with the tragic story of two friends who had been separated as children, and who had come together after many years; one of them, once poor, now a rich actor, and the other one, a barber like his father. I fell in love with Shahrukh Khan’s acting (yes sir), his great ability to make me cry with his tears and make me laugh with his chuckles. But mostly, I fell in love with that country where everything took place, where film’s songs run in everyone’s bloodstream, and where film’s scenes are engraved in everyone’s memory. That night, while everyone slept, I dreamt.
I became an avid Bollywood fan. I watched all of Shahrukh Khan’s movies, then discovered Aamir Khaan, Shahid Kappoor, Ranbir Kapoor, Kajole, Deepika Priyanka, Sidhart Malhotra… Now, being in the land where Bollywood started, I am amazed by how movies are the unifying factor of mother India.
It was in Hyderabad that I started to come with this realization. I had been looking forward to go to Hyderabad since the beginning. And now, that we had completed the first part of our assignment, we got to go to the city that is catching more and more people’s attention throughout India and the world. To make it the best experience, rather than a plane ticket, Naandi decided to book a train ticket for us.
After checking in our hotel, we were ready to go see Naandi’s main offices. I was able to see a little bit of Hyderabad on our drive there; I saw the construction of a new metro system, Pizza Huts, KFC’s, Hardrocks, and big malls with Tommy Hilfiger’s advertisements on their front walls. As big as the Tommy Hilfiger ad of Gigi Hadid was, it was not the main attraction. The biggest ad was that of actress Deepika Padukone and Ranbir Kapoor holding an Oppo phone. Again, Bollywood ruled the city.
But it was another instance where Bollywood demonstrated to be well within the Indian DNA: when Taylor and I visited the Mahindra Pride School. While meeting the voice behind the phone, our coordinator Anupama, she told us that she had scheduled a visit to a center that was part of Naandi’s education branch – a Mahindra Pride school (MPS). These schools are intensive training centers where disadvantaged youths who have graduated the university develop specific skills to be able to acquire a job. Young men and women- who come from farmer’s villages, slams or poor sides of the city- have English classes, Math lessons, strengthening personality sessions, and work on their computational abilities, all this in 90 days and for free.
Like its name suggests, these schools which are starting to expand across India, are strongly supported by Mahindra – a big Indian company which provides Naandi with funding. Mahindra’s ample business network provides job openings and guarantees that these pride schools get 100% employment rate. This means that every youth who completes the program gets hired and is able to sustain themselves and their family.
The manager of the MPS we went to had arranged two classrooms to be free during our visit. She expected us to have a chat with the students, to tell them about our experience in India so far. Later she explained to us that all she wanted was the students to have an encounter with foreigners so that they were used to make conversation with everybody. But for me, it was much more than that.
When I entered the classroom, I was welcomed by a myriad of curious eyes and rhythmic clapping. There were about 40 properly-dressed students, who were eager to hear the words I had to say. As of me, I was wordless. I had talked to young children before, told them about my story, about how I got to Penn, about who I am. It was easy to teach young children, who had lived less than I had, and who could definitely learn from my “wisdom”. But I felt that these youths in front of me knew more about life than I did, that somehow those eyes that looked straight at me were older than they seemed. This feeling proved to be right, when, after introducing myself, I asked them to tell me their stories; student after student told about how they were forced to provide for the family after their fathers had died, about how they had to live with other friends in small apartments because their families had stayed on the farms waiting for money to be send, and about how they had never wore oxford shoes before; they told about how their dream was to work “in those big skyscrapers in the center of the city” so that they would be able to send their little siblings to school.
They had been dealt a rough hand in life, and I felt that they should be teaching me, rather than me teaching them.
However, I remembered that I hadn’t been dealt such an easy hand in life either. I told them my story. I told about how my grandfather was a farmer too, and about how my dad had to work extremely hard to leave the farm and acquire higher education. I told about how we lived in a little province in Peru, and how my parents decided to move to the capital to give their children a better education. I told about how my parents had taught me that sacrifice, perseverance and effort is all success required. I told about how it was my grandfather’s words – that night where he told me how he had built his house with his own hands- that had motivated me to go beyond what everyone expected. I told about how I had filled my college applications with no help except that of my mom’s power milkshakes. I told about how my non-English speaking mom was the best counsellor in the world, how she knew the names of every American university as a product of her late nights doing research. I told about how I got a scholarship. And I told about being a Latina second-generation student in Upenn.
I told them that if I could do it, they could do it as well.
The students seemed motivated, but not fully. And then I remembered that next to English, movies were also an official language in India. Maybe the most official one.
So I started telling my story using ‘films’ language. I told them that just like in “3 idiots”, my mama had taught me that studying is not only for the sake of passing grades, but for the sake of knowing and being passionate about what we do. About how I had learned that being a woman doesn’t mean limitations, but means strength, just like “Dangaal” showed. I told them that family support, as showed in ‘Kuch Kuch Kota Hai’ is important, but willingness and strength of mind is even more important. I told them that they should value their roots and their culture; that they should where they came from so that they know where they are going, just like ‘Billu, the Barber’ had showed me.
The youths seemed amazed. I was speaking in the same language, and they understood. Thanks to Bollywood.
That day I left my mark in those students, and they left a mark on me. I left my grandparents and parents’ words on them, so that they could linger, grow and germinate. I think back and I realize that maybe, the universe wanted the Jaws and Mission Impossible CD’s to be scratched, that I was meant to meet Shahrukh Khan and Kajole, and that world of color and flavor behind it, that I was supposed to learn another language so that someday, I would use it for best.
And I did. Used it for best.
I became acutely aware of my reluctance to negotiate in everyday situations one day as I was waiting on an Uber for 20 minutes on my way to work. I often opted for Uber over going to the street to call an autorickshaw, or tuk-tuk, to avoid haggling for the price, and any miscommunication about my destination. Last semester, I took Negotiations in Wharton, and while my peers evaluated me as one of the most skilled for distributive negotiations, which includes traditional bargaining, I didn’t find myself wanting to negotiate for the price of a rickshaw ride in India.
Growing up, I remember watching my parents adeptly negotiate for things like furniture, but when I tried bargaining, even at the flea market, I felt clueless at first. Haggling for prices is a skill that I think many people from “Western” countries do not develop in everyday life; the existence of price tags eliminates a need to bargain, yet in many parts of the world, people still bargain.
However, for me, bargaining with my auto driver includes another level of unsureness – I am an extremely economically privileged person from one of the most economically powerful countries in the world. When I bargain for a rickshaw ride, it’s usually over a few dozen rupees, which is a few cents. These few cents, quite frankly, are worth more to him than me. But this shouldn’t be act of charity, either; I’m not trying to be a “benevolent” rich person and donate my cents to him. Should I try to follow cultural norms of bargaining? People see me and hear my American accent and know that I am willing to pay more. Although at first I felt a sense of injustice that I was being “ripped off as a foreigner,” I also am reminded of the sheer irony of the situation, as systemic injustices have disproportionally “ripped off” the economically marginalized.
The emergence of Uber and Ola into the Indian market has created competition for autorickshaw drivers as Uber and Ola tend to be less regulated than autorickshaws; for example, autorickshaws in Delhi are required to use CNG, or compressed natural gas, for fuel, which is more expensive than diesel. Additionally, Uber’s business model focuses on gaining as much market share as possible through increased demand and rock-bottom pricing – sometimes, I find that I end up paying similar amounts for Uber and a rickshaw. Uber drivers, who enter the job with guarantees of a stable income, have found themselves making not only little profit, but also in deep debt due to the capital cost of their vehicle, as well as cost of fuel. On an early-morning journey to the airport, our Uber driver pulled over and asked us to stop the ride and start a new one because he had to meet a certain quota to receive a bonus. Despite our language barrier, I could tell that this bonus was very important to him.
Throughout my time in Delhi, I have reflected more on my position of economic privilege and ability to bargain. I have haggled for the price of hotel rooms and boathouse stays, yet bargaining for a rickshaw is more uncomfortable for me. Perhaps I have opted more for Uber, rather than rickshaws, not to avoid a logistical inconvenience, but rather an ethical dilemma. Although sometimes I feel that I am overanalyzing the situation, I know that taking time to think critically about the context of negotiations is important, especially in a different cultural setting.
June 18, 2017
There is an argument in Evolutionary Psychology that humor exists as encryption-decryption process. Being able to understand humor implies a similarity between individuals. The underlying idea is that there is some culture-specific implicit knowledge or “key”; without which, only surface meaning can be interpreted.
I am adjusting to life in India, but this ever-elusive key still escapes me.
As I pay the foreigner fee at tourist attractions or the auto drivers tell me the fare to work is 50 rupees (even after I’ve been paying 40 for three weeks), this dichotomy frustrates me. I am ripped off like any other American, but when the Ola driver or delivery-man need to discuss anything, I expected to act like the Indian I look like.
But contradictions more than anything seem like the norm here. Dirt, pothole- ridden roads lie below gleaming tech buildings. No one spares a glance at men holding hands, but same-sex marriage is taboo. People will argue on the streets for a difference in 10 rupees, and argue with their friends later that day for the honor of paying the 10,000 rupee bill. Beautiful, historical palaces lie in polluted water. Everyone constantly seems to be in a rush on the streets, yet no one ever is on time. Admittedly, I am victim to the IST phenomena as well.
The streets outside PHFI are bustling with activity- cars speeding by, often almost running us over. The noises of the street are a direct contrast to our office environment, where is largely quiet. The AC hums in the background, and light conversation can be sometimes heard, but it is nothing compared to the whirlwind six floors below us.
One thing that is simple, immutable: India’s love and passion for cricket.
The India-Pakistan final was yesterday, and the build-up to it was crazy to watch. Border patrol officers on TV interviews claimed we’d undoubtedly win- as we always have. WhatsApp forwards made light of the match’s scheduling on Father’s day, laughing that India’s “son”, Pakistan would lose to its father.
This confidence is something ever-present here: drivers assuredly getting lost, trying to convince you that this is indeed your location (It wasn’t, we were 45 minutes late to dinner), fellow passengers claiming that the station was actually Jaipur (it wasn’t, if another intern hadn’t messaged us right then, Nancy and I would have completely skipped our destination).
And disappointingly enough, India lost the match as well. But witnessing the hordes of strangers gathered around screens set up the streets, a city of millions (almost) quiet as they united to watch a cricket match, I experienced a part of India I never have before. Indians love their country-quirks and all.
To my co-intern Quan Quan, whom I promised a well-deserved shout out. So few of my memories with Quan Quan are outside of India (as of now), and so few of my memories in India are without Quan Quan. As I reflect on my time in this country, separating the two is nearly impossible.
To our countless unfortunate, unglamorous adventures which likely won’t be the first ones to surface when asked “how was India?”, beginning with our confusion as we took our first steps in Pondicherry nonetheless:
Much to our surprise, the bus from Madurai had not dropped us off outside Aravind as we were told. It was 5:00 am. We proceeded to “Aravind Guest House”, which we now know is a remote, beach-area guest house in the complete opposite direction of Aravind Eye Hospital. It just coincidentally shares the same name as the clinic. 500 rupees later, the desk boy at this Aravind guest house (who we had no choice but to awaken at the then-ungodly hour) informed our tired, sweaty, desperate souls that indeed we did not have a 10-week reservation at their establishment. Alas, we trudged on to a main road about a quarter mile away with every belonging we had brought with us overseas. Another rickshaw. More communication issues with the driver about Aravind Eye Hospital. Finally, a call back from someone at Aravind to Quan Quan’s ancient Nokia phone, someone who could clear things up with the driver in Tamil (as much as one can with the Nokia’s questionable sound quality). 500 more rupees shelled out, and we had arrived at Aravind at last. We wandered aimlessly around the hospital campus grounds until we gathered enough strange looks as foreigners with large luggage for the right person to notice. Approximately two and a half hours after getting off the bus, we entered our new home for the next ten weeks. Anger and frustration had left us speechless, but in the heat (literally) of the moment we did not direct it on each other. We soundly slept.
To the looks we have shared being pushed around like sardines on the public bus:
Panicked glances, like when google maps revealed we were headed in the opposite direction of our scheduled surfing lesson to which we were already running late.
And other times, looks indicating we were both at ease, laughing at the comedy of the language barrier as the woman next to us addressed us in Tamil as if we were natives and had known each other for years.
To the bickering, not unlike the way my sisters and I poke and prod at each other, which made me feel a little closer to home:
Quan Quan picked out the pomegranate Olivia and I had been eyeing all day from the fruit bowl. She brought it to the housekeeper, Malika, to cut up. Malika returned, bringing the pomegranate in a single bowl and setting it in front of Quan Quan as Olivia and I watched, wide-eyed with envy. Quan Quan smiled matter-of-factly. Olivia and I threw up our arms, jeering, “Why do you the pomegranate! That was for all of us!” as Quan Quan defended herself, “Well I was the one who picked it out and brought it to her!” Malika, innocent and alarmed and not knowing much English, had no issue interpreting our immaturity. “Madame! Madame! I will cut another, no problem!” she said, settling us down.
And the numerous spats that resulted from only having each other to validate our recollections—“How do you NOT remember how much we paid the driver of the fifth rickshaw we took two weekends ago!!!”
In fact, our bickering is the reason for this very composition. Having introduced me in her own blog, Quan Quan felt simply BETRAYED I hadn’t done the same.
On a more serious note, to the support that not all co-interns may give, or even need to give, each other throughout their temporary employments:
Navigating the workplace across the world brought a new challenge every day. In the peak of my dilemma of trying to get a Stata package (see previous post), Quan Quan must have heard me vent about it at least twice daily, in one way or another. She offered tips and listened to me without ever complaining that I sounded like a broken record.
When it felt like our projects were moving at a rate slower than the line at Allegro Pizza on a Saturday night, I would have surely gone insane without the comedic relief she never failed to provide.
Interning so far from home also meant being immersed in a new culture outside of the professional realm. Some norms were perplexing to our western-born minds, but I couldn’t have asked for a better, more open-minded person to discuss with and help me wrap my head around new ideas.
I began this post by saying separating my time with Quan Quan and experience in India would be nearly impossible. But it’s more than that. It’s like trying to take the chili powder out of a nice tomato chutney— not only would it be extremely difficult to do, but no one in her right mind would want to remove the vital flavor from the dish in the first place.
I’m not sure why, but I have always found comfort in anonymity. In the U.S., I enjoy blending into my surroundings, just one person in a sea of others, each a little different but overall just another small piece of a much larger landscape. Maybe it is the introvert in me, but I have never been one to enjoy being the center of attention.
As a result, I am always thinking about how to fit in, trying my best to carry myself in a way that doesn’t warrant any extra attention. In India, I have found it nearly impossible to do this, to fade into the background like I have always done. No matter where I am, I am always thinking about what I’m wearing, how I move and talk and act…
Is this shirt too American-looking? Am I taking too long to cross the road? Am I acting touristy? Is my backpack weird? Am I talking too loudly? Was that gesture I just made impolite? Why are people looking at me? Do I look lost? Am I lost?
…a host of questions whirring through my head at high speed all at once, no matter where I am.
It can be overwhelming to be thinking about so much all the time, but I find the sensation of sticking out to be much worse. Perhaps the fewer stares I get walking through the city or sitting in a restaurant or wandering through a store, the more I feel like I belong in a place so different from where I have lived my whole life.
However, I know deep inside that I can never fully fit in here, no matter how hard I try. I might be able to change my behavior, but I can never change how I look or sound. And I can never fully understand a culture I was not born and raised in. I still need come to terms with this, I think. It takes time to accept the fact that there are places where some people might inherently never be able to feel like they belong.
This struggle to fade into the background has given me a lot of perspective on how some people around the world feel every day of their lives. I’m privileged to not experience this same struggle at home. In the United States, I am able to sink into the background when everyday countless others live their whole lives in fear that they will be scorned, attacked, or hurt for acting differently or having the wrong skin color.
I keep this in mind as I finding myself getting lost in my thoughts, trying to figure out how to modify my behavior and appearance to fit the surroundings. I have found myself the happiest when I am not trying so hard to blend in. Coming to terms with the fact that I might never fully be able to do so, and reminding myself that what I’m facing is trivial compared to the struggle of others, has allowed me to let go a little bit.
One Saturday evening, a friend from the area decides to take us to a local venue where people our age go to dance and spend time with friends. At first I am nervous, worried that I would feel like an outsider. But to my surprise, as we arrive, I find myself once again fading into a sea of people, a crowded space filled with laughing and singing and dancing and music that’s a bit too loud. I felt comfortable, at ease, even. I don’t think I felt this way because I looked and acted like everyone else (which certainly wasn’t the case), but because for the first time in a while, I let myself let go of obsessing over fitting in. And that night, if even for a moment, it felt like I really did belong.
As my main project with Aravind’s eye bank wraps up, I think it’s time I blog about it. I have been hesitant to write about my actual work at the hospital because throughout much of my time working on the eye bank study, I was frustrated with my progress (or seemingly lack there of). While I have been having a valuable learning experience seeing the groundwork of a health initiative not unlike those I have studied in my courses at Penn, I felt like I myself was not giving back anything meaningful to the hospital.
Let me back up.
Aravind Pondicherry has an eye bank within its hospital which collects corneal donations from a few sources: volunteer organizations, other hospitals, and trained Aravind doctors who do home retrievals themselves. Upon acquiring these donations, eye bank specialists evaluate the donation quality and determine if there are any surgeries for which it may be used. Those tissues suitable for surgery are then stored until an appropriate recipient is available. Those which are not suitable for surgery or whose storage time is exhausted are typically used for research and training. All records of donations as of May 2017 were done with pen and paper and stored in carefully labeled binders.
After I arrived on May 25th and told the hospital about my statistical background, my supervisors proposed I work with the eye bank. They explained to me how, as of then, they hadn’t considered any data about the eye donations, but they suspected there were potentially avoidable gaps in the number of tissues approved for surgery and the number actual used for surgery. In other words, perhaps the utilization rate of cornea donations could be improved, but without the data there was no way of knowing.
This all sounded exciting to me—delving into the different parameters which could be affecting utilization. The possible pertinent factors were the cause of donor death, the difference in time of death and enucleation (eye removal), difference in enucleation and preservation, duration of preservation before surgery, age of the donor, sex of the donor, which organization collected the donor tissue…this list goes on. I was ready to get to work on the data set.
That is, until I learned the data set didn’t exist. And because Aravind Pondicherry doesn’t have a statistics department, even if the data did exist I wouldn’t have had access to the Stata package I would’ve needed to begin analysis anyway. Alas, it seemed like a minor roadblock. Two weeks of manual data entry loomed ahead of me, but I hoped during that time the hospital would be able to secure Stata software for me to use once finished.
I’ll spare you the details, but essentially what I had thought would take me 12 work days to enter (working 6 days a week) ended up taking nearly 4 weeks due to some miscommunication. Further, once I finally finished the tedious task of entering all the donor information in the spreadsheet, I found out obtaining Stata was, in fact, a problem (despite initially being assured otherwise). It would be impossible to install the expensive software in Pondicherry for free, and it would be useless after I left because no one here is familiar with the language. It would be a wasted investment for the cost-conscious eye hospital.
I felt like I had just spent the past month doing perhaps the worst part of data work— the entry, a mindless task anyone could complete— only to be told I wouldn’t be able to participate in the analysis which I had looked forward to the most. My data set would just have to be sent off the Madurai statistics team.
When I met with my supervisor to show him the final excel file, we decided it would be best to additionally use Madurai’s eye bank data before giving it to a statistician there to investigate. I knew it would be better to have more observations, but I couldn’t help but wonder who in the main tertiary care center would sit down and do the painfully slow data entry I had done? Who would take on that task, given there was no one here in Pondicherry to do it before I came? I feared the excel file I had slaved over (okay fine, the work wasn’t laborious, but it did nearly bore me to tears and was very time consuming) would be emailed to Madurai, only to gather digital dust in someone’s inbox.
As I began woefully putting together a formal research proposal to send with my data, the thought occurred to me that the person who would receive the half-finished data set might be more compelled to see it completed if the numbers crunched so far were intriguing. I didn’t have Stata to do a preliminary analysis, but I did have R, a free program.
I am less familiar with the open source software, but with the reliable help of google.com I managed to come up with some (unconcise) code and interesting findings after all. The statistic which stuck out to me the most was that for the donations deemed suitable for surgery and never used, 70% did not have a donor blood sample collected. Because an operation cannot be completed without a blood sample, presumably the cause for the non-utilization was not the lack of waiting recipients, but rather the lack of serum availability. This indicates taking a blood sample is missing from the protocols of some of Aravind’s donation collectors. The next step would be determining what it would take to change those protocols so as to improve utilization rates.
When I showed the preliminary stats I found to my supervisor and the doctor I was working with in the cornea clinic before we sent the research proposal to the Madurai team, they were enthusiastic about the possibilities that lie ahead with the project. For the first time, four or five weeks in, I felt a sense of purpose in my work.
Since then, we’ve done a phone meeting with the manager of the eye bank in Madurai, and I am much more confident this research will continue after I leave. It took a while before I felt I was making any progress here, but truth be told it wasn’t all bad along the way. Throughout my weeks in front of my computer and 600 donor records, as gloomy as the featured picture looks, the women who worked in the eye bank gave me something to look forward to when I went in every day. Not only did they retrieve the records I required, translate the papers written only in Tamil, and clarify handwriting when needed, they kept me company. Without the data entry, I wouldn’t have those friendships.
Looking back, it’s easy to say I wish I hadn’t gotten so discouraged at times. I wish I could have avoided the miscommunication which resulted in more data entry time. I wish I hadn’t gotten so hung up on using Stata, and considered using R earlier. I’ve been lucky enough with my job doing data analysis at Penn that I haven’t needed to do large-scale entry before. But I realize that, as an undergraduate, this may not be the last time I’m tasked with it. Nevertheless, I now have the foresight to keep an open mind should I come face to face a 3-foot stack of handwritten records again.
A few weeks back I feel to the southern portion of India to spend the weekend with my fraternity big, Aaron, and his mom, Audrey, in Pondicherry. I left Delhi super excited to explore a new part of India with two of my best friends. Yes, both my friend and his mom are my best friends.
The flight was fairly easy to Chennai, but once there I needed to wait for Aaron and Audrey at the airport as their flight from Madurai was arriving a bit late. While waiting, I sat down next to another young girl in the baggage claim area. I could feel her watching over my shoulder as I was editing a photo of my friend and I on Instagram. She candidly asked me, “Is that your girl friend,” and I candidly responded, “Oh no, I’m gay.” She stared back at me with wide eyes and a slightly ajar mouth. She certainly was not used to hearing that type of characterization in a typical conversation. I quickly, remembered where I was when I saw the surprised reaction on her face and whispered, “Oh, sorry. Yeah I’m gay.” She answered back, stating, “Um oh okay,” and that was the end of our conversation and she quickly found a reason to get up from her seat. This experience set a few notions regarding Indian culture and global acceptability, in general, in perspective for me. Being so comfortable in my university environment at Penn, I truly had forgotten that there were still young people out in the world who were not totally comfortable with that topic. I feel both blessed that I am able to enjoy these liberties in America but also excited to change perspectives of others both inside and outside of India in regard to their notions on sexuality and acceptability.
The rest of the weekend with Aaron and his mom was an amazing time. Upon arrival we checked in to our hotel which was a restored French villa in the center of town. As I stepped out of my room at night to head downstairs for dinner I was immediately blinded by my own glasses. The change in humidity from my room to the outside air was so dramatic that my lenses were entirely clouded. The nights outside in Pondicherry were the most humid experiences I have had in life to date; luckily the fans and misters in the hotel dinner space kept us cool. I woke up the next day excited to visit the Ashram and have the yummy pizza I heard about there. I was fascinated by the structure and interested to learn a link between it and the hospital Audrey was doing work for in Madurai, as Aaron was able to make a connection between the spirituality at both the hospital and the religious space. We also managed to make it over to the Botanical Garden in Pondicherry which turned out to be not so well maintained but still was an interesting place to check out. Sadly, all of the jellyfish in the aquarium tank were dead.
When I got in the car to head back to the airport I was sad because I was leaving my two best friends but also excited to get back to Delhi to continue working on my risk analysis project.
Reflecting back on the first project I did at MMTC-PAMP, I feel accomplished and proud. My co-intern and I, Soomin, were assigned a project that focused on the analysis of over 200 operational risks at the firm. For this project we worked with two MMTC employees for approximately 5 weeks. The project began with us brainstorming probability proxies for all of the risks given to us, as we were planning to use these proxies in combination with the analysis of historical data, both internal and external to the firm, to generate concrete probability percentages for the likelihood of a risk event.
The project was both comprehensive and informative regarding the operations of MMTC-PAMP in all of its 17 departments and the gold market in India, in its entirety. We spent the bulk of the project extracting data from all the departments, visiting both the production plant and the PVC distribution centers multiple times to get the information we needed. We also sat with all of the divisions at the corporate office to extract the necessary past data from them. From this portion of the project, I learned the difficulty of an internal auditing process, as no portion of a company likes to be questioned about the mistakes they have made in the past.
After the data extraction portion, we created a comprehensive excel workbook that including information on the risks, their department, their controls, their data availability, and there historical probabilities. We then combined these probabilities with cost impact proxies for each risk to generate numeric values for each risk, allowing us and the management to quantify the incurred risk adjusted cost each department carries.
Overall from this portion of the internship, I learned the value of collaboration, flexibility, and drive to achieve an over-aching goal.
Transportation in India is quite flexible. I was charmed when I first saw tut-tuts on the road. With only three wheels, no doors, and a handlebar instead of a wheel as a steering device, I was dubious with how nimble and swift this type of vehicle could be; but behold, it even overtook motorcycles! Most of the roads here are jammed with motorcycles and people going both ways on a one-way street, paying little heed to the stop signs that are more of decoration rather than a mandated regulation.
And the buses.
There are really three types of buses that I’ve distinguished here: the local bus, the overnight sleeper bus, and the overnight seater bus. Surprisingly, several of my favorite memories and stories I like to recall come from my experience on a bus.
At prime time, the local buses in Pondicherry are packed. Body forms peak out of the window, obstructing the source of ventilation for those within. The inside of the bus is much hotter due to the amount of people crammed together, so I find myself being extra careful not to flick my sweat onto others. I tightly grasp a pole to steady my balance as the abrupt stops and turns of the well-traveled bumpy roads causes me to barrel into others.
Compared to 200 rupees in a tut-tut, is this 5 rupee bus ride worth it?
Heck yeah, it is!
In the beginning, stares, especially within such a small space like a bus, were inevitable; but I quickly found that the feeling of uneasiness would usually be replaced with amiable curiosity if I initiate a smile. My first time riding the bus, I was snugly fit between two women. The limited number of seats on the bus were certainly out of my reach with the locked position I was in, which was why I was so surprised when an older woman waved for me to sit. It amused me even further when other women around me enthusiastically followed her gesture. I politely declined and observed her offer the seat to smaller children and older women before taking it herself. I thought this was such a bizarre thing to do, as I was accustomed to the aggressive shouldering on Septa back in Philly. This offering of free seats has happened every single time I have been on a bus. Insignificant as it may seem, the openness of her actions alleviated some of my self-consciousness about being a foreigner, and encouraged me to reciprocate the friendliness.
Call me cheesy, but I am a sucker for small acts of kindness.
My second time riding the bus, a woman sitting beside me started rapidly speaking to me in Tamil. After many hand movements and laughter from both parties, I realized that she was asking me where I wanted to go. After communicating that I wanted to go to the bus stop in Pondicherry, she patted me on my lap, nodding and silently assured me that this was the correct bus. As we arrived at my destination, she held my hand and motioned for me to get off, even though I was fully aware that this was my stop.
Before my discovery of maps.me, I was in a constant state of fear of being lost. I severely lack any sense of direction, and without any service on my phone, I was at the mercy of my co-intern who traveled with me. A simple gesture of making sure I was on the right bus and getting off at the right stop made me feel so much safer and welcomed in a place where I knew I was constantly under scrutiny. I know that my co-interns prefer taking the bus because it’s so much cheaper than a rickshaw, but I also secretly enjoy the fleeting interactions I have with locals around me.
The local buses typically don’t have the option of air-conditioning, but if you do get the choice, ALWAYS CHOOSE AC OVER NON AC. The sleeper buses, on the other hand, offer more selection for your comfort. They are exactly as they sound: for long distances of +6 hours, passengers can sleep on twin or single beds as the bus drives overnight to its destinations.
*See photos below*
Is that intimate?
What’s really the worse case scenario?
Twin bed on a non-AC bus.
And guess who got the worse case scenario.
The first bus I ever took was on a non-AC sleeper bus in a twin bed with my co-intern that I had only known for not-very-long. The twin space had curtains that we could pull to cover outside disturbances as well as make our space even more intimately claustrophobic. The main problem was really the heat. It was too hot to keep the window closed, but it was also too disturbing to keep it open with the blaring noises from the roads and uncontrollable wind blasting our hair in whirling directions. As awful as this experience might sound, there were some good things that came out of it! For example, we knew after this experience that we (mostly Maggie because I had zero directional capabilities before I downloaded maps.me) are able to navigate Pondicherry even with our nonexistent Tamil skills; we will never pay 500 rupees for a 15 minute drive; we discovered Aravind is specifically in a place called Thavalakuppam, and we don’t always easily cry under pressure. It’s a story we love to tell people with some additional flare.
Now last weekend, Maggie and I took our first seater bus to Kodaikanal. And of course, the only type of bus available was non-AC.
Seater Bus Package to Kodaikanal Includes:
- 8 hours overnight in a seat
- 135 degrees seat incline so the person behind you can peer right down your scalp and assess when the last time you washed your hair was
- A wailing baby
If you’re from the U.S, think Megabus seat, but worse.
In truth, this is another story Maggie and I like to dramatically recount because it’s funny how little sleep and little personal space we really got in those 8 hours.
I certainly wasn’t expecting to write about something as mundane as buses, but as I thought about some of my comical experiences here in India, I realized that my times on these different buses facilitated many of these memorable events. The thought of riding an overnight bus was never on top of my “things to do in India” list, but in Hind’s sight, I’m glad I’ve had this experience.
Next weekend, Maggie and I are going to Kerala to meet up with our fellow interns from the LEAP program. The bus ride is listed as “8” hours.
Hopefully, it’s AC.
With only a few weeks remaining before my return home, I’m forced to think of what I love, and will miss about India. The food is amazing with spices and breads of all styles. Aravind is an eye-opening new image of healthcare. But these both pale in comparison of the adventures India offers me.
With a free day I can hop on a bus, travel into the mountains or down to the beach. I can view acres of tea plantations or aged stone temples, explore new restaurants, take photos, and then ride a different bus back home by nightfall. Each weekend I strive to leave and find something new that India can offer me, taking me across its hills, coasts, and country sides. Here are a few precious places I have found.Munnar
Most hill stations in India were built by the British to escape the heat and disease of the plains during the summer. This station, hidden in the crevice of the hills of Kerala, is cool, green and fresh. Thousands of acres of tea plantations span its hillsides, giving them a mottled, mossy texture. I traveled here with several British Medical students as they ventured further North.
Click to view slideshow. Pondicherry
Established as the headquarters of the French East India Company in 1674, this French inspired, tourist attracting city lies on the coast of the Indian Ocean. It offers a great variety of tourist attractions, however its previously beautiful coast has been steadily eroded away, requiring the creation of a rocky seawall. Of interest to me is the Aravind eye hospital just outside Pondi, one of the five (soon to be six) tertiary level Aravind Eye Hospitals at which our fellow interns Maggie and Quan Quan work.
Click to view slideshow. Rameswaram
Named after Siva, “Lord of Rama,” this island city is the closest geographical point to Sri Lanka, and is one of the most sacred Hindu points in India. Populating this island are 64 Theerthams, wells powered by the deities that reside in the land after Siva built a land bridge to Lanka to rescue his wife. Hindus come from across the country to bath in the Theerthams and wash themselves of their sins. If you walk in the footsteps of Siva you will find the land bridge leading almost to Sri Lanka down Danushkodi beach, a straight white road sandwiched by white sands and curling waves.
Click to view slideshow. Kodaikanal
“Queen of Hill Stations”, “Gift of the Forest”, “Forest of Creepers”, all are titles for this nearby hill station. Like Munnar its climate is moist and cool and its hills are green. However, this station is dedicated to more tourist attractions rather than tea plantations. Spanning its hills are rocky spires, waterfalls, and trails hidden in the usual midday clouds. In the center of the station is the valley’s Kodai lake. We met our friends Maggie and Quan Quan here and rode across the hill sides, got soaked, completely immersed ourselves in tourist crowds, and cruised along the lake.
Click to view slideshow.
I have found it all in India, quiet solitude in the lush hills of Munnar, nostalgic reminders of colonization down the streets of Pondicherry, awe-inspiring ancient lore on the coasts of Rameswaram, the bustle of tourists on the trails in Kodaikanal. Between each of these adventures lies a whole spectrum of experiences, culture, and people that all shape my time in India. I’m honored to have had these journeys and will miss these opportunities once my time to leave arrives.
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As I briefly touched on in my last post, Aravind’s eye camps are held with the intention of reaching patients in need who would not otherwise seek out ophthalmology treatment themselves. Camps are sponsored by local organizations like Lions Club International, Rotary International, religious groups, banks, hospitals, community NGOs, and other social welfare clubs. They are responsible for providing a place for it to be held, food and water for the 6-hour operation, and, most importantly, publicity beforehand. While this costs the sponsors some money, the good report they gain within their villages far outweighs the financial burden. Aravind absorbs the price of the doctors and nurses time and treatment equipment, making the entire process free to patients.The day of the camp, the system works something like this:
- Patients register.
- Nurses test visual acuity.
- Patients wait in line before seeing a doctor, who checks on pupil reactions and eye health. Three doctors came along to the camp I went to, which is standard.
- Patients needing cataract surgery go on to get their vitals measured, while all others continue to refraction. If any complications arise, sometimes patients are sent back to see the doctors again.
- Patients who got refracted and need glasses then go to retrieve their new eyewear, which is made on the spot at the eye camp locations.
- Patients with cataract are evaluated for diabetes and receive a retina check. Testing their tear ducts and intraocular pressure of those over 40 is also done on site.
- Cataract patients are bused back to Aravind that very day with the doctors. They receive their free operation the following day, stay at the hospital for another two nights in recovery, and then are bused back to the camp location they left from three days prior.
- Two months or so after the camp and subsequent procedures, Aravind doctors return to the camp location to do follow-up check-ins with those who received surgery and ensure recovery is going smoothly.
I meandered through the school building of the camp location, capturing pictures of the different stages. At one point, a woman motioned me over and pointed to her face, wanting me to take a shot of her. She beamed when I showed her the resulting photograph on the digital screen, and soon enough the entire line who had been waiting to see the doctors, using their smiles and hands, asked for me to do the same for them.
What stuck out to me the most was how grateful and cooperative the patients were. I found my economic interests getting so wrapped up in the camp process, the resources, and the efficiency of it all that I almost forgot to appreciate what the camp meant for those being treated. The people I saw were suffering from impaired vision, many of the older ones having severe cases. After coming to camp, receiving care and cataract surgery if necessary, their vision would be restored. For the children, it meant they could reach their full potential at school. For the young adults, it meant they could now work more or get a different job, contributing a higher salary to their family’s expenses. For the elderly, it meant they could remain self-sufficient even as they age.
The eye camps elicit this powerful, priceless impact which will continue to motivate me not only throughout the rest of my time at Aravind, but in public health work beyond Pondicherry as well.
Who determines if a generalization about race is inappropriate? A colonial legacy shapes the way race impacts society today; during my time in Delhi, I have been challenged by people’s perception on race, but some of my experiences here echo conversations I have had with people in America.
One day during lunch while we were eating maggi (Masala-flavored instant noodles), one of my favorite coworkers asked me if I could do Asian fan dancing. I thought to myself if someone asked me at Penn, I could give them a LECTURE! But I also understand that people have different experiences about race, and at that moment, I was unsure how to articulate myself in a way he could understand, so I replied no and changed the topic of conversation.
Later that week, the same coworker, along with another one of my favorite coworkers, jokingly asked me to teach them karate!, complemented with the ever-so-classic Hollywood-style “Wacha!” sound effects and hand motions. I told him that what he said could be interpreted as offensive in America, to which he replied that he’s not trying to be offensive and that I shouldn’t be so sensitive about generalizations (I’ve only heard this a hundred times before!) After I explained my thoughts on why this generalization was offensive (Why do we not see as many caricatures about white people?) he apologized and tried to explain that his image of East Asians was based on what he saw in movies, but didn’t see how what he said was inappropriate.
It doesn’t require rocket science to see that people of color in America have been disproportionately underrepresented or inaccurately represented in a variety of contexts (Just so we’re clear, racism is alive and well). Until college, I was unsure about my Asian-American identity and I didn’t feel like I had the vocabulary to understand my experience. I knew that I felt a certain way when people asked me “Where are you really from?” or when strangers greeted me with the old “Ni Hao” and an over exaggerated bow, but I said to myself a million times, Words should not hurt me. I am in control of how I feel about what others say. And anyways, they’re not meaning to be offensive. But why do I feel hurt?
Learning to see these verbal statements as microaggressions has helped me to legitimize many of my experiences regarding race and be more comfortable with my identity. Not being generalized by one’s race is a privilege. However, I am aware that some people think that microaggressions are harmless, and furthermore, others believe that the existence of the term “microaggression” worsens “victimhood mentality” and makes problems from things that don’t exist. I am convinced that labelling microaggressions as what they are is justified, but during my time here, I have become more aware of the importance of considering the cultural situation when evaluating this type of casual, non-malicious language. My coworker has not had many East Asian American people in his life, and a large his understanding comes from caricatures. Even though he is not trying to attack my identity, his words will still have an impact.
It all started at 6:30 AM on a Sunday. A group of sisters, a doctor, and I were ready to board one of the Aravind buses headed to Rajapalayam, a two-hour ride away. As much I would have liked the trip to be a little vacation, it was instead a work trip to Aravind’s eye camp. By the way, sisters are young Indian girls that Aravind trains to assist eye doctors in all the small steps that a patient goes through to be treated. None of them is my sister, just so you don’t get confused.
The ride was another opportunity for me to explore the splendid landscape that India offers. Meanwhile, I was able to chat with the doctor, who looked so calm despite the fact that she was about to change people’s lives in a few minutes. She and another doctor expected to treat 200 patients at the camp, and she estimated 50 of them to be transported back to the hospital for surgery. Finally, we arrived in a school that was about to be transformed in a hospital for a few hours. My role for the day was to be an observer. I guess I was supposed to observe everything, which I did.
The sisters set the place up and the work began. You wouldn’t believe how an eye camp works. Patients’ lines were moving with an incredible coordination, while the 2 present doctors were scrutinizing the patients’ eyes, using a torchlight. The other crew members were taking care of all sorts of auxiliary examinations and tasks. Two blue clad sisters were at work making glasses on the spot as prescriptions were being issued. I could notice passion on the faces of each member of the crew as they knew they were rescuing people’s future. We usually take it for granted, but imagine if you were prevented from seeing the world. Anyone who would offer you again that chance to see the light would be a savior! That’s what Aravind does, reaching out to even the easily forgotten people, down into the villages. There are many hospitals with far stronger and more advanced facilities than Aravind’s. But it takes more than knowledge and technology to do good to everyone.
After having lunch around 2pm, we were due to return. A big bus full of patients had left earlier, taking them to Madurai Aravind eye hospital for surgery. At Aravind, doctors are so used to their miraculous work that an onlooker could confuse the operating room with their offices. For instance, I had to meet with a doctor to talk about my project. Unfortunately, or fortunately, he was so busy that he told me to find him the following day in the inpatient block, as he would be operating on patients. Happy to be in the surgeon outfit, I walked into the room and found him with an anesthetized patient, ready to be operated on. As soon as the surgery started, the meeting started as well. He was talking to me at the same time he was punching the patient’s eye with needles and all that. I was impressed. I wish I could tell the patient what was happening during the surgery.
Bottom line, Aravind’s staff shows more than capability. To quote Dr. Venkataswamy, the founder of Aravind Eye Care System, “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.” Dr. V said it all.