Huts, monsoons, and a new friend

Wading through knee-deep mud puddles and sheets of stubborn rain, tightly covering my hair with the drenched dupatti, I suddenly thought to ask, "are there snakes in these waters?" Squish squish squish... George cocked his head and thoughtfully replied, "I don't think so... at least, not poisonous ones... well, probably not". I raised an eyebrow and looked down, just in time to avoid a wandering chicken.

I spent the past two days with staff from IIF visiting remote villages in the Thane District. In Maharasthra, there are tribal people, called Adivasis; they are the indigenous inhabitants of this area who, over the years, have been marginalized by mainstream Indian society. Although Indians in even the most rural places may have brick homes and motor vehicles, the Adivasis still maintain their traditional lifestyle: people live in mostly wood and straw huts and thrive off of subsistence farming or fishing. Walking (or wading) through the villages, I feel that I have entered a different world - chickens and goats run around freely, women carry baskets and dishes on their heads, and children cover their hair with giant leaves for protection from the rain. IIF works in these areas to promote better access to healthcare, including vaccination campaigns, family planning, nutrition, and hygiene. They also work to encourage primary education for children and the formation of women's self-help groups in which the women are encouraged to save money together towards common goals, such as buying land or starting up small businesses selling fruit or making handicrafts. Unfortunately, there is a great deal of work to be done - hygiene is poor, and although physicians are available, people's education and health awareness is lacking, so that children often die or suffer serious complications from preventable and treatable diseases. As we traveled around, people heard that an "American doctor" was visiting (talk about pressure!!) and started showing me their children; some of the things I saw were disturbing to the point that I insisted we take them to a hospital immediately. Amongst many problems, I saw several children with incredibly bad scabies (dark, papular rash all over their bodies); a few had scratched the rash to the point of creating open wounds, allowing bacterial infections to cover arms and legs. In the end, we did manage to convince them to take a few of these children to the doctor, but clearly, major interventions are necessary to give these children proper care.

One of my main projects with Impact India is continuing the first aid training program started by Dr. Christine Zink when she was here two years ago. By visiting the tribal communities and meeting with local health workers, physicians, and traditional healers, she developed a basic first aid manual addressing common problems seen in this population. Some of the guide was later translated into Marathi, but the training was difficult because the majority of Adivasis are illiterate. After seeing the manual and discussing these difficulties, I came up with an idea for rejuvinating the program and, hopefully, making it more effective. The Adivasis have a tradition of art, called Warli art (see the sample below); in every village, everyone from children to 'professional' artists create these drawings, depicting daily life and special events, such as harvesting and marriage. IIF has used this art to convey some of their health messages, such as the benefits of later marriage and breastfeeding. My idea is to take a few of the most important topics from the first aid manual and develop drawings illustrating the concepts; then, through a translator, I would be able to teach these ideas to villagers using the drawings as both instructional tools and as a way for them to remember the information later. We decided to target the women's self-help groups for the training, conducting 1 hour sessions for 20-25 women at a time. Although there are many important first aid topics, I carefully chose four on the basis of simplicity, ease of illustration, and relevance. The subjects are: (1) diarrhea and rehydration therapy, (2) snake bites, (3) burns, and (4) recognizing severe illness in small children. If I find that I have extra time, I will also discuss common, non-emergent conditions, such as lice and scabies.


Traditional Warli art

Luckily for me, IIF has a permanent Warli artist on staff; I have already discussed my ideas with him, and he has produced some preliminary drawings for field testing. I have spent the last two days traveling to villages, asking the Adivasi women for feedback. Over the next two weeks, we will develop a final set of drawings, which will be made into large posters and smaller handbooks to be handed out to the women during the training. With the help of George (who runs several of the healthcare projects), I have networked with several village physicians, and already have a list of about 100 women who can undergo the training. Once the drawings have been finished and printed, the planning will become logistical - some of these villages are hours away, and I will need to arrange for a driver and an interpreter. However, Dr. Dhir (the physician working with IIF) and George are encouraging, and assure me that we will be able to make this work. As always in India, i'm wary of promises, but Impact has been incredibly helpful so far, so i'm keeping my fingers crossed! This project is turning out to be quite a challenge, and it's absolutely thrilling to be developing something that both embraces the local culture and, hopefully, provides an innovative solution to an important problem.

In other news... I have adopted a puppy! I was walking around Palghar with Priyanka tonight (in search of fabric and nose rings), when i saw this little guy walking through garbage. He looked so sad and sickly; at the most, he's about 2 or 3 months old, and I decided that if I didn't take him home, he would most likely die of exposure and malnutrition. I washed him (he didn't complain!) and Priyanka brought him a little milk; although he drank some of it, he vomited most of it up later. Right now, he's sleeping peacefully in a corner with a cool dish of water by his side; tomorrow, we're going to look for a veterinarian (I suppose this would be a good time to start learning doggie medicine!). I've named him Moti; in Hindi, it means "little pearl", and in Hebrew, "sweetheart"; looking at him, it's just perfect. I don't know how long i'm going to keep him for, but i'm going to try to nurse him back to health (with vaccinations and all, if possible) before letting him back on the streets. Wish me luck! (and, yes mom, i'm washing my hands a lot :).