Tuesday, July 21, 2009

Cumily, Thekkady, and the Periyar Wilderness Preserve

Going to Kumili:
William and I left Karaikudi at around 12:30 pm. We took our normal bus to Madurai, where we jumped on another bus headed for Rajapalaim. On the way our bus stopped and picked up an entire bus load of people, whose bus had broken down. (their is one thing about India, you never EVER forget that 1 BILLION people live here) There we might up with Connor, Fillip, our buddy Roman, and 5 other volunteers from across Europe (mostly French though.) We all jammed in to a Tata SUV (yes 10 in one Tata) and started out on our "3 hour Rs2500 drive to Kumili. Things took a lot longer then expected, after four hours we reached the Tamil Nadu/ Kerala boarder where we were held up for 30 minutes because the drivers permit was only for 6 people, not ten. I'm not sure what happened, I imagine some bribing occurred and we made our way in to Kerala. We finally arrived at our accommodation, Mickey's Homestay. Long story short the driver made up pay Rs500 more because of a boarder crossing fee (bribe.)
Mikey's homestay is essentially a bed and breakfast. Will and I shared adjoining rooms with Connor and Fillip in the upstairs. The 5 French volunteers had the back house and the 6 volunteers who came from Madurai took the neighboring house. The rooms at the homestay were large, open, and airy. They had high sealing which vaulted to the center. Our room had a nice big balcony and a covered foyer between our adjoining rooms and the other rooms on the top story. It was of course raining in Cumily when we arrived and rained for most of our journey, and I mean RAINED! The Western Ghats is known globally as one of the rainiest places on the planet, and I never once doubted it.

Saturday: We woke up early Saturday morning expecting to go on a Jeep safari through the reserve, but because of the rain we were persuaded out of it. Instead we started the day with an elephant ride and then took a lackluster boat ride around lake Thekkady, which is in the reserve. We saw deer, bison, lots of birds, and one lonely wild elephant. After the park we took autos to a restaurant that served beef. (Kerala is almost entirely Christian, so they will eat beef.) We then returned to Mickey's at around 3:00pm and we all went our separate ways, the plan was to meet back at 7:30 to go to a Keralan BBQ. Will of course went to sleep(his favorite hobby, only behind tripping on things.) Fillip, Connor, Sophie, Emma, Christine, and I hit the streets of Kumili to a little shopping, and Fillip wanted some junk food (his favorite hobby.) We wandered the town and I bought some spices for my folks. I got Safron, Vanilla beans, Cardamon, Black Pepper, Curry Powder, and Coffee. My total was Rs500 or about $10.00. I'm not an expert on spice prices, but I don't think you can even get Saffron for that price. At 8:00 o'clock we arrived at the house where the BBQ was at. It was a families house that had a big covered pit and large tables. They had a small unattached guest house with a large kitchen where two Canadians, were working on making parata (sp?) (that was one of the options to learn how to cook the Indian food, we decided against it.) Some people started helping the Canadians with the food while other drooled over the chicken being cooked over the pit (guilty.) A couple hours later diner was served. The beer had been flowing like wine up until this point and everyone was starting to relax and have a good time. I ate with the two Canadians and we bullshitted about school and concerts and India. The food was AMAZING (and I don't even really like Indian food.) The chicken was great, the perata light and flaky, and the beer wasn't warm (a chronic problem in India.) They also served curried chicken, chili bean type dish, noodles, and Kerala rice (HUGE GRAINS.) After dinner the whiskey came out, in celebration of Roman's birthday. We drank and laughed and joked late in to the night. We finally went home at around 1:00 am. Will and I slept like stones, on the actually mattresses. And believe it or not the room was so cold that I had two use two of blankets. (we're at about 4500')

Sunday:
Sunday morning was an uneventful day in the rain we ate breakfast and took a 6 hour bus back to Madurai, then the 2 hour bus back to Karraikudi. And so ended the weekend. In the coming days: William is leaving tomorrow morning at 8:00am and I will be staying at the Chella nursing home the remainder of the week. Friday night I will be taking an overnight train to Chennai where I will spend Saturday and Sunday fishing for Giant Trevally. Saturday night RJ (the canadian) and I and his other western friend are either going out to a western restaurant or having a steak bbq. He's been in the country for a couple months now and can supposedly get his hands on great steaks. Monday morning I will be taking a bus to Bangalore where Connor and I will be living like kings until Thursday. I will then hop on another bus to Kodaikanal where there is an organized Projects Abroad trip. Sunday I will head back to Karaikuddi, and Monday I will go back to Chennai to get my flight home.

If anyone is interested in a welcome back party in E-burg let me know.



Left: On an elephant. Right: Me, Will, Ellie


Both: Lake Thekkady Periyar reserve.


Left: Lake again. Right: Ok I'm gonna try to get everyone's name and nationality here: Rameeta UK, Me USA, Ellie UK, Kristine USA, Sophie Belgium, Elephant India, Roman French, Short girl French, Fillip (back) Italy, June Austria (front stripes), Connor USA/French, Will UK, Two french girls.

Elephants

and so you dont think I just have fun. Left: where you wash your hands to be "sterile." Right: Syringes, no guards.

The ever famous, surgical flip-flops.

Thursday, July 16, 2009

Visiting the Lepers (contains sugical pic/vid)


The white ambassador (the yellow crown vic of india) barrelled down the road, horn blaring, and swerving every ten seconds to avoid the two wheelers and oncoming buses. My body rocked back and forth with the movement but not much else mattered. At this point I have am accustomed to the driving in India. Plus it is 0700, and Will and I are making our way to The Leprosy Mission Hospital in Manmadurai, a one and half hour drive (if we don't die first.)

We arrive at 0930 to the sounds of synthetic church bells and christian prayers in Tamil. We are shown to the dining house where a sweet Tamil lady has already made us breakfast and has 4 cups of chai waiting for us. A few minutes later Connor and Fillip arrived and we are shown to the guest house. The house is a nice (Indian nice) three bedroom with 2 beds in each room, and best of all it has a TV. (Unfortunate to us, and not so to William, the only channel we get in English is the cricket only Chanel.)

The first person we were introduced to was the director of the clinic who told us about the clinic and a little bit about leprosy. We were then introduced to our coordinator for the two day trip. She promptly took us to the ward where the head nurse showed us around.

The Ward:
The ward consists of separate male and female sections. The male section have 20 beds and the women's 10 beds. Their was also an intensive ward with about 10 beds. There were around 30 patients who had been checked in with Leprosy. We were shown by the nurse some of the primary and secondary deformities and disabilities cause by Leprosy. Most of the patients had large ulcers (sores) on their feet due to anesthesia of the extremities. The simple ulcers ranged from through just the top layers of skin to through all of the skin. The complex ulcers were much worse. In a complex ulcer you could see bone, tendon, muscle, the whole bit (in vivo foot anatomy.) After the ward we were introduced to a Russian OB/GYN doctor name Natalia who is spending a year at the Leprosy clinic.

Natalia:

Natalia is a young doctor in her early thirties who is trained in OB/GYN. However at TLM she does general practice as well as amputation surgery. We spent about thirty minutes observing her in her office and we were then invited to see minor operations.

The Operations:
*if squeamish please stop reading

Since Lepers have no sensation in their feet anesthesia is not used. The observations we observed were the removal of metatarsal bones due to infection that had entered through ulcers. The first surgery was plain gruesome. Natalia (no scrubs, mask, cap, scrubs *see pics) began by cutting the man's foot completely open with surgical scissors. Then she removed the septic bone and any surrounding infected tissue. she then packed the wound with spirit drenched gauze and it was dressed with clean gauze. The wound would be dressed days later. We witnessed five or so more surgeries similar to this at which point we were introduced to the physio doctor who taught us all we could handle about Leprosy.
If you are interested in learning more about the disease please wikki it. I don't feel like typing it all our so here's an abridged version
Leprosy is cause by the micro bacteria Lepre (sp?) it attack and destroys you PNS (peripheral nervous system. Patients if not treated will develop clawed hands, foot drop, loss of hand/foot movement feeling and gland secretions.

More time was then spent with other doctors and more lepers were seen. That night after diner Connor, Fillip, Will, and I decided to make our way 3km to Manmadurai in search of some Kingfisher to bring back to the house. We took the Rs3 bus ride and got to the small town. It was around 2100 and the town was a buzz. The town had an unwelcoming air to it, even the children did not look happy to see us. We asked around and we found a 'wine' shop where we bought 6 Royal Challenge (local beer) Will and Connor picked up some scissors (local smokes) and we were soon 4 crammed into an auto and on our way back. We spent the night living like real (American) men. We drank they smoked and we played cards. The morning we awoke at 0700 for lunch and were back to the clinic for more observing.
The next day we said our goodbyes and it was back to Karaikudi and the Chella Nursing Home.
*Please don't look at the pics if you're squeemish, or the video.


The wards

Using a flashlight because the power went out mid operation.

Lepre
Simple ulcer

Natalia removing some metatarsal.


Sunday, July 12, 2009

Kochi and the Kerala Backwaters. (long skip to the end for photos but please read)

Getting There:

Blink
Blink
Blink, blink, blink
Still dark, don't need to wake up yet
A gentle rocking motion lulls me back to sleep.
Blink, Blink
Hmmm, stickier then I remember
Better peel my face off this vinnyl matrre. . . off this vinyl.
Ahh it's all coming back now

Sleeper cart number one, seat/bed number 33. The train, Madurai to Ernakulum.
It's all making sense now. William and I left the clinic 12:30 and got a long cramped bus ride to Madurai followed by a less cramped more stressfull auto ride to the train station. We found old faces from last weekend and a couple new. A nursing student from Kansas, and an American living in Paris (cheesey teen movie?) The seven of us boarded the train at 5:30 (an hour late) and startd the 11 hour train ride to Ernakulum (mainland of Kochi/Cochin.)
The sun wasn't out but I stayed up anyway, it was 3:00am and the train was due to reach Ernakulum at 3:30. A few shaddowed faces hear me rustling around searching for a headlamp and a book.

Are we there?
Don't think so
OK
Don't worry their is signs in English for each city
Oh, good

Ernakulum arrived an hour late (as did the train) at 4:30 am. The seven weary travelers unloaded and made our way past the naggy auto drivers and out of the train station. But not before asking which way to the Kochi ferry.

How far is it to the Kochi ferry?
?????
Which way to the Kochi ferry?
???????
Friends, Friends where you coming?
(our turn)??????
Where you coming?
Ummm Kochi ferry?
No, no, no where you coming?
Ohhhhhh, uhhh US
US
US
France
Italy
France
UK
Ohhhh I see friends
Ummm which way to the Kochi ferry?
A, thanks
Nandri
This is Kerala dipshit they don't speak Tamila

So we left, the night pitchblack and no one really knowing where to go. The first road out of the train station seemed big and bright so we stayed on that untill we saw a couple of cops. We asked them and they pointed us down a dark narrow street.

Their till the end then right.
Ok, thanks
Seems sketchy
It's India, everything is kinda sketchy
Good point

We make our way through the narrow road my self being the only one with a flashlight and it puts onto another large bright street.

Well this looks promissing
Yeah, sure.
Well I guess we go right then
Yeah
Hey
*whistle
Guys this sign says ferry right
Oh good catch

We head down what looks like a small alley and are greated by a small Chai and snack stand. We order 7 cups of Chai and 7 bottles of water and take our places on the concrete cubes that cover the sewage system. An hour later we're on the ferry our Rs14 payed and on our way to Kochi, still pitch black still no plan.

I think this is the Kochi stop
Hmmm I guess no signs though
screw we're getting off sounds good
Excuse me sir
Sir
Is this Kochi?
???
This? Kochi?
Kochi, Kochi
I think that means yes
good enough for me
where are we staying?
A place called Oy's homestay

We make our way through narrow street and alleys as the sunrises being navigated by my Brunton and William's Lonely Planet's map of Kochi. We finally find Oy's as the sun is just starting to jut above the highrise apartments of Ernakulum. A young man stumbles to the door, eyes still blood shot. He tells us this is just Oy's cafe and he'll take us to the homestay(it's Oy's brother, literally) We get checked in. Three rooms Rs350 ($6.00) each. They have a gueen sized bed, a balcony some, wicker furniture, and most importantly a western toilet. The room is bright and clean, no complaints from anyone. Oy's brother informs us that we should eat at the Kashi cafe' and that he will book us a backwaters houseboat for the day. We make our way to Kashi only to find it is closed and we sneak next door where we eat honey and banana crepes and fresh mango, banana, jack fruit, papaya, pineapple, and watermellon (all grown in the outdoor garden we are dining in) The meal costs about Rs900 (~$20) , that is for all seven of us. We make our way back to Oy's and cram 10 people into a TATA SUV and make our way to an old rice boat converted into a house boat.

The Backwaters:

The kerala (care-a-la) backwaters are often described as the Venice of India. I say, hell wouldn't know never been to Venice. We spend the day lounding around the rice barge snapping photos, doing a small hike through the jungle to a spice plantation and then getting in small cannoes and paddling through narrow corridors lines with palm trees and littered with kingfishers. It is the most relaxing journey. For seven hours you can forget about the dirt, the grim, the horns, the sick kids, the sick dogs, the sick toilets. Nothing really matters. To describe the backwaters is like trying to describe any beautiful and surreal. The Times New Roman cannot transform into dense folliage and hand made canoes. So I will not try to, just look at the pictures and imagine you're there. (for the full effect cut up a mango dump every spice in your cabinet on it and then start a fire and let the concoction marinate in the smoke. It's almost what India smells like)


Friday night:
William and have a great discussion about our motivation for wanting to enter the medical field over a couple (2 each) bottles of Kingfisher beer.

Saturday:

A lazy 10:00am wake up starts the day, a nice cool shower follwed by the use of a nice clean toilet (go give yours a hug, or I'll sneak in to your house at night and install squats) We make it to Kashi which is small european style cafe. They have two choices for breakfast French Toast or a tomato and cheese omelet. Both cost Rs90 (~$1.50) both are or course served with: one whole mango, sliced; a single banana, whole; three slices of watermelon; three slices of pineapple; and two slices of papaya. All fresh of course. We eat, we jok,e we talk, and its great, but its not India (as is a theme in Kochi.) Unfortunatelly at this point filippo becomes very ill and long story short goes the hospital due to dehydration (humidity is a lot higher in Kerala then Tamil Nadu) Connor accompanies him and they both insist that the remaining five have a good day, so we do.

The fishing wharff:

After the ordeal we make our way to the fishing wharff which is a beach covered with old Chinese style fishing nets. The girls quickly made friends with a young indian man about our age. He invited all out on to his uncles fishing dock. We talk and joke and they let us have a hand at pulling in the net*. We catch one large snapper and it its off to the street market to be sold. We then hire two autos take us to the spice market.

Spice Market:

If you didn't know, a lot of the worlds spices come from India especially Kerala. We got a tour of what was essentially a distrubtion center for Keralan spices for local sale in Kochi. The smell of the area is amazing (dont say you can imagine, cause unless you've been I doubt you can) we get to see large burlap sack filled to the top with every spice available. Then (of course) are offered to by some spices. They had raw vanilla beans and safron (both fresh) for sale at around a dollar or two. Would have got some spice but I didn't see the bag containing the Johnny's, Lowry's, or Montreal Steak (oh well.)

Leaving:

Another verry long story short. We take autos around Kochi back to Oy's collect our bellongings pay our bill take Connor and Filip their stuff and take Autos to Pizza Hut. Yes I ate Pizza Hut in India. Why you probably want to know. Well if you had been eating traditional Indian cuisine for three weeks straight anything from the west would start to sound good.

Going home:

(cluster F**K)
It turns out that we were waitlisted for the train. The ticket checkers (who cary pistols) tell us to just got on and eventually seats/beds will free up. So thats what we do. Which also mean we spend a good 30 minutes wandering around the sleeper carts getting pushed around by angry Indians (dots, not feathers) The train finally gets moving and we settle into that cozzy spot between the beds and toilets. I know you're familiar with it. Its diamond plated steel, about 3 feet wide with doors on either side. We "settle" in and I start reading. 5 hours later I'm delirious my book makes no sense, maybe my mind makes no sense, can't remember which. Well we finally got to Trivandrum where most the passengers got off and we all snagged some beds and slept the remaining 6 hours of the journey. Finally home, one more destinatino under the belt.

Next weekend Thekkady and the Periyar animal reserve: Lions and Tigers and Elephants OH MY!
Sorry it's long I hope you liked it. If you asked questions in the comments go back and read the comments I answered the questions in the comments part.

I just spent a ton of time uploading all these so you better enjoy them!

Top:Kerala backwaters Bottom: Our houseboat converted from an old rice boat

Top: Similar to the canoes we rode around in Bottom: pushing a barge full of sand

Top: Self photo in the jungle Bottom: Some flower



Top: Not mangos, can anyone guess what they are Bottom: Another self photo at the fishing wharffs


Top: spices also used in Ayurvedic medicine Bottom: Bags and bags of spices

Top: More spices Bottom: Kerala is known for their monsoons and we were lucky to experiance some it. verry amazing.
Top: Captain at the fihing dog we visited.
Bottom: * so here is how these work. Pictured the net is obviously out of the water. their is a large boom extending back to the hut in the back. Several men left the boom up which has lots of large rocks attached as counter balance. this dips the net in to the water. then you pull on large ropes hanging down from the large boom this brings the net back up out of the water.

Sunday, July 5, 2009

Weekend in Madurai (Ma-Dry)

The Children of the World ( a brief interlude) The setting is the top of our 7 story hotel in Madurai. It's a cool damp night and their is a high cloud cover. William and I are sitting at a 25ft long table, all around are the voices of the 30 other projects abroad volunteers, who've come from every part of the world. Their is a Frenchman named Roman, a loud Italian of Indian birth, a Persian who was born and raised in french Canada, several from the UK, and stragglers from the rest of Europe including, France, Germany, Netherlands, and Italy. Everyone is asking the same questions: where are you from, what is your placement, how long have you been her,e how long until you leave. Their is a unifying bond being formed through the thirty students eating diner on the roof regardless of their country of origin or language spoke (although everyone spoke English.) It was a truly amazing experience to meet these people and hear their stories and be able to tell my own. Never before have I felt like a citizen of Earth and merely US by passport.




Now to the weekend.


Friday:

William and I left Karaikudi at around 4pm Friday afternoon we got into a bus where both of our knees where smashed in the sheet metal back of the seats in front of us. The inside of the bus had so much un-rounded sheet metal inside that I felt like i was traveling in a Cuisinart. We arrived at the Hotel Supreme 2.5 hours later and got checked in to our room (AC finally!) which was about $60 for two nights. We immediately headed up to the roof top veg restaurant and met up with Christine the American studying medicine and Mohammad (38P MCAT) the Persian from Montreal. Will and I drank clean water and talked with them and slowly everyone trickled in. We ate western style food (first in a week and a half) and told stories. After diner we all headed down to the Apollo 96 which the spaceship themed bar in the basement of the hotel. I ordered a $2.00 double whiskey and coke and sat back and met everyone. Too quickly the bar was kicking us out (Indian bars close at 11) Max (Englishman) Will a few other and I wandered down the road until we found a bar willing to serve us to midnight. At midnight they asked us to leave after selling us a couple bottles of whiskey and vodka and we went back to the hotel where all thirty volunteers and the three desk officers met up with us and we partied till about 2 or 3 in the morning.

Saturday:

We started Saturday off by traveling to the ruins of an old large palace which I photographed extensively. Their is not much more to say about the palace just view the pictures. After that we ate another western meal and nine of us headed to a theme/water park. The water park was amazing and almost completely out of place in India. It was located on the outskirts of Madurai. It was almost completely empty and it was a sunny and hot Saturday. The park was divided in to two sides the first being a large pool with a canal running its perimeter. Their was about 12 or so slides ranging from tubes to speed slides. A few of which would never be allowed in the west. It was a blast! They also had a wave pool and artificial water fall you could stand under. The second half of the park had about a half dozen more extreme slides which we rode. Overall the park was great and very clean. Saturday night we all ate diner on the roof again and a most of went to the Apollo 96 for a beer (nothing like Friday night)


Sunday:

We started the day by going to the Meenakshi temple (a very large Hindu temple) we spent sometime there I was blessed by an elephant the put their snout on your head and then spent the rest of the day shopping in Madurai.We went to the tailor shops where you can get Indian Cotton shirts and trousers made. I got two shirts made for me which cost about $10. I also picked up some presents for people back home (sorry can't say what, surprise!) Will and I then took another very painful and long bus ride home and here I am back at the cafe. I feel like this ran short at the end but I don't really feel like typing more. I will try to upload some more pictures for everyone but it is slow. I just started the upload and also realized that I shot most of the weekends pictures as .RAW so most of them you wont be able to see until I get home. Which reminds me I will post the link to my Flickr photostream once I'm home so that my loyal followers can view my photos.


William and I at the shops In Madurai. Where the tailors and such are.
Another views of the shops. some volunteers (dont know who) looking at scarves and trying to avoid the pushy salesman.



Temple with will in the foreground taking a photo


pond at the temple. that small gold statue in the middle is a lotus that is solid gold and weighs 130kg.





Wednesday, July 1, 2009

Dr. Chellapa and life in the hospital.

Finally what you've all been dying to hear about .

Dr. Paul S Chellapa is the doctor who I've been obseving for several days now. He has been a practicing doctor for 40 years. I'm not sure how old he is, but I'm assuming around 65. He has his MBBS, MS, and FICA (also some other degrees I dont remember the abbreviations for.) His speciality is in ENT (ear nose throat.) But on a daily basis is a primary care provider, oncallogist, pediatrision, and general surgeon only to name a few.

The doctors life:

On my way to kairakudi Austin told me about how doctors in India live like kings have large nice houses and drive nice cars. I told him it was the same in the states. While by Indian standards this is true, by western standards the doctor's possetions would be considered normal while his lifestyle considered elegant. The doctors house is a pale green two story surrounded by a barbwire fence whih keeps the guard dog , whose only weapon is his bark ( and the rabbies from his bit) at bay. The inside of the house is kept clean but lacks a modern feel. All of the lighting is flourescent and everything in the house is from Ca 1970. One of the first things I noticed when entering his house were the large pictures of Jesus on the wall (the Dr. is christian) I have only ever seen the entry way, living room, and dining room. Will and I are not invited to the upstairs. Dr. Chellappa has somewhere around 5 or 6 servants/drivers/maids. Their are three women who do the cooking and cleaning and live with the doctor and his wife. He also has a driver who I also believe yard work. In addition to those four he has a sort of personall assistant who will sometimes drive us and also works in the hospital and performs such tasks as answering the doctors phone or telling a nurse to get the doctor some juice/water/tea (yes the nurses get the doctor drinks and also food from local street vendors.)

The clinic:

Simply put the cleanliness of the clinic scares me. Now that that is out of the way I'll explain a normal day. The doctor sits in his office at his desk with a stack of 4x6 sheets of paper, these are the complete medical records of patients. He then simply goes in order and the patients are brought in to the office by one of the 4 or so nurses who are constantly running between his office the injection room and the wound dressing room. The doctor will see a patient make some orders then the nurse will take the patient fill the orders if they can be at the clinic and then the patient will return to see the doctor. While the first patient is gone a second patient will enter and so on through out the day. The doctor NEVER washes his hands between seeing patient even if he has just squeezed puss from an absses. The tools he uses through out the day are kept in a rusted metal rectangular pan. Once they are used he puts them in a small steel bowl under his desk and when he runs out a nurses will clean them. This is unless he needs a tool and he ran out, in which case he will just use a dirty tool. His ottiscope has only two plastic replaceable tips that never get replaced or cleaned, they simply go from infected ear to infected ear. Their is no sharps box in the office either (or the clinic as far as i've seen) None of the needles have any king of quard on them and get passed like a basketball between the doctor and the nurses. I stay very diligent as I would rather be a hobbit in mordor then get stuck with a needle in India. My day as of lately involves sitting on a folding chair observing the daily work. Later this week or early next week I should start being to help in a more hands on approach. I'm sure that i've left something out that i will add later but thats all for the clinic for now.

Surgery:

I am in great self debate about the surgeries I've observed. They seem near torture and here is why. 3/4 surgeries observed so far where done only under local anesthsia. Those done under local were an appendectamy and two deviated septum repairs. The patients remain poorly draped in questionably cleaned cloths. It is gut wrenching to watch *grusem be ware* a patient moan and wringle in pain while flows from their nose and mouth soaking the sourronding cloth as the surgeon chissels away at their nose. However the doctor is performing needed surgeries with what he has and what the patients can afford. An average surgery at the clinic costs about Rs11,000 (~$200) Their sterile technique is beyond questionable and when asked the doctor said that infection rates are low at his clinic. The first thing that made me question their technique was when I was made to wear a pair of "surgigal flip flops" in lew of my Chacos. Beyond that their were not other requirements for William or I. We simply wore our days clothes, and mask and cap of course. Many of the nurses including the scrub nurses simply went barefoot in the OR. None of the equipment in the OR is disposable (except for suringes) Anythign in their that is metal has a reasonable amount of rust on it and the only modern equipment is the puls oximeter everything else is Ca1960. Again I'm sure I forgot some stuff but this gives you the gist of it.

The clinic:

The Chella clinic was converted by Dr. Chellappa from an old building 30 years ago and nothing with in it has been updated. Their are 10 beds in the hospitals 2nd and 3rd floors. It is in general a dirty place that I would not even eat food were it made inside let a lone go their for a doctors apointment. however the doctor charges only Rs50 for an appointment (~$1) this way the local people can afford it.

Bellow are various pictures I took yesterday includign pictures of William and I in our first auto-rickshaw ride :S pictures of the outside of the clinic and more pictures of people on the street.

screw it pictures take too long here maybe tomorrow.

Monday, June 29, 2009

Life in India. . . continued



I have now been in India for about 200L of waters. I have not been measuring my stay in the country as hours or days but rather as liters of water. I think 200L puts me right around 4 days. For easy reading I will break this entry into groups with titles as I did before.

Food:

My first experience ever with Indian food was the fine dine served on my Jet Airways flight. It was simply horrible and turned me off on Indian food for about the first 100L of water I was here. My second taste of Indian food came at a crowded restaurant here in Karaikudi. Austen, another Projects Abroad desk officer, and our cab driver made our way through the busy restaurant past the kitchen through the patio and to a less crowded back dining room. Austin ordered us rice and vegetable curry. Right away a waiter comes out and sets the table with four rectangle leaves,which are used as plates and pours threeglasses of tap water. (Austin got me bottled water) Immediately after the leaf was down another waiter showed up with four large pales. The first contained rice which each of us got several heaping scoops of. Then from a second bucket the rice is covered in curry. The other too buckets contained a gourd type food and some other mushy vegetable dish I didn't care much for. The way you eat this is that you mash the curry and rice combo together with your fingers and then grab a ball of this mixture with the tips of your fingers and scrape the food in to your mouth using your thumb. This was not a bad meal and warmed me up a little bit to Indian food. Every meal since then has been about the same. It is a large helping of rice mashed together with curry served with vegetable sides (today's lunch included mashed potatoes!) Breakfast now is on a new level. It is as if the doctor cook (more to come on that) knew me before I showed up. My first breakfast I was greeted by a large plate of toast and a jar of peanut butter and a jar of jam! heaven.She also makes a very delicious coffee based drink that tastes like a sweet cappuccino I alternate between that and very good chai tea. The fruit here is out of this world. So far I've only had a couple bananas and some mango. The bananas here are like nothing you've had (unless you've had an Indian banana) They are short and stubby and so much sweeter then any other banana Ive had. The mango's here simply melt in your mouth and have the most vivid flavor, yet are unfortunately about to go out off season (thought they grew all the time here.)

Stores:

Karaikudi is littered with, amongst other things, stores. Unlike in the west the stores are packed shoulder to shoulder and you rarely ever go in to the store. Rather is as if the store is built into a garage stall. In the morning the store owner rolls up the door and behind it immediately is a stall width counter and the products being behind the counter. You simply walk up to the owner and tell him what you want and he simply gets it for you. All stores are this way including pharmacies, tile stores, electrician stores, electronic stores, bike shops, everything. Only the larger cell phone stores, bike shops, clothing stores, and super market are stores you enter. The super market is a similar system but you go inside and the center is all fresh fruits with a counter running the perimeter with the more normal items located behind the counter. I went there one time so far to buy a Fanta and a tube of tooth paste. My total was Rs124 (Rs120 for the Fanta and Rs4 for the tooth paste, Rs124 is about $2.00.)









The people:

For the first 50-75L of water of my trip I thought the Indian people were somewhat cold shouldered and rude. I have since then realized that they are very nice people. Last evening I spent sometime outside with my camera trying to capture some of the families zooming by on their motorcycles. I was greeted by almost everyone that walked by. They all want to know your name and where you're from. Just walking the streets people will stop you and shake your hand. The people are more then friendly and live getting their picture taken. If you have a camera out, you will surely here the yell of children(6yrs-15yrs) yelling photo photo photo. Once such photo is the one of the one posted of the store owner and his son standing proudly outside of their clothing store.

My source of travel:

William and I are blessed by Shiva (or what ever Hindu would bless us westerners) to have two size small female bikes. The Jupiter and the ironically named Goliath. They are all steel single speeds with a fat ass seat (spring seat) fenders an interested kickstand device and built in lock. The kick stand with a bracket that attaches to the rear of the bike by the drop outs (rear axle area) it is hinged and sprung so that it flips up for riding that you kick it down to park the bike on. The built in lock is located right next to the brake and is simply a circle that stops before entering the spokes. To lock the bike you flip a switch and a bar completes the circle through the spokes and you can then remove the key. These are a real pain in the ass, legs, and back. However, they are how we make the -2L H2O (~10min) bike ride to the doctor's house.

Kairakudi by the numbers:

98 degrees, temperature outside
63% humidity outside
0 number of wrecks and needle sticks witnessed (very oddly enough)
0 number of sharps containers and bio hazard disposal bins in the hospital
8L amount of water drunk per day


That's all for now. I have so much more to write and so many more stories to tell already. However I want to give everyone a chance to read this with out getting overwelmed as I know I am being long winded.

I appreciated the comments keep em coming. Still feel free to ask any questions

Rick "your friend sweating like a pig in India"

Saturday, June 27, 2009

India atlast (long, grab a drink and get comfortable)


*view from my room at the Chella Nursing home

Arriving in India:

Late Thursday night I finally arrived in Chennai India. Upon arriving in India I disembarked the plane made my way to the baggage claim, collected my bag and my way in to the madness that is India. Once you exit the baggage claim area you are welcomed by yelling Indians who are kept at bay by a aluminum fence. As I walked by the fence I carefully read every sign looking for my own name. When I got to the last person holding a sign and realized that the name on the sign was not my own a sense of panic settled over me. Before I know what was going I was in the midst of the taxi depot. Drivers were approaching me and asking in a thick Hindi accent if I needed a ride. After turning down rides from several drivers a nice man speaking only some diluted English asked if I needed help. I explained my situation and showed him the email that had where I was going and the number for the hotel, Hotel Mount Manor. He quickly took the paper from me made three rapid fire phone calls and said that they were on their way. At this point the madness of it all started to sink in and realized what was going on. I had no idea who this man was and upon asking him I got a fast spoken long answer that I believe amounted to him saying he was some kind of transportation manager. He had an ID badge and appeared to be legitimate. But my mind kept wandering to the scene in Taken where the girls driver tells the Albanians where they are staying. I was scared this man called him thug buddies and they were gonna pick me and do who knows what. To my astonishment a Hotel Mount Manor van showed up with a driver wearing a matching Mount Manor polo. I figured he was legit enough so I got in and he took me to the hotel.

The hotel at the time seemed rather questionable but now that I have seen India I realize that I was staying in a rather nice place. The door to my room had 3 dead bolts, there was A/C and a semi-working TV.


Projects Abroad:

I woke up early the next day knowing that I had to catch a flight from Chennai to Madurai. I however, did not know what airline or when the flight left. I got up and checked out of the hotel room (which cost ~Rs1500 or about $30.00) and was at the airport by 6:30. I proceeded to ask every airline if I was on any flight to Madurai till I finally won the jackpot at Paramount airways. Unfortunately the flight didn't leave until 2:00pm so I had a solid amount of time to sit and read. I finally got to Madurai around 3:30, where I was met by Projects Abroad desk officer Austin, who is actually an Indian guy. Austin was a very nice guy who has a degree in English literature and spoke English fairly well. We got into a cab in Madurai and left for Sivakassi. This is where I was introduced to the Indian roadway and way of driving. In India there are, as far as I can tell, no laws for driving. The cab driver barrels down the road at a max speed around 60mph but slows for nothing. If a bus is ahead they will just pass, if you cannot pass they will wait literally 3 feet behind the bus and honk and then they will fly headlong in to oncoming cars and then cut the bus off just in time to not smash in to a truck full of people or propane or whatever. On the road everyone honks their horns ALL THE TIME. Unlike the states when you honk here it is just to signify that you are passing, not that they are in your way. Everyone here drives motorcycles( or as the locals say, two wheelers.) they bomb around town on their motorcycles and it is not uncommon to see a family of four or five on a motorcycle. usually a small toddler sits on the father's lap holding the handlebars, then the mother sits behind the father holding the baby and a teenager sits behind the mother. The Honda Hero is a popular choice and almost everyone drives one.


Karaikudi and the Chella Nursing Home:

After a six hour white knuckled cab ride from Sivakassi I got to the Chella nursing home in Karaikudi. Although the title is nursing home it is more like a hospital. Their are 3 doctors, 10 beds and an "Operating Room" (more to come on Indian surgery.) My room is on the 3rd floor and consists of two twin sizes mattress-like pads on metal frames. Their is a spout coming out of the wall that we use to shower and to our luck their is a western style sit down toilet. We also have a small balcony where I set up a clothes line. Ahhh before I forgot, I do have a roommate his name is William and he is from the UK. He's twenty and studies medicinal chemistry and some UK university. Their is not much more to say about the room, I think the picture will speak for its self.









Well I suppose that is enough to get through for now. I'll write more soon about life with the doctor, Indian surgery, Indian food, how the clinic works, and anything else you want to know.

Please leave comments I'd like to hear from friends, family, and friend of my family. If you have any questions feel free to ask in comments.


-Rick "your friend culture shocked in India"