India….final chapter….for now.

“How do you think I got this?” I pointed at the big scab on my chin.

Standing in front of a classroom of eight year-olds in India, they made outlandish and simple guesses, “an accident?”

“Yes, but what KIND of an accident?”

Of course I had to give them the answer because who is going to guess that I skinned my chin climbing up the trunk of an elephant?

While the clinics were a powerful and important experience they were surely not the entire focus of my third trip to India in a year. With my friend Joan there was certainly a lot of fun as well. We did a lot of the things you DO when you visit India. We went to the Taj Mahal. We ate spicy food, pause, with our fingers. We stopped by the side of the road to see some nomadic blacksmiths at work. We did some shopping, especially textiles. I had my favorite cotton Indian blouse copied in linen. It was so nice I asked them to make two more. We went to the Ranthambhore Tiger Reserve and we even saw tigers.

“Luck and chance,” is what we heard over and over again about whether you will see them. I know several people who haven’t. But what wasn’t luck and chance was our good fortune to get a cancellation of a private jeep, called a gypsy, which allows greater flexibility in following the cats.

Joan got the heebie-jeebies when Goldie, sitting in the left front seat, would turn around to talk with us. He wasn’t driving, though, as in India the driver sits on the right and cars drive on the left. “I knew I was getting used to it here,” said Joan, “when I stopped taking pictures of the cows every where.”

And of course we got to have our elephant encounter. We got to feed them, paint them, ride on them. There is a tall platform with stairs to get on top of the elephant, but once I saw the elephant rider climb up over the trunk I decided that would be a good a idea.

“Really? You want to do that?”


And so the call went out. “Crazy American lady over on aisle 7!” My Hindi isn’t so good, but I’m pretty sure that’s what they were saying, because an audience appeared seemingly out of nowhere.

How do you climb up the trunk of an elephant? You use the ears as handles, reach your foot up as high as you can in front, stepping on the trunk, using it as a springboard as you scamper/shimmy up over the head. That audience was also helpful as a couple of the men were pushing on my feet and trying to make sure I didn’t fall down. Up on the head of the, facing backwards I was having a huge laughing fit.

“Now turn around.”

You want to know what Pilates is really good for? When you are on an elephant and facing the wrong way, you are fifteen feet up in the air, THAT is when your Pilates workouts will pay off for you. Evan and Kaitlyn at OnPointe Pilates would be proud.

I even have a video of this, which I am incapable of loading here, but if you email me, I’ll send it to you. Guaranteed laughs. Somehow my chin kissed the elephant’s head in this process and I walked around with a big scab for 10 days.

And after me Joan decided she wanted to climb up the elephant trunk too. Totally graceful. No bodily injuries. Can’t bear to think how much Pilates she must be doing.

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Tales from Medical Camp

Remember Givraj Sen, the handsome young man from Kanai who was burned as a boy? The cook who would love to have doctors give him a new ear?
Well, Mr. Rathore took Givraj to Jaipur, three hours away, to meet with a plastic surgeon. The surgeon said Givraj doesn’t have enough flesh on his head, near where his ear should be, in order to construct a new ear. They can help him, though, and offered to do skin grafting from his leg to his neck. This will give him increased functionality—the tightened skin has been limiting his range of movement—and improved appearance. With the resilience of youth, he jumps.
“Can we do it today?”
The family decided it might be more convenient to wait until Karen, their visitor from the US, leaves so that they can better support him. Doctors tell Givraj to have a family member from the village come to help care for him in the hospital after surgery.
And he is not the only one from the little village facing big medical problems. The very day of our clinic a Mr. Singh, in his late fifties, falls down with uncontrollable tremors in his leg. He had been experiencing occasional vertigo, and a decrease in hearing in his right ear. Months ago a doctor in the town 20 kilometers away gave him pills for the vertigo, and he tried to ignore that, along with the weakness that came upon him occasionally. Just one more thing along with the crop failure, to worry about. The tremor however, was a new and terrifying symptom. What to do?
Come to the medical camp in Kanai Kalla!
As with Givraj’s plastic surgery needs, mystifying tremors and weakness are, as they say, “beyond the scope” of our little clinic. Our medical coordinator, however, refers him to Jaipur, and neurologists.  With a population of three and-a-half-million and as the capital of Rajasthan, the largest Indian state, Jaipur is a major city with modern medical care. Mr. Rathore brought both Mr. Singh and Givraj to Jaipur for consultations. Mr. Rathore’s little diesel Ford—most cars are diesel here—was fully occupied for their journey to Jaipur.
Big surprise, for me, is how quickly appointments could be scheduled. Within two and a half days, Mr. Singh has an MRI and consultations with two neurosurgeons, an ear nose and throat specialist, plus a general practitioner.
The big shock, for him, is the result of these appointments. Mr. Singh has a brain tumor, a left sided acoustic schwannoma, which is in the inner ear growing into his cerebellum. Small comfort to him that the tumor, at 2.3 centimeters by 3 centimeters, is not cancerous. It will require brain surgery to remove it.

Givraj Sen

It will also require surgical and medical fees of about $2,700.

 That’s all? I thought, for brain surgery and a hospital stay? It might as well be $2.7 million dollars.  As a farmer Mr. Singh is too poor to afford medical insurance, but not quite poor enough for the “Bahmashah card”, similar to a medicaid card, that will pay for his medical care.  It is left to him, and his family, to figure out payment.
The two neurosurgeons agree on the surgery and excellent prognosis. Following surgery he has a 95% chance of making a full recovery. A four percent chance of some nerve damage to his face. One percent chance of death. They disagree on the urgency; one says surgery as soon as possible, the second one says as soon as convenient.
Mr. Singh wants to finish the clean up in his fields—he’s got the current crop harvested– and get winter wheat planted so that while he is recuperating from surgery the new crop will be growing. He expects that process to take two to three weeks, which puts him at Devali—the biggest holiday in the Hindu calendar, roughly equivalent in importance to Christmas. He agonizes about how to tell his wife about his condition. How to tell his mother, who is in her upper eighties? His son, who is 19? Should he sell his land to pay for the surgery? But then how will he earn even the modest living he does. The economy is depressed and even if he does sell his land it will bring far less than it should.
“He is crying constantly,” says Goldie.
“I’m not surprised,” I say. “I would expect that.”
“Not in India. We don’t cry in India.”
Two days ago Givraj Sen had surgery. Plastic surgeons in Jaipur took skin from his right thigh and placed in on his neck, hoping to improve both his functionality—the scarred skin in that area was contracting and limiting his range of motion—and also to improve his appearance.
What does not require improvement is Givraj’s good spirits.
When he saw me in Jaipur Givraj made an airplane motion with his hand, to show that he planned to visit me in America someday.
I hope he does.
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It takes a Village….no, it takes TWO Villages….

Last spring it was a vision clinic—“eye camp,” in local lingo— in the little village of Kanai Khurd in Rajasthan, India, population 997. That went well and we learned a lot, getting prescriptions and glasses for 127 people so this time we partnered with a local NGO and provided more services. Not wanting to duplicate, it made sense to move operations the next village, Kanai Kalla, which is four kilometers away.
Four kilometers doesn’t sound like much, at less than three miles I can easily do that for a morning walk, but in a place where most people get around by foot….carrying burdens and working in fields, it is a definite distance. Kanai Kalla has about twice the population—kalla means “big” and “khurd” means small. It also has a newer more spacious school, which we were allowed to use for our clinic. We occupied three classrooms the first day, for vision and cardiac services—classes doubled up in the remaining rooms—and on Sunday when school was out, we used seven classrooms.
In many ways this school is entirely familiar. I took pictures of the math problems on the blackboard to send to my math-teach sister and brother. Boys and girls are lined in neat rows for morning assembly. The children wear two-toned brown uniforms and hair is tidy in the morning, girls with braids, boys with sharp parts. Having created chaos in the school, it seemed polite to visit the classrooms. The eleventh and twelfth graders were ones who had doubled up. They are tall, seemingly better nourished than their grandparents were, and in this classroom there are none of the skinned knees and rumples of the little ones.  Also missing are girls. Not a single one in the twelfth class. I turned suspicious; child marriage is a problem here, but not a single girl?
“Where are the twelfth class girls?” I asked.
“They are all in Ajmer for an athletics competition.”
So much for my understanding of local culture. A few days here doesn’t do that. A few weeks doesn’t do it. No matter how many questions you ask. And I ask a lot. And I keep my eyes open too. The prime minister of India is also in Ajmer, about 80 kilometers away, and so our clinic has serious competition. But most important competition is the time of year.
We are at the peak of harvest and the villagers are desperate to get their crops in. Untimely rain destroyed about 60 percent of my host’s Mung beans, an important dietary staple. People here also grow sesame seeds (for oil), cotton, wheat, and lentils. Also lot of livestock.
Volunteers aplenty here. The classrooms need cleaning and furniture moved. the walkways need sweeping. We need to register patients—in the temple, or under the tree?
Under the tree, and under the next tree on another table a technician checks blood sugar numbers. Nineteen year-old Honey serves as impromptu pharmacist. I had bought mirrors so people could see how they look in their new eyewear. Deepu, however, is the fashion consultant for frames, looking at a person’s face and making a snap recommendations. The mirrors didn’t even make it out of the box. Only once do I see a problem with frames. A man in a white turban and dhoti—long fabric wrapped into a cross between pants and skirt—was holding a pair of pink frames and Goldie had to tell the man that the frames are for ladies. (Sunglasses are so highly prized that the men—who especially need them for riding their motorbikes—could care less if the frames are for women.)
Most of our volunteers, though, are in the field, literally. Flyers have been distributed to every single house in both villages. Many people are illiterate, however—the eye test uses symbols not letters—and so we do more than that. Two days we have a tuk-tuk—a baby taxi—drive around with a megaphone. And on the clinic days we go to where the people are, into the fields.
“I know you are busy, but you have to take a break for lunch? Just half an hour.”
My accounting on expenses goes squirrely, diesel for tractors to pick up people, tuk-tuk fees to bring them in for a quick check up. None of the costs are much, but glad I’m not going to audited. And how to be equitable between the villages? We are going to provide cataract surgery for those who need it, but what about those who came to our clinic in the spring and needed cataract surgery? Preferential treatment for Kanai Kalla over Kanai Khurd? A reminder, if ever I needed one, why I’d never want to go into politics or government. No matter what you do, everyone will not be happy.
“How many of the cataract referrals are for ladies?” I ask.
Mr. Rathore flips through the stack of twenty papers. “Six.”
They hadn’t noticed the gender imbalance in the patients. I had. So we agreed to give women preference from the other village and if anyone drops from the list, the replacement will be female.
The best part is the delivery of glasses, seeing how much difference that can make how quickly. And even the pictures—glasses delivered to people’ homes—shows a good bit about what life is like here. The ladies who wear veils; note the heavy tribal jewelry and ceremonial henna on the woman in the pink veil, the cow right there in the other. Turbans. Work clothes. The sleeveless shirt on the one man has so many holes it looks like lace. I am especially pleased about the eighth grade girl pictured here.
I don’t know her name. But that’s okay, you won’t know the names of most of the people you help. The girl has no vision in her right eye, obviously so, it’s cloudy and turned inwards. She was miserable and self-conscious during our clinic and I don’t blame her. It was a bit chaotic, people asking her to do new and unfamiliar things, so many adults she didn’t know. The thirteen-year-old was so clearly uncomfortable I didn’t want to take a picture of her from the front.
I’m thrilled to see her here, in pink and blue weekend clothes, looking calm and beautiful, wearing the glasses that will help the remaining vision in her left eye.
And just maybe change her life.

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“Where’s Your Bindi?”

“Where’s Your Bindi?” Goldie asks me in a tone half-way between panic and scolding.
“On my face?” I reach up to feel, but that little fashion dot has gone missing. I had it on this morning. We are on our way to a meeting with Tulcha Ram and to learn about the Bishnoi people, the original tree huggers who live by subsistence farming. I love my Indian wardrobe; kurtas (tunics, usually with a slit on the side) are flowing and flattering for all. The pants underneath have either drawstrings or elastic waistbands, and are comfortable as pajamas. I like to sit with my legs crossed, Indian style, and the clothing is great for that. The loose waist easily accommodates what I fear is happening from all of the delicious food that’s coming my way. The “Lassis” are so yummy that the shop is in guidebooks and trinket sellers hover, lamb stew was prepared for me on the back patio, and chapati is fresh and hot in infinite supply. If I reach for the plate a fresh hot one is ordered up for me. (Cold ones are saved for the cows.)  And at the movie theater two days ago, there was my favorite popcorn, cheese and caramel mixed together. Yesterday I went into the fridge deciding to warm up some leftovers. NO! Panic in the kitchen….no leftover for me. Food is prepared fresh. Every time.
My morning walk is no match for all of this food. Before leaving for India I requested on-the-go workouts from both Evan, my Pilates instructor and Devin, my nephew who is a trainer. Both were really helpful with suggestions, and I’ve got stretchy “therabands” to use for the exercises. Do you think I’ve used them?
And while I love the clothing here–the cotton and linen is to die for–I can also get confused over the rules. Rule 1) always have a scarf. For me it’s not necessary to put it on my head very often, just during a welcome ceremony and in some temples.
“Which temples?” you ask. “How do you know?” I tend to watch and follow the crowd. Plus scarves look especially nice with kurtas so it’s no sacrifice.  The Indian way has the tails in back and gentle swoop of fabric in front. It’s necessary to wash before worship and before going in some temples. I’ve never been asked so much if I’ve washed.
Rule 2 pertains to shoes. Most homes and all schools require shoes to be removed before entering. The pile of shoes near the doorway is a clear indicator! And of course you need to remove shoes before entering a temple. Unlike most flip flops, my comfy Olukais have arch support. Carefully I left them outside of my very first temple, a very old one in a rural area. And when I came out I couldn’t find them.
Really? Felt a bit like I do in a parking lot when I’ve forgotten where I left my car. So I looked and looked….THERE, fifty feet from where I thought I left them, were my distinctive purple Olukais. I slipped them on and they were wet! I looked down. Wet and clean!!
“They washed my shoes!” I told Goldie. What a nice custom. I’d never heard of that before.
“Actually,” he said, “someone stole your shoes. It can happen at a temple. It’s considered good luck to have your shoes stolen,” he paused. “And you stole them back.”
“Huh?” Took a moment for this to sink in. “It’s not stealing if they really are my shoes.”
I much prefer to think that someone washed washed my shoes, than that someone stole them, but that’s just me I suppose.
I did, though decide to have “disposable shoes,” flip flops that no one would want to steal, and that I wouldn’t care about if they did. If only I remembered to have them with me.
“Take your shoes off in the car,” said Goldie preemptively. I did and began the barefooted walk to the temple for Ganesha. But my feet are tender and soon I was hobbling along. Goldie lent me his huge shoes.
What about carrying shoes into a temple? Absolutely forbidden.
Took my sunglasses off in preparation for our meeting with the Bishnoi.
And there, on the inside of the nosepiece was my red bindi.
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Being Human

Givraj Sen is 19 and a good looking young man. And that’s important. The very first thing I

Givraj Sen

want you to know about Givraj is that he is handsome.

Because the second thing I’m going to tell you about him is that as a young boy he was severely burned.
It’s one thing to give statistics about our clinic; we served 154 people on Saturday and 144 people on Sunday, with these tests or those medications. But behind every number is a person. A real person who has a family, who is hungry sometimes and full sometimes. A person who laughs and cries. A person who celebrates and suffers. Givraj is one of those people and he has suffered a lot.
That night 16 years ago, when he was three years old, the cooking fire in the village of Kanai was larger than usual because of a celebration. Exactly what celebration doesn’t matter. It is overshadowed by what happened next. A woman aimed to enhance the fire with kerosene. Instead, she mistakenly poured a can of gasoline on the fire and it exploded. One small child was killed on the spot. Three were burned. Givraj is one of those children.
He was burned along the left side of his head, his ear was consumed, his neck, upper  torso and arm were all burned. The little boy spent a month and a half in the hospital enduring many painful procedures. His arm began to contract and the doctors forced extension so that he would retain the use of it. Although he was very young he remembers every bit of that.
Givraj is a handsome man, remember that. He has enormous thoughtful eyes and an intense manner about him. If it wasn’t pointed out to me I would not have noticed that he was severely burned. His face was spared and the scars are a similar tone as his beautiful brown skin. His black hair covers the missing ear.  Givraj comes from a caste of barbers. Barbers as far back as time. But Kinai is small and there is not so much barbering to be done and so Givraj also became a cook. Many people here have multiple jobs, trying to keep lentils in their family’s belly. An excellent cook, Givraj often works weddings and large events. The last couple days he has been working for us, cooking for the staff of our clinic and for us. Providing fresh hot food for visitors is an absolute cultural requirement. (Joan and I require separate meals because the local food is far too fiery for us.) Givraj has been cooking non-stop. I’m too busy eating and gawking to swallow the names of the dishes. The woman of the house, who’s been cooking for most of her 58 years has even learned a few tricks from the 19 year-old.
“Being Human,” reads Givraj’s shirt one day.
I love it.
“Does he know what the t-shirt says?” I ask.
“He knows it is English.”
Being Human is a brand started Salman Khan, one of the most successful actors of the Indian film industry. Being Human clothing items are sold in 15 countries and funds go to a charitable trust devoted to education and healthcare initiatives for the underprivileged in India.
Despite his injuries, Givraj has full functionality. Sort of. His hearing seems to be fine. His movements are okay. Thanks to good barbering his absent ear is not noticeable. But the skin on his neck has begun to tighten, impeding full and normal motion of his head. Mostly, Givraj is bothered by the absence his ear. I can’t help but think that he is approaching the age of marriage.
He would like plastic surgery to get a new ear.
How to go about that?
“If the government card won’t pay,” says Givraj, “I have money saved for this.”
Plastic surgery is far beyond the scope of our little clinic, but we can at least get him pointed in the right direction. We meet with the facilitator from the local NGO, who explains grafting and other possible treatments and gives Givraj the name of a plastic surgery center in Jaipur….about two-and-a-half hours away, depending upon how many cows are on the road. Mr. Rathore, who is coordinating logistics, agrees to take Givraj to Jaipur and accompany him to meetings. We try to make it very clear that this is not something that can happen quickly or at one time. (One man brought his blind son to our vision clinic and became quite angry that we couldn’t cure him, and NOW. “You call yourself a VISION CLINIC? Fix him. NOW.”)
Givraj seems to understand that. I hope he does. Like many people here who endure intense hardship, he never complains. The men in the line to see the general practitioner, suffer the intense pain of kidney stones move slowly but don’t protest. Every person, every pain is not a statistic, it represents an individual. And if we can do a little bit for a few people then that is a good thing.
I’m rooting through the box of glasses donated by Manhattan Beach vision, hoping to find another pair of sunglasses. Men get around by motorbike here and the sun and dust are brutal on even unscarred skin. I hold several pair up to the light. Darn. All have prescription lenses. Blessedly Givraj still has good vision. I’m sitting on the floor in front the battered box, looking at pair after pair and finally I find one.
The last pair of sunglasses goes to Givraj Sen.
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