Namascar! (same as Namaste, just another version of hello)
So I'm going to start this e-mail off with a bang: Cricket. That crazy British game, quasi-resembling baseball that India, Pakistan, Bhutan and other countries can not get enough of. And has been rendered nearly impossible for Americans to understand, especially the scoring. But here are a few basics:
1. There are 2 sets of 3 wickets that the batting team runs in between to score runs.
2. There are 2 batters of the same team running between the wickets at one time. Only 1 receives the pitch. They are called "batsmen"
3. The man who pitches, or rather LAUNCHES a very hard, small ball is called a "bowler."
4. The rest of the bowler's team is in the outfield.
5. The rest of the extremely complex rules do not apply to the rest of my story...
So we decide, as a class of around 12, that we should try to play a round of cricket. One of my classmates, Jayendra, is from Bhutan and therefore quite knowledgeable of the sport. We start off with Jayendra bowling, in a amateur-friendly slow pitch fashion, to one of my male classmates (Eldon from UNC). Everything's going pretty well, except Eldon soon discovers that a cricket bat is an exceedingly heavy and awkward version of an American baseball bat. So his brilliant idea? Let's let Laura give it a go. By now, we've accumulated a few spectators. The male, Indian staff of the CRHP has started to come out to see what the crazy Westerners are up to. Now I'm OK at baseball. So with Jay pitching slowly, I was pretty successful. And many of the Indian men watching have NEVER seen a female play cricket, or any other sport. So they were surprised and commented in Marathi (translated later by Dr. Arole's son, Ravi), that this white, American girl is pretty good. To top things off, I launched a long ball over the squat building they use to build artificial limbs, securing my bragging rights. However, I should also describe our "field." It's a back lot to one of the main CRHP compound buildings, that's littered with leftover bricks, tiles and other rummage aaaand a line of latrines. You can only guess what happened. When retrieving my long ball, one of the very kind, young Indian men stepped over a bunch of tiles, covering the septic tank, and landed in a pool of human sewage. Awesome. He was fine, without injury except possibly his pride. But oh wait, it gets better. I'm appalled and promptly give up the bat, banishing myself to the outfield. But after awhile, I decide to get up again to bat. I launch ANOTHER ball over the same artificial limb hut, and a *NEW* CRHP staffer runs to get it. Now my Marathi is pretty terrible... but I still attempt to shout STOP, STOP, STOP!! (Thamba, Thamba, Thamba). But to no avail. I sent two Indian men into a large pile of crap, chasing after cricket balls. Maybe I'll give cricket a rest for awhile. :)
Back to health. I think it might be interesting to talk about... Diarrhea. Especially since it melds with the cricket story. So as many of you are already aware, diarrhea is a massive cause of infant morbidity and mortality in developing countries, like India. However, it's also one of the most common reasons for hospitalizations of infants in the United States. What's the big deal, it's just diarrhea? Well, the main problem is not necessarily the infection (though Salmonella, E. Coli, rotavirus and other nasties that cause diarrhea don't help when multiplying out of control in your gut). It's rather the extremely rapid loss of water and salts that get expelled from your GI system. Compound the loss of water and salts onto the fact that the vast majority of children in developing countries are malnourished to start, and you've got a really dangerous situation. Not to mention, that here in rural India, it was sometimes thought that a ghost or other form of black magic had grabbed hold of the child presenting with diarrhea. And how to you get rid of a GI ghost? Well, the mantrik (witch doctor/healer) says you must starve the ghost and thus the child. Which of course ends poorly for the sick child. Remind me to tell you how the mantrik "cures" tuberculosis. You'll love that one. So in the end, American infants and children don't die from diarrheal illness because we are pudgy, well-fed kids. Plus our American moms and dads were educated in the importance of maintaining adequate nutrition and hydration, AND can afford Pedialite. But here, CRHP has more of an uphill battle to fight infantile diarrhea. But here are a few ingenious ways:
1. Installing tube wells for drinking water. The CRHP worked with a German NGO to ensure that the villages stopped drinking the water they were washing in. You see, most diarrhea-causing bacteria and viruses are spread through the fecal-oral route. These tube wells reach the water table ranging from 75-200 feet below the ground surface. This depth ensures the water has been naturally filtered from contaminants. But I'll have another e-mail on water... it's a huge focus here as you can imagine.
2. A Latrine campaign. Like I've mentioned before, much less than half of the village members use a toilet. Dropping trow (spelling?) in the fields or outskirts of town is the cultural norm. Furthermore, even when the CRHP teams up with the Farmer's Club in the village to build a whole bunch of latrines, most people end up using them for grain storage!! The Village Health Workers, women's groups and Farmer's Clubs of the village end up having to hold whole village meetings to stress the use of the new toilets. Also, we're not talking western toilets that flush. I'm talking little pit-like, latrine toilets.
With little imprints for your feet on the sides. (see photo) But the campaign is working. People are starting to want latrines, especially after they see the upper crust members of the village with them. A rather interesting take on "Keeping up with the Jones' " One elderly village man in a turban approached us on our last visit, saying, "Please! Build me a toilet!" He thought our very obviously foreign group were engineers, were building toilets.3. The most ingenious, and my personal favorite. Educating the adolescent girls and also the young children. The CRHP had the Village Health Workers come up with little songs about the importance of nutrition, and how to make "limbu pani." Nutrition will be it's own e-mail, but limbu pani is quite interesting. It's rural Maharashtra's Oral Rehydration Solution (ORS)!! ORS is a life-saver for developing nations, as many of you already know. It's a balanced combination of salts, sugar and water to ensure that rehydration occurs while also re-establishing electrolyte balance. The science behind it is ingenious, the glucose (sugar) is used to "carry" the other salt ions across your gut wall, into the bloodstream. The girls and kids are taught a song about the ingredients of limbu pani, which is simply homemade ORS of lime juice, sugar and salt with water. Since measuring cups are hard to come by, they are told that the mix should be no sweeter than a banana, and no saltier than your tears. They are instructed to start limbu pani at the first signs of diarrhea, and to continue feeding the child. This method has drastically reduced infant mortality. Plus, the village health workers came up with an alternate recipe for some of the new villages joining CRHP. These villages are significantly farther from Jamkhed, and limes are harder to come by. The VHWs thus substituted rice water. Brilliant! This is cheaper than manufactured ORS tablets, and much easier to access. Maybe this is something that could be useful in the states, for more impoverished areas?? The use of ORS solution would save a lot of healthcare $$ in the US, by preventing hospitalizations for IV fluid rehydration... hmmmm.
Things to ponder:
The book, Freakonomics. It's short and written by a very young, un-traditional economist. He's considered quite brilliant, yet controversial for many reasons. He became a Harvard Society fellow at the age of 26. I better get a move on, my 27th birthday is right around the corner. :)
The Bollywood movie, Lagaan. It's fantastic. Albeit, 3.5 hours long. :) But it's chock full of dancing, singing, love and cheesiness. And the villian: the BRITISH!! The subtitles are often interesting. Whenever there was a scenic interlude between dialogues, the caption read "vanilla." But no one was speaking. :) We have yet to figure out what on earth the caption writers think vanilla describes.
I've attached 3 photos. The "adolescent" is one of the many girls who swarmed me for photos while they were visiting. Many of them have never seen a white person with blue eyes before. If you notice, there is a Bic mechanical pencil tucked into her blouse. It's one of many that I dispersed of the donations I was given by the lovely ladies of the primary care office. I had to teach them how to push out and retract the lead. They were a huge hit, these "American pens." The 2nd photo is of Yamunabai, the village health worker with 2 of the girls from her village. As you can see, they have quite a bond. Yamunabai is lovely, and so kind. She is of the untouchable caste and has had an extremely hard life. She loves big hugs and tries to talk to me in Marathi... but we have a pretty good sign language, head bobble thing going to communicate. :) And the 3rd is of the infamous "Indian toilet." You can figure out for yourself what the little buckets are for...
Well that's all for now! I have to get to class. Hope all is well back home. Keep in touch! Bare yete (see you later in Marathi)!
Wish you were here,
Laura
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