SWOT Team Week One--Mission Status: Complete

***Jackie the last few parts are for u in response to ur comments...***

Saturday evening...one week officialy down for the SWOT team. Today was a relaxed day...we woke up pretty late (is around 8 late???)...then Emma headed off w/Hema and Sudarshan to Apollo and we left to go to the National Museum. The minute we stepped outside of Bapu Nature we were SO thankful to have rented a car as opposed to having opted for an auto. The museum was really nice and had some great artwork else as well as other stuff (stuff up to 4000 yrs old and as recent as 50 yrs back)---the most amazing to me was this preserved skeleton of a middle-aged woman from abt 4000 yrs back...complete w/the remains of bangles on one of her hands as well as the diya lit above her head---even the pots of the offerings made for her after death were untouched...absolutely unimaginable. We were also amazed to see some pots that dated back some thousand years and looked like they hadn't been touched. There were also paintings from the times of the Moghuls that depicted scenes from the Mahabharata, Ramayana and Bhagavat. Farah and I played great historians for a few seconds as we deeply analyzed one painting---of course I think in reality both of us probably had no idea what we were looking at or what we were saying.

On our way back the driver drove us up to the Parliament etc right across from India Gate and then also stopped at this one store to buy showpieces etc but it was just way too overpriced...after that headed home.

Tommorrow we are most likely headed off to our apartment in Vasant Kunj for our rotations this coming week since Jaipur is on-hold for the moment.

Well it's nice to know that someone is kind enough (read Jackie) to read these pathetic attempts at blogging and make comments...muchos gracias mi amiga :)

Jackied commented: "What do you do when you have some spare time? I am so curious to see what your accommodations and the clinic and the outside and everything look like."

Last weekend we had visited an upscale mall and ate out and also done some sightseeing (e.g. India Gate...Qutab Minar...Lotus Temple)...last weekend post-orientation Sudarshan had also treated us to a nice lunch at Chopsticks-a very upscale buffet place...a place that the celebs here rave abt. This past week we were staying at Bapu Nature Center...it is a center where alternative medicine is practiced and such services are provided. There are guesthouses on the second floor and we're staying there---actually our first night here when we arrived early Saturday morning (4 am or so) we were put in a very basic room which totally freaked us out. The next day however we were shifted to a little more up-ety room (I promise nothing fancy) and we've three single beds...a bathroom w/shower and toilet...and a fridge as well as AC. Of course the past two days the AC has not been working so that's an issue in itself (Delhi heat does not go down much at night). We also have a TV but that too doesn't have any channels working and w/the power out along w/the AC we've lost the power to the TV and fridge...fun stuff eh? In our spare time thus far we've walked to the cafe in the evening to log online and also stop on our way to pick up the basic necessities---bottled water...detergent to clean clothes (yes mom we cleaned clothes on our own)...and some candy :):):) Otherwise we usually just head home and eat in Paul's room and hit the sack. This schedule will probably change every week depending on where we're lodging and where our site visits will be.

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Jackie commented: "How hot is it would you say?"

Temps eh? Here is the official forecast for the coming few days...

High: 106°Low: 81°
High: 107°Low: 83°
High: 106°Low: 85°
High: 111°Low: 86°
High: 111°Low: 89°

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Jackie commented: "This entry did not talk about the CSW's but I cannot get over the fact that they service 8-10 ppl per day!!!!!! Ouch...Is there mental health support and services for these people too"

There is counselling available to them but it cannot be really called mental health support...I think it's more so simply to provide them w/the education to work more safely.

Strengths, Weaknesses, Opportunities, Threats a la SWOT

Below: SPYM Truck Driver/CSW Center, Delhi

Below: HIV Rapid Testing

Below and Below: Pizza Hut

For those who asked...the title answers your question :) We learned it in my fave man Dr. Calderon's class. Wow so two days since the last blog eh? What if I were to say I cannot even remember what we did about 30 minutes back. Yesterday---we visited the truck drivers center run by SPYM where they provide education...rapid-testing...as well as condoms, etc to truck drivers, CSW's (commercial sex-workers) and others in the area. It was very interesting to interact w/the social-workers as well as the guy who conducts the rapid-testing (takes abt 25 minutes to come up w/the results). The situation is very grave particularly among the MSM (males who have sex w/males) and CSW's. Some of the times business is conducted for financial reasons...actually in all fairness almost all of the times services are provided for money. These CSW's serve around 8-10 clients in the day time (charge each client around $5-$10) and then hook up w/one big-buyer for the night time who pays them around a $100 and provides the booze...meat...whatever else the CSW may want to the spend the night. The situation for truck-drivers seems to have improved as now many have not only heard of the word HIV-AIDS but tend to know a little abt it...as opposed to sometime back where around 90% had only heard of the word but knew nothing more. These services have also worked to break the misconception that the disease is spread ONLY via sexual-relations. We also had time to interact w/the peer counsellor...an older amma (mother like figure from the community but who is not a CSW) who works w/the women and educates/provides condoms/etc directly at the addas (e.g. where the women conduct business). If we hadn't been so exhausted from the heat we could've probably asked even more questions but all in all it was a great experience. Also-because of the heat we were unable to go out in the field and interact directly w/the clients (e.g. truck-drivers).

Today was a lighter day and we left later. We visited a detox center again run by SPYM (don't ask what it stands for because right now I cannot remember...maybe one of the other three remember). They work w/substance abusers to help them overcome the addiction. Though we didn't spend too much time there the few hours proved very valuable. Towards the end we played a bollywood trivia game w/them and they 'returned the favor' by also entertaining us (Farah had bought cookies-biscuits as rewards for answering questions right in the Bollywood trivia and it worked wonderfully). One of the truck drivers acted out a part of Ram-leela (the part where Rambhagwan breaks the bow) and he was FANTASTIC. I later found out from Farah he was a performer. Several others sang songs or recited shayaris (poetry) and one of the young social worker guys (or was he a student) sang 'Hothon Se Choo Lo Tum' w/all his heart put into it :):):) Another one of the guys working there told a story abt a rickshaw driver-police man and interwined the old song 'Awaz Na Do' into the story...it was creative. The men at this center are provided w/the sessions throughout the day that are not only fun but also are helping w/their detox. When we first walked in one lady was playing a game w/cards to teach them the alphabet and at the same time asking them to identify words from each letter of the alphabet that correlate to their problem...e.g. if the letter being taught was 'ga' then maybe some guy might say 'ghum' (sadness) as a word started w/'ga'.

After that we left for lunch which was none other then Pizza Hut...of course it happened in a totally different context...not at Noida...we went w/Sudarshanji to another one but definitely enjoyed it. Thereafter he dropped us off at Ansal Plaza...a sorta upscale plaza w/everything from Lacoste to Levi's to Gap to what not. But NO Baristas or Coffee Day :(:(:( Lol ok that sounds spoiled I know...but we did find Dots Ice Cream which was good but not nearly enough...35 Rs. for a small cup...it took us a while to find a rickshaw but we lugged home eventually...our first time coming home w/no help and saving money w/out overpaying :):):)

Mewat did not happen today because of political tensions...very intense in the surrounding areas...and Jaipur may also not happen which may mean another week in Bapu Nature...fun-stuff eh??? I think I will be on this weekend as we've time now...

Just Another Typical SWOT Day

Below: St. Stephen's Hospital, Delhi

Below: Me, Dr. Jain, Paul, Emma

Am writing in a bit early today because we got a chance at the hospital cafe. It's the three of us...Farah had to go home earlier w/Shalini because she wasn't well (she fainted while we were doing rounds w/Dr. Jain). She IS absolutely fine so no worries. She is at home resting---or atleast we think. Dr. Jain was standing right w/us when it happened so it was really a blessing. We had lunch and came down here to wait for Dr. Jain's clinic in the afternoon...ok gotta run...

Am back...after lunch we ended up going to the cyber cafe briefly which was yet another internet using experience here w/crashing computers and not-working internet (yes that is gramatically incorrect). Around 2:30 we were finally at Dr. Jain's HIV clinic where we sat in as he consulted w/patients. There were many men of many ages but the one case I think we will all remember is a girl around 18 y/o to whom Dr. Jain broke the news that the final set of test results were HIV+ and she had it. She took it pretty well we thought since she already knew she had it and was waiting for the confirmation. She had contracted it from one of the less-familiar ways---when she was younger her parents had taken her to a local practitioner for TB, pneumonia, etc and received injections where she was likely to have contracted it. It was beyond any words I can think of to see Dr. Jain tell her and their conversation that followed as he told her abt the disease...how it works...what to expect...etc etc etc. The best part was hearing him tell her to live life normally-and that it was possible for her to do. At the end of the clinic hours we bid him farewell and came home to find yet some more excitement awaiting us...

Total aside...we all found Dr. Jain to be just fantastic. He showed sincere interest in teaching us and showed full interest in answering all of our questions. He took the time to explain the case of each pt and what exactly was going on (patience---not a virtue possessed by too many doctors). Such a nice person---Emma complimented him on his devotion to his work and he didn't respond...very modest.

Farah who had come home earlier (and is doing just fine) had found a mouse running around the room---lol imagine the chaos that followed. As of now we believe it's gone from the room but who knows what we'll find waiting for us when we're back there :)

Good Times

Today started off very early (too early) at 5 when we woke up to leave at 6:30 so that we would be at the St. Stephen's bus stand to catch the 8 am bus. We got there an hour early so had to hang around bfr the big car (so much for a bus) drove us to our site for the day...the outreach center run by St. Stephen's Hospital in east Delhi which manages to serve approximately 90,000 people in the slums areas that surround the center. The work done there is amazing---services are provided so that the first visit is 10 Rs. and each visit thereafter is a mere 3 Rs. (and prescribed meds are altogether free). The center is staffed by some 75 people including some of whom we met...Dr. John (female doc who has been working at the center for more then the past two decades)...Dr. Ramona (a resident from Indore)...Dr. Robin...and several other community medicine postgraduate docs. Throughout the day we observed the various activities taking place at the center. One of the major concerns within the area is malnutrition among children...it is extremely common to find young children w/pica and insufficient calorie intake.

There is also emphasis on providing women w/the necessary training and/or support to generate income. Women at the center make and package masalas (spices) for income and Dr. Robin also took us to a shop near by that is owned by the center...at the shop upstairs girls are taught how to sew, etc to make kurtis, purses, etc which are then sold downstairs. Beautiful stuff I tell u!!!

As an aside---at the center there is also a daycare center where single and struggling parents (only those who qualify) leave their children for the day. The kids are ABSOLUTELY adorable...heck I wanted Emma to convince Todd into adopting one or two!!! It was so sad to hear that not only were some of these children malnourished but many were also physically abused by their parents. The daycare center serves as a safe-haven for these kids and provides atleast a few hours of happiness...there was one little boy Dr. John told us abt who is abused by his mother. She told us when he first came he never smiled but after spending time at the center he has learned to smile :):):) These are things we only read abt in the books---it was a blessing to have heard the story firsthand.

Today was a little bit more sane so nothing too exciting or dramatic atleast in comparision to the last couple of days. But there are still a few hours to the day left so anything is possible :):):)

Oh btw we're getting a hang of this rickshaw thing---we sorta got lost but after a call w/Shalini we managed to be home just a little while later...my apoligies for not having posted videos or pics. This is not to say we don't have them---we have plenty...it's just hard to get them to the cafe and load them up...so we're waiting for when we get a chance to do so...

Whoa for all of us :):):)

Below: SWOT Team at SAHARA Transgender Center

Below: It rained as soon as we stepped out :(

Below: Five people rickshaw ride---goodtimes :):):)

Well what a day...this morn as we were peacefully talking and waiting to leave in the little front entrance of Bapu Nature a massive lizard flies down from the wall and hits the ground only a little away from us!!! YUCK!!! So the gang headed out today at 7:30 in the morn with Shalini who is our 'guardian'/guide here for our first site visit at St. Stephen's Hospital (the oldest hospital in Delhi---and doing the best work)...where after a video orientation w/the director's secretary John we did rounds w/a very nice Dr. Jain. I don't think I can sit here and describe what we saw and experienced as we walked through the various wards. St. Stephen's is a private missionary run hospital that does some great work. Just so many people and such (absolute) substandard conditions and yet the docs and nurses work so hard and manage. Our system in the US is leagues ahead in terms of technology etc but personally I feel docs/nurses/HCP need to be commended here for managing to provide just as effective if not more effective tx to pts...pts from the slums...pts from very low incomes...pts w/chronic diseases...pts w/whatever u can imagine. Unlike the US it is not uncommon to find pts w/typhoid, polio and TB. What surprised me was seeing multiple pts admitted w/RA...definitely something I didn't think ppl were commonly admitted for. HIV tx here is free but only for the standard protocol retro-virals...for the secondary types pts are still required to pay...except they just cannot afford it and therefore they cannot receive it!!! Viral loads and CD4 counts are quite often done only once a year for HIV+ pts if even that---as one viral load test costs 4000 Rs. (close to a $100). How can they afford that??? We are talking abt individuals who are living in the slums and who just don't have the resources.

That was just the morning. We had a delicious lunch at the hospital staff mess (there was yum fresh mango pickle that Farah and I devoured) and then headed off to the SAHARA Transgender project which is also established in Old Delhi. That again was quite an experience...up till now we had only read about sex-workers and what not in the scholarly articles but to be able to meet them personally and ask questions was just something else...hijra's...MSM...etc...such nice people who are greatly unjusted by society and the ridiculous cultural norms. Just imagine being beat by a cop on the road or even worse selling yourself to a client for 500 Rs. (roughly $10) and going into a room w/him to find that you have to 'serve' five people not one. Rates charged for services (read sex-work) are anywhere between 100 Rs. to 1000 Rs. (which is approx. $2.50-$25). The SAHARA Project is set up in locations across Delhi and each location is designated to provide different services including medical services, health educator counselling and most importantly a safe haven. These individuals (the transgender population) work from the evening to the morning hours...in the day time they often go to these SAHARA centers to hang around w/others...where they have available food...medical care...condoms...peer sessions...what not. Just being there and interacting w/them was SUCH an enlightening experience and I should be writing a lot more on this but just cannot put it into words right now. We have pictures that we will load up later. (We had a little side-drama as Emma was bit by something but luckily nothing too harmful.)

From there we headed out to go home and but of course found a downpour on us as soon as we stepped out...after some waiting and what not the five of us were squeezed into a rickshaw driving home...again can this experience be incomplete w/out some drama??? Abt half-way through our ride home some dude on a scooter touched (sorta hit) the side of our rickshaw but decided to instead blame (read yell foul language) our driver and stalk us for quite some time bfr we finally lost him...Shalini concluded he was insane...and I concluded he must have left home having fought w/his wife or work having fought w/his boss...

And here we are now...and it's still only 5:30 in the evening...who knows what can happen in the next few hours :):):) Such a quiet and peaceful day eh?

Whoa for Emma...Vat for Farah...Something for Me

Below: Bapu Nature

Below: Emma, Shalini, Me---Rickshaw Ride

Two or three days later? How many since we arrived in Delhi? The fact that I am asking this in itself says plenty. I have two blogs written on my laptop but since there is net at the cafe I don't have those blogs w/me. It's been two days but feels like we've done so much and been here much longer. Key points:

-China Airlines is definitely fly-able for the future...
-Don't have shady pictures of yourself in ur US passport in a foreign country
-India is the land of extremes...for EVERYTHING
-It is fantastic to be here in a group as opposed to being alone
-America still has something that makes it look very desirable---esp after being
here---though I love it here too
-Who says wifi is easy to get in Delhi now??? They lied!!!
-Getting ripped off is the only talent we possess here
-'Nahi chaaiye' is the word of the day
-Riding w/Emma on my lap is very possible and completely normal
-Getting stared down everywhere has become second nature---literally!!!
-Getting a cellphone charged up w/a balance took my passport---America's Homeland
security listening???
-Too many more to list which my fried brain cannot remember

Oh and for anyone who cares...my # here is: 011 91 9974165816

Packed

All packed and ready to go---the wait the day before seems the longest-even longer then the months of waiting. So further proving Leo's mssg in "Blood Diamond" I've made sure I have packed all the stuff that we spoiled Americans just cannot live with out :):):) India here comes the SWOT Team!!!