Looking through the seemingly endless charts at Vikram has not been the most exhilarating experience. To supplement my week with something more palatable, I have been going on outreach trips with the members of PHRI. There are several opportunities to get involved with the multiple projects that are going on. In addition to these outreach projects, the organization provides reproductive health supplies and offers free medical service for women in their clinic. The clinic is a part of the CSI Holdsworth Memorial Hospital in Mysore.
One of the outreach programs is aimed at TBA's. These can be either trained or traditional birth attendants. In India, about 60% of births occur outside hospital settings. Therefore, it is imperative that the birth attendants be well trained, offer accurate information, and have full access to life-saving medications. I have been doing some reading to learn more about this project, and I am completely engrossed. However, we can save that discussion for another time. I went out with the group to interview a few TBA's in different villages surrounding Mysore city. We listened to their opinion about how the government has failed women in their profession and gained valuable information about their resources. The organization (namely Tom, Naomi, and I) has bought a hefty load of birthing kits to distribute to these TBA's. The kit contains a thick plastic sheet to create a clean environment for the delivery, a pair of latex gloves, a bar of soap, some gauze and absorbent pads, and a sterile blade for the umbilical cord.
The picture is of the group giving a TBA some birthing kits. On the right they are Selvi, Seema, and Reni. This project is incredible and has the potential to have a significant, tangible impact for women, and families, in these rural areas. Maternal mortality rates are high in the rural parts of India, and this program is working on saving the lives of these women and subsequently, their children.
Side note: We were driving into this village in the Prerana van, when a big (7 ft???), black snake crossed the road ahead of us. The driver slammed the brakes real hard and all the girls (present company included) screamed. Ok. It was a snake on the road. We are in a car. No big deal? The car was silent for a minute. I was asking them if they were ok. No response. Silence. After about two minutes of complete silence (despite my attempts to break the silence with stupid questions wondering why everyone was quiet), Seema turned around to explain to me the reason for the silence. In their religion, some snakes are revered as deities. It is bad luck to have one cross your path when you are coming into an unfamiliar environment, like this village. I am assuming it is the equivalent of a black cat crossing your path, except it is not superstition to them. When this happens, you must silently pray to Naga Devata so that bad luck will not follow. Ok, now I see the reason for the silence, this makes sense. So you have to do this everytime a snake crosses your path? No. Wrong. Only when COBRAS cross your path. What? Are you effing kidding me? That was a cobra? Now I am the one in the car freaking out, while the rest of the group is calm. That is not cool. I hate all snakes in general, but especially big, black, deadly cobras. I keep thinking about that stupid program I watched on Discovery about the world's deadliest Cobras, 3 of the top 5 being in southern India. Great. If I ever see one, I will assume that it wants to, and is trying to kill me.
The other outreach program is about HPV and cervical cancer. These are aimed at women in defined communities around Mysore. The women congregate in a communal (usually very small and hot) room to view a slide presentation. These meetings are set up in advance by Sattya and Praba, with the help of a local community organizer.
The women seem to really enjoy these presentations, and the questions are usually pretty good. Most, if not all, of these events are in the local language, Kannada. Therefore, I can not contribute, or get as much out of the events as I would like. I do offer some comic relief for everyone. They give the women who organizes the event a small, gift wrapped present. Yashoda insists that I hand the present to the women, while butchering something in Kannada. I have become accustomed to uninhibited laughter that follows. Nevertheless, the meetings are fun and offer a welcomed break from the medical charts.
True to form, I make friends with all the kids that follow me around. The camera is always a big time hit and I find myself taking picture after picture of these kids. They never seem to get tired of posing, and will often call out to other kids. I feel like I am back in the daycare.
These events are always followed with some chai, which I am now officially addicted to. They put so much cream and sugar in it that I'm a little worried I won't be able to drink black coffee when I come back home.
The living conditions in some of these areas are dismal. Forgetting medicine for right now, there are so many public health interventions that need to happen. Open sewers, cows, chickens, feral dogs and cats, and cooking indoors with cow-patty fuel are just some of the areas I would focus on. Being in an unclean environment, with such close proximity to cows and other mammals is a great way to contribute to the spread of disease. The government (or maybe not considering how they have operated thus far) needs to step up and tackle these public health problems. There should be a social marketing campaign getting people to change some of their behaviors. Open sewers and lack of clean water are not the fault of the people and they often do not have enough of a political voice to bring about necessary change.
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