YUM!

Rickshaw Ride in Vellore, India

Two (wo)Men Down, A Cyclone and The Banyan

Okay, so today our group total was four people, including Marjorie. Two wo(men) down, one wo(man) up. Today we visited The Banyan, an NGO that serves homeless women with serious mental illnesses. It is one of a few organizations that addresses this need. The location of the community was the village of Kovalam. It was a peaceful one-hour ride from Chennai, even among the looming storm, cyclone Laila. We arrived this morning and were greeted by a very friendly bunch of residents to the background music of a local Indian soap opera. We all felt overwhelmed by our celebrity status as they each wanted to shake our hands.

Our fabulous guide for the day was Miss Kiruthika. She is a social worker who has been with the Banyan for 10 months. More info about the Banyan can be found at: http://www.thebanyan.org/. Mrs. Kiruthika is in charge of pretty much everything at the PC ("Protected community" where the women live) and it is amazing to think of how she is practically able to run this center with a staff of only 10. She does everything from keep the women inside when it rains to dealing with emergency episodes overnight. She refers to the doctors and participates collaboratively in their care. In addition, there are four health care workers who take care of the women's health needs at the center. The only training they receive is at the center but they are able to deliver medications and care for the hygiene and personal needs of the women. It is truly impressive how calm and well-run the entire environment is. The women living there participate in their own care by cooking and doing chores  and small taks that are appropriate for their functional status. They are reimbursed for their work as an incentive. This location appeared to be a wonderful sanctuary where the women were able to be themselves and have their needs addressed. This safe place is also so inspiring because of the normalization of mental illness. Kiruthika does not speak of the women as people with problems, rather she addresses all of their functional aspects and told us stories about the ladies as if they were completely normal and merely had different sorts of needs. For example, she told us of a lady that liked to go out all of the time. Kiruthika explained her story in a way that did not make wandering seem abnormal. Rather she said that going out was allowed so long as the women fulfilled their tasks., and their whereabouts known. The environment itself helped to normalize behaviors such as wandering. We found this very unique.

Next stop: The Banyan's Community Mental Health Project, where Davakir (coordinator of The Banyan's hospital and OPD) introduced us to the comprehensive inpatient and outpatient facilities. Here, Marjorie and Davakir delight in the baskets that are handmade by the patients and then sold at local shops...

Ferdinand and his friend take shelter from the storm.

Cyclone Laila brought MASSIVE waves to the coast (although we were tempted to take the pictured boat out for a spin, we elected to stay cozy in the car, listening to current Tamil pop hits)

Saree Night with Mrs. Shirley

Monday night found us playing dress-up at Mrs. Shirley's house. She outfitted each of us with a saree from her colorful wardrobe with matching bangles, earrings and necklaces. We really needed guidance from an expert because navigating the 6 meters of silky fabric would have resulted in a tangled mess of nursing students! Our proper Indian outfits were completed with bright-red lipstick bindis.

* Trivia question #1: Where did Caitlin purchase this beautiful yellow saree? (Hint: please see prior blog posts for the answer)

The New Nursing School at CMC!

On our last full of day in Vellore, we had the pleasure of a guided tour of the new nursing school, which they are planning on moving into over the next few months. The space is absolutely gorgeous and very well thought out, down to the 't'. Dean Rosaline and Mrs. Shirley were giddy with excitement as they showed us their new chapel, offices, classrooms, gardens.

Weekend with Aparna's Family: Good People - May 15-16

Friday night, we said goodbye to Carla who was heading back to Penn for graduation. Bon Voyage! Aparna's mom came for a visit and after visiting the golden temple in Vellore, she suggested we come back to Bengaluru to stay with her family.  With the promise of amazing sights and better weather we abandoned our loose plans in hot and sticky Vellore and travelled four hours west to Bengaluru.  We stayed at Aparna's auntie and uncle's lovely house where we were fed delicious food and spicy chai tea until we were stuffed.... and then we were fed some more.  At the end of the weekend we all left a few pounds heavier... and happier ;)

On Saturday we drove to Mysore to see the famous Mysore Palace.  Our first stop was the grand  Lalitha Palace for lunch in the sky blue dining room. 

We then travelled up to 1062m to the top of Chamundi Hill to see the Sri Chamundeswari Temple. The temple was awe-inspiring, but the monkeys were what really held our attention! They seemed think they owned the temple territory.

 We finally made it to the palace in the late afternoon and met up with Geetha - another one of Aparna's aunties.  She continued the family tradition of spoiling us and showed us around Mysore Palace and then took us out for coffee.  The palace is one of India's grandest buildings by far.  It was built by an English architect in 1912 after the original Sandalwood Palace was destroyed by fire.  The architecture is a combination of Hindu, Muslim and Edwardian architecture dominated by colorful tiles, stained glass and intricately carved doors.  It is, as Lonely Planet describes, "undoubtedly over the top".  Unfortunately interior photos are forbidden, but enjoy the shots of the exterior - it is especially spectacular when lit up at night for half an hour once a week.  What luck that we happened to be there to see it lit!

On Sunday morning we took a relaxed walk around Lalbagh Botanical Gardens, guided by Aparna's Uncle. The gardens were built in 1760 by Sultan Haider Ali and are filled with very old trees from around the world and was a peaceful respite for all.

Good Eats!

We were honored to be invited to dinner at Dean Rosaline's house with her family.  The meal was delicious and it was so nice to be treated to a homecooked meal. 

Here is a smattering of some of the other rich, local fare we've indulged in.

Treated to chaat by Aparna's cousins in Bengaluru - thanks Savitha & Janaki!

Treated to breakfast by Aparna's uncle after our walk through the public garden.

Breakfast at Aparna's family's house:

Jack fruit on the street of Mysore

Lunch at Lalitha Palace, on our way to Mysore

CMC Community and Psych - May 12-14, 17-18

Urban Health -

We finished up our community health rotation with the CMC College of Nursing Urban Health Department. We saw another impressive example of nurses and student nurses making an impact in a low-resource environment.

Among other valuable lessons, we learned how to make an economical and ecological small paper bag out of newspaper for stool specimen collection - I'm sure this will come in handy at some point in our careers!

Psychiatry

The psychiatry hospital at CMC is a truly family-centered program. On the grounds of the hospital are housing options for patient and family where families are required to stay with the patient in order to learn about their therapy and drug regimen in order to make the transition back home easier. The hospital also features an impressive family center for children with intellectual disabilities. The multidisciplinary team of doctors, nurses, occupational therapists, social workers and many others collaborate to provide comprehensive care for the patients and their family.    They also use electro-convulsive therapy (ECT), aka "shock" therapy for some patients.  Below are the drugs used during ECT, as prepared by the nurse.

May 10-11 - CONCH, CHAD and RUHSA

CONCH:

We visited a variety of sites run by the Rural Community Health Department starting bright and early Monday morning. There are a total of 20 sites, each entirely run by nurses. Nursing students from the College of Nursing spend a considerable amount of time at these sites learning assessment skills, patient education skills, and community health theory. We were guided by Mrs. Priya, a nurse-midwife with nine-years experience and a fellowship in Family Practice. She is also a tutor (lecturer/clinical instructor) at the CoN.
On Monday we visited Arapakkam, a village with a population of approximately 2,000 people. The nurse run clinic there is associated with the College of Nursing Community Health (CONCH) program. They provide care in the clinic as well as making home visits. They do home visits for antenatal patients, postnatal patients, patients with chronic illnesses (most commonly hypertension and diabetes), infants and malnourished children. We visited a government run preschool in the village, took a tour of the village, observed a home visit for an elderly women with hypertension and observed prenatal care at the clinic. Below is a shot of the medication being dispensed at the clinic.

On Tuesday we visited our second CONCH site, another rural health clinic, again accompanied by the fearless Mrs. Priya, who somehow had not run out of patience for us! The model was the same as the first with a few more programs such as a geriatric day program being conducted as well as a community health lesson for local mothers about child, home safety. Coincidentally, we also saw a young boy come in with his mother with burns from spilled hot tea which served as an anecdote during the lesson. He was given first aid and referred to the hospital for further treatment.

Of interest, the temperature hit 108F today.
CHAD:

Community Health and Development (CHAD) is a Christian Medical College (CMC) run program serving the Kanniyamvadi block. Our orientation leader, Julius, a college tutor and nurse, gave a thorough overview of the available services offered at the base hospital and the outreach services.
They offer a family centered model of care. Weekly specialist clinics include TB and HIV, high-risk antenatal care, general clinics, diabetes and leprosy. They also pride themselves on their research collaborations with CMC, NGOs and international partners. In terms of outreach services, CHAD runs doctor-run and nurse-run clinics. Both models extensively involve nurses to deliver home base care and gather vital population statistics for each village. Other outreach services include income generating activities for women, a suicidal intervention program, marriage counseling, and training and development for village health nurses.

RUHSA:

The Rural Unit for Health and Social Affairs (RUHSA) is another CMC run program serving the K.V. Kuppam block, which is composed of 100+ villages, 18 centers and approximately 100,000 (1 lakh) people. Each is managed by a rural community officer who coordinates the volunteer corps that helps run health, social development and economic development initiatives. They have an integrated model for rural development which complements government initiatives. They organize youth groups, trade co-ops, women's groups, elderly daycare centers, tribal development education programs and a community college.

Along with their community initiatives they also have a 75 bed hospital with secondary care services which serves the 100+ villages. They can perform a limited number of surgeries including tubal ligation (tubectomy) and cesarean sections. Pictured below are the labor and delivery beds and the laboratory for in-house blood tests and urinalysis.

May 8-9, Mahaballipuram

On our first weekend off we made a trip to the coastal town of Mahabalipuram, aka "Backpackistan" - famous for temples, monuments, beach resorts and of course, backpackers.

We started off at 6am in a hired car (this time with glorious AC!) and a super friendly driver - Ashok. We were deadset on heading straight to the beach, but were sidetracked by a temple in Kanchipuram.

Ekambareshvara Temple: This temple is famous for its 1,008 lingas, which represent Shiva. It was mostly constructed in the 16th and 17th c. In the middle of the temple is a mango tree which represents the marriage of Shiva and Kamakshi. What was supposed to be a 15-min sidetrip, turned into a 3-hour tour... After being sufficiently blessed, and with empty wallets, we headed back out on the road.

Mahabalipuram: We rolled into town late morning and found a little restaurant that served a nice mix of French (crepes!), British and Indian - everyone was satiated. The heat was fairly unbearable so we could think of no better way to spend the afternoon than going on a grand tour of 6 monuments - with AC in the car in between!

Monument #1: Tiger Cave and Lookout Point
Tiger Cave - Included a niche surrounded by carved tigers where kings meditated.
Lookout Point - Used to search for approaching adversaries and where our tour guide clambered up to escape the Tsunami in 2005.

Monument #2: Shore Temple

This temple is one of the oldest temples in south India, built in the early 8th c. It's design spread across south India and southeast Asia. The temple is surrounded by the bull, Nandi, and has an east and west shrine, as can be seen in the photo.

Monument #3: Five Rathas aka Panchapandava (aka Smurf Village)

These date to Narsimhavarman 1, between 630-670CE and represent the five chariots of Pandava, an Indian dynasty. The monument is composed of 5 sculptures immitating traditional temples (and looked like Smurf Village-like houses) and a lifesize elephant. The style is a model for Dravida, southern style. We were again asked to pose for many Indian family photos - its funny to think we will be included in a strangers family photo album!

Monument #4: Mahishasuramardini (Old Lighthouse Temple)This temple was placed on a high rock ledge where a modern day lighthouse has also been built. There were lots of goats and a great view all the way to the shore. The rock carving is one of the most celebrated pieces of Indian art. It portrays a battle between Mahishasura (bad guy) and the good guys (gods).

Monument #5: Krishna Mandapa

This detail of the very large, intricate bas-relief carvings at Krishna Mandapa shows Krishna milking a cow.

Monument #6: Arjuna's Penance

Another intricate bas-relief example with a life-size elephant and elephant calf. It depicts the story of Arjuna traveling to the Ganges to do penance in the hope that Shiva would part with his favorite weapon, a magic staff.

We relaxed with a stroll on the beach among the fishing boats after our long temple-touring day.

On the way home on Sunday we stopped again in Kanchipuram, again, for what we thought would be a quick trip, this time to a Sari shop, but turned into many cups of masala chai, a demonstration of silk sari making and just a few purchases...

We made it home by 8pm and went to bed soon after, in anticipation of a busy week with the College of Nursing Community Health and Psych Departments.