The Oldest Profession

After yet another all-too-lengthy hiatus, The Chapters are back in business. In the coming days expect a host of new posts (and maybe some ghosts?) detailing several of the reasons for the delay (including trips to a gorgeous wild-flower plateau and the city formerly known as Bombay). However those chapters will have to wait as they simply won't be done justice without photographic accompaniment.

In the meantime, I thought I'd rattle off a post about the reason I've been particularly busy this past week, and that's due to my Directed Research project. First a little background: as part of the academic component of the Contemporary India program, every student here is required to complete an internship or a directed research project (or, brand new to this semester, a documentary, but for simplicity's sake we'll focus on the first two). In either case, each student is paired with a company or organization that in one way or another aligns with some part of the short statement of interest we all wrote many months ago when we were applying. For the internship people (about three quarters of the students) their purpose is fairly straight-forward: do whatever work/project/manual labor their organization instructs them to do (just kidding about that last one-I hope). Meanwhile, for the directed research people, the focus is decidedly more scholarly. While we're still paired with an organization that reflects our research interests, we're also given a short research "menu" that lists the two topics that we're allowed to do research on (I didn't ask whether we could craft our own option since both of my topics were quite compelling, but I'm sure there's some flexibility there) . Once a topic is selected, a fairly lengthy (10-12 pages, 1.5 spaced!) Research Proposal is drafted basically setting the foundation of the project with a review of relevant literature, hypothesis formation and methodology planning. After that you do some actual research for five weeks and then tie it all together in an even longer paper (15-18 pages!).

*Side-note: The internship also have to write a paper of some sort but we all know that the directed research people are the real scholars here. Who needs work experience when you have the scientific process??

Now, returning to my project specifically, I noted above how the time when we wrote our statements of interest was long, long ago. As such, I could not for the life of me remember what I had written about other than that I had said something about health and might have mentioned alternative medical practices as a possible area of interest. With that in my mind, I'm sure you have no trouble imagining my surprise when I found out that I would be paired with an organization known as Saheli, a female sex workers' collective. Turns out I had also mentioned STD prevention as a possible area of interest which naturally suggested my desire to work in the red-light district of Pune. All kidding aside though, despite my surprise I was actually really excited to find out about my placement since I knew it would be just another eye-opening cultural experience; not quite like re-learning to eat with my hands or remembering to ride my bike on the left side of the road but in the same ball-park of new experiences provided by India.

Since learning about my topic about two and a half weeks ago, I've already visited Saheli three times and have only positive things to say about my experience thus far. While they're located just off one of the biggest and craziest shopping streets in all of Pune (Laxmi Road), the actual facility is quite non-descript, consisting of two-stories tucked away down a narrow alley. The first floor is actually a 24-hr nursery for the children of the workers, complete with a kitchen, play room and cubby room (and beautifully decorated for the impending Diwali holiday). This nursery provides an invaluable service to many of the women who would otherwise be forced to keep their children in the brothel, or in the case of a less understanding brothel-keeper, let them roam the streets on their own. Up two flights of stairs is the main office, consisting of the director's room (Tejaswi), the accounting room (where Manu and Sarika work) and a general work room (most everyone else, including myself and Karunadeep). None of the rooms are particularly big nor the power particularly reliable, but in my three trips I've yet to encounter someone who wasn't noticeably happy and upbeat the whole time I was there.

Tejaswi (the director) is a women in her early 40s who radiates authority without being (too) intimidating. She's been with the program since the it began as a short-term project of a major NGO in 1991. When the NGO ran out of funding and looked to close up shop around 1997, she and other's at the organization realized that their work with these women could never really be done and so remade themselves into a sex worker's collective, an organization for sex workers and run by sex workers, and thus Saheli (which means female friend in Hindi was born). I talked with her for quite a while on my first visit just going over what we expected out of each other, what she thought about my topic and just general information about the role Saheli plays in these women's lives. I came away thoroughly impressed by the determination to help these women lead independent, healthy life styles and the dedication to work long days and in often difficult circumstances to do so. Manu runs the books at Saheli, keeping track of all the paper work that needs to regularly submitted to their main source of funding, the Bill and Melinda Gates Foundation. She also exudes energy and passion for her work, and was quick to offer me any help she could provide. Sarika is the program manager at Saheli, a role that everyone in the office agreed was by far the most taxing. The program manager is tasked with making sure all the various services provided by Saheli (focus group meetings, free condom distribution, information sessions, the nursery) run without a hitch. Despite this incredible work load, Sarika is always my go-to source for information for my project, never hesitating to take a moment away from whatever's she doing to answer my questions. Karunadeep, usually the only other guy at the office besides me, is the general do-everything worker that every organization needs, doing everything from data-entry to tea-making (a very crucial role when you're talking about India) and of course helping me learn everyone's names. Karunadeep probably has the biggest smile of anyone in the office, and while we can't always communicate verbally because of language barriers, somehow he always manages to understand what I'm trying to say.

I realized I never actually mentioned what topic of research I actually ended up choosing for my project, clearly a fairly important piece of information for those of you still with me. My project will look to understand why many of these women are reluctant to seek STD testing and treatment despite showing symptoms and having positive support institutions like Saheli and government health clinics. Much of this past week was spent researching the answer to this question, and while the women will ultimately provide the final say, a few key factors have emerged. The most prominent based on the literature seems to be a fear of facing stigmatization, discrimination and rejection my peers and loved ones if a test were to come back positive. Particularly in regards to HIV, women are deeply concerned that they'll be completely ostracized both from their families and their line of work if a positive test were to become public knowledge. Sarika also suggested that a lack of knowledge about what happens a positive test has led many women to view a positive test result as a sort of "death sentence," and that they'd just rather not know than live with that sort of fate hanging over them. I'm also hoping to find out whether things like alcoholism, restrictive brothel keeper policies (their bosses not letting them seek testing/treatment) or some other factors might play a role. My research will consist primarily of interviewing the women directly, as well as other members of their social network, like their "partners" (non-paying lovers), peer counselors from Saheli, their brothel keepers and health workers. Hopefully by talking to all these people I'll be able to get a better handle on why these women won't do what's ultimately in the best interest for both them and the community at large.

This post has already become much longer than I envisioned but I hope that the change of pace has been a welcome one to most people. I'll try to add some pictures of the organization when I can but in the meantime look forward to the upcoming travel-related posts and of course the eventual return of "A Turn to the Tummy." I promise I'm just collecting photos of many different types of food (and of course subsequently sampling them), but expect to see the fruits of this labor soon! Once again sorry for the delay, now that we're entering the Internship/DR part of the program some of our classes are ending so blog posts should be occurring with more frequency. But for now its time for my host parent's massive concert at their house (coverage by the Chapters to follow of course) and then off to Madrid to see a Miss Hickey! Namaskar!

Taking the "Tribal Village" out of "Tribal Village Visit"

Two weekends ago we left the barely controlled chaos of Pune behind for one of the hallmark components of the Contemporary India program, the "tribal village" visit. I say "tribal village" because a good portion of us never actually got to see much of a tribal village at all. However, that's not to suggest that I felt the trip was a waste or even disappointing, because of the quality of what we got to experience instead. While we weren't able to do much on the day we left for the village, on account of the leisurely 7 hour van ride, the next day had no such downtime.

Immediately following breakfast, the 12 of us in the Public Health course were whisked away to the nearby Primary Health Center. A PHC is essentially the first significant line of defense in rural healthcare in India, ideally serving a population of no more than 30,000 but unfortunately ideals rarely find a foothold in reality. This particular center wasn't too overstretched though, serving a community of between 35,000-38,000, albeit with chronic understaffing in some of the lower level positions. Centers are designed to provide substantial preventative care, like vaccines and ante-/post-natal services, but can also treat relatively minor illnesses like diarrhea and vomiting. Anything more serious merits referral to a Community Health Center, a small, rural hospital and the next "rung" on the healthcare ladder, or in the most dire of circumstances, patients can be sent directly to a major urban hospital for advanced treatment.

Returning to our PHC though, upon taking a tour of the small campus (which contained both medical facilities and residential spacing for the staff), we discovered the first remarkable fact about the center, as well as the first disappointment. Aside from a five rupee (~ 12 cents) fee charged for the initial check-up, all of the services offered at the facility are provided at no cost to anyone who walks through the door. Sadly, even this theoretically "nominal" charge represents a substantial burden for a significant portion of the rural community. Part of the reason for this is the not inconsequential matter of actually getting to the center from one's village. In some cases the villages can be as much as a dozen miles off, which doesn't sound like much until you consider that almost no one in these areas has a car and a scooter's not exactly ideal transport for a pregnant woman or someone with a broken leg. The government does subsidize private car owners in the area, but even then the patient is expected to come up with 20 rupees on their own. Such a sum is substantial in and of itself in these areas, but combined with a lost day's wages (men almost always accompany their wives to the center), the financial burden can prevent a family from making the trek to the center.

Main medical facility- disregard really sad-looking tree

The unintelligible Hindi word you see many times

in the right column basically means "free"

Congratulations on your first Hindi lesson!

Less disheartening was the recently renovated pre-natal room, an immaculate room for housing women in the last week of pregnancy. Whereas the other rooms around the campus had stone walls and ceilings, this room had bright, white tiles and freshly painted walls, along with a tv and private bathroom. All of this (and the 400 rupees a day that a woman gets while she stays in the room) is part of the massive push by the government to reduce maternal mortality in India. While infant mortality has declined substantially here over the past few decades, maternal mortality has remained stubbornly high. Fortunately, efforts like these should go a long way towards turning that trend around.

Swanky pre-delivery ward.

My potential competition in keeping the values of modern

medicine alive and well. Or just a really nice guy.

The best part of the visit was talking to the doctors though, since the two we got to meet were actually trained in two different types of medicine. While one had been trained in modern (or allopathic) medicine, the other had gone to school for just as long to learn Ayurvedic medicine. This type of medicine has long been practiced in India and attempts to maintain harmony between mind, body and soul. As someone who has a vested interest in preserving faith in modern medicine (got pay back those med-school loans somehow), I'd had a (mostly healthy) skepticism of this alternative branch of medicine. My fears were largely unfounded though, as the Indian government seems to think along the same lines. In addition to paying them less than half the salary of their allopathic-trained counterparts, the government actually makes it a point to train any Ayurvedic doctors in their employ in the essentials of modern medicine. What these policies amounted to, in my mind anyhow, was an institutionalized marginalization of Ayurvedic medicine. While the doctors didn't quite put it these terms, they did admit that Ayurvedic treatments were mostly confined to gastrointestinal problems, and that in almost all other circumstances allopathic treatments were the go-to cure. The doctors also shared the encouraging news that despite being trained in different medical fields, conflicts over diagnoses and treatments almost never emerged. With my future career in medicine mercifully unthreatened by the encroaching tendrils of Ayurveda, we left the PHC for a quick lunch and the next stop on our "tribal village" visit.

This stop brought us to the farms of BAIF, an NGO that works to develop sustainable agriculture in rural India and also our fine hosts for both sleeping and eating. While I could understand the lack of enthusiasm among some of my peers at seeing the wonderful world of rice growing experiments, my combined passion for the outdoors, environmentalism and the scientific process made sure I didn't share in their doldrums. The key to the whole operation was a revolutionary substance affectionally known around these parts as "wormy compost," an environmentally friendly mixture of nutritious, decaying organic matter and those world-class aerators known as earthworms (ok maybe not so revolutionary but you can't not love the name).

The scientific process at work!

(I can feel your excitement from here).

Less scientific but still really awesome vista.

These were everywhere.

Wormy compost! (More unfettered enthusiasm from my readers I'm sure)

After perusing the experimental fields where all the tests are done, we got to see one of the finished products, though in this case the farm specialized in the exciting crops of mangos, cashews and flowers rather than the humble rice plant. As much as I love crop gazing, I was definitely part of the consensus that the best part about our visit to the farm was our brief exchange with a slightly elderly tribal woman who tended the crops. While our conversation took place through a translator and lasted only about ten minutes or so, the rush of learning about a life so far removed from any you can ever hope to find in the U.S. left everyone on a study abroad high. We learned that since BAIF had gotten the farm going (they handle the start-up costs and related procedures, then turn over the operation to the community) she and her community have experienced a much higher quality of life. Even as we probed her about any ways in which the government or BAIF could do more to make her life better, she expressed her contentedness, stating that she would like to have better access to veterinary services and technology but that she enjoyed her life as is. We also found out that she's an active member in the political process (she says she votes in elections) and that her greatest aspiration is for her children to receive a quality education so they can make better lives for themselves in the future - even if it means leaving the rural area they call home. After a few minutes of excited and hurried questioning, we reluctantly made our way back to the vans since we were already in violation of some silly thing known as "the schedule." This largely needless and arbitrary document did provide for us a quick stop to see a gorgeous waterfall from afar (see picture for visual confirmation) which made up just a tad the disappointment we felt at leaving the tribal woman.

The sadly fruitless mango tree... ... and its equally bare counterpart the cashew tree

Our wonderful host and two other villagers we didn't get a chance to converse with.

Stunning column of rapidly falling water or unparalleled insights into a different culture? I leave these complex moral decisions up to the all-knowing schedule.

The next day we had only a few hours to take advantage of before we had to start the dreaded process known as "the drive home" but fortunately we were able to capitalize on these too. It was during these hours that many of us got our one and only "tribal village" experience, though even then it was less about the village and more about seeing a couple of the local artists that lived there. This particular tribe, known as the Warli, actually lend their name to a particular painting style that I've had the pleasure of learning during my time in Pune. Sadly my amateur skills were exposed as the barely-above-stick-figure level artistry that they are in the face of the incredible paintings done by the local painter we met with. So impressive were his skills, that a couple years back, when the program came to him for the first time, the students cleaned out his entire stock of paintings, leading him to simply take down their requests for a later shipment to Pune. There was no such shortage this time however, although some people (including your humble narrator) took down orders rather than buy on site for fear of ruining the products in an attempt to bring them home. As you can see from the pictures below, the art style isn't actually too far removed from stick figures, albeit much more impressive and intricately drawn stick figures. In addition to the painter, we also got to meet a family of paper mache artists, with the head woman of the household actually showing us the entire process of crafting a paper mache turtle. She naturally made it look far easier than it could ever possibly be, something I learned afterwards could be attributed to the fact that she's been at this almost every day for the last 18 years (not turtle-making specifically but many much more intricate projects as well). Sadly, like nearly every part of the trip, our stay with the Warlis quickly came to an end, and before we knew it we had scarfed down lunch and were back on the road to Pune.

The artist steps up to her canvas

(or wad of paper in this case).

An as yet unidentifiable blob of mushy paper and glue.

And the finished product! (Aw, isn't he a cutie!)

Ganesh and his less godly counterparts were also in the artist's repertoire.

We had quite the fan club.

Stick figures have never looked so classy!

While I'm sure this post is already way too long (I had to compensate for my two and a half week hiatus somehow!) I can't leave the tribal village behind without first discussing the incomparable beauty of our surroundings while we were there. Because of the nature of the area, we spent a fair amount of time in the vans being shuttled place to place, but this was just fine with me since we were exposed to so many breathtaking vistas comprised of deep, verdant valleys and smooth, undulating hills that I actually got a little excited every time we rounded a blind turn just out of anticipation at what could be waiting just around the bend. I think I must have told just about everyone who would listen that there was nothing I would rather do than just hop out of the car and start walking, not to any one point in particular, but just walk until the sun set and my eyes could no longer take in the incredible landscapes all around us. With that romantic, tree-hugging section out of the way, I must thank all of you grizzled readers once again for sticking with me once again for a far, far too lengthy post. Hopefully the pretty pictures partially compensate for your undoubtedly priceless time!

Can't blame a guy for getting a little sentimental over views like these right?

Right?