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).
(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?
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