Just how many days can I go without sleep?

With Dr. Jain of St. Stephens Hospital

Well in the past 5 days that we've been here I've had a total 7 hours sleep on Monday night only and this thanks to an Ambien Farah gave me. I'm exhausted, my brain is fried and I really need some sleep.
Today we had rotations again with Dr. Jain at St. Stephens in the morning and spent the afternoon in Dr. Jain's HIV clinic located in the hospital. He is so incredibly nice, humble, and dedicated. He took his time explaining each patient's medical history, diagnosis, prognosis and course of treatment to us and was open to our questions.
The HIV clinic was really eye opening. We observed Dr. Jain's visit with each patient. One particular case which was especially striking. A young young woman about 18 years of age came in to have her preliminary test results confirmed and Dr. Jain confirmed her that she was HIV+ right there in front of us. She didn't even flinch, I think she had prepared herself, I probably would have fainted, but that's just me.

She thinks that she was infected by a dirty needle used by her local health practitioner when she was given injections for TB with reusable syringes when she was younger. Although the government has banned the practice, it is still practiced by unlicensed quacks who set up shops in remote villages, gain the trust of the local community, bribe the local politicians and through unsanitary practices transmit the virus from patient to patient. Dr. Jain mentioned that the governmetn lacks political will to stop these poeople from taking advantage of innocent people and any awareness campaigns undertaken by the government fall on deaf ears since most of the rural population is incredibly poor and illiterate.


Upon our return to our room we found a mouse running around which scared me to no end, last night Farah was terrified by a giant cockroach who possibly had wings (cockroaches have wings here, ew)and our first night here Sejal ran screaming from our room because there was a lizard resting on the wall. I am really creeped out by all the wildlife here, but I guess that's real public health for you.
I'd write more but my brain hurts.

Poor but happy: St. Stephen's Outreach Center

Women's empowering project: sewing clothes and purses

Today started out really early at 6:30 a.m. as we spent the day at St. Stephen's Community Center and Clinic in Delhi's biggest slum. The center serves 90,000 of East Delhi's poorest slum dwellers and is run by St. Stephen's Hospital. We met with Dr. John, one of the senior physicians of the center and with several community health residents and post-graduates, including Dr. Robyn, who introduced us to some of the programs the center runs including income earning initiatives which empower young women by giving them sewign lessons in a shop donated by the community. These women make beautiful clothes and purse which they sell throughout Delhi. We of course purchased some goodies and took some video for the Global Health Review and lots of photos, which I still can't post just yet, but hopefully will do so from Jaipur next week.


The center also has a child care center where children, some from abusive homes find refuge, love, and good food at a center that is devoted to furthering their health and wellbeing. It broke my heart to see these beautiful children with bright soulful eyes who weight so much less than their peer in developing countries. It made me think of the childhood obesity epidemic in America and how unjust it is that so few should have so much and so many have so few. The kids were so happy to see us and take photos with us and see the results on our "fancy" digital cameras. It was very endearing.

After a presentation by one of the resident physicians regarding Nutrient Indeficiency in India, which included a discussion session with the head of the department, Dr. Amoun as well as a Professor Emeritus from a university in Delhi (I'm ashamed to say I neither remember his name nor the university), but he's purported to be a public health encyclapedia, so it was fascinating to hear him talk about micronutrient deficiencies, which we've discussed so often in class.

This was made even more real when we attended the center's Nutrition Clinic in the afternoon. Most of the infants and their mothers were incredibly thin and underdeveloped and several women complained of their children having Pyca, which according to Sejal, our resident Hindi translater, rickshaw price negotiater and nurse, is a deficiency of minerals that causes kids to eat dirt to replace the minerals. This is something we covered in our Environmental Health class, and today it was made real and had a human face.

Actually, so far our exposure has trully been phonomenal public health in practice, because it brings everything we've learned in acedemia to life in a very real way, including development, poverty, malnutrition, sanitation, HIV and other infectious disese and so much more.
Once more, I count my blessings to be where I am in life, for my loved ones, and for everything I have.

Namaste from Delhi.

Rickshaw Adventures

Monday 5/28/07
With Transgender Commercial Sex Workers at Sahara Transgender Center

Today, our first day at work with CFHI we had rotations with Dr. Jain of St. Stephen's Hospital in old Delhi seeing patients with chronic and infectious disease, including HIV,Typhoid, and TB. The hospital, first was founded by Priscilla Winter in 1864 and is a private missionary run center is the oldest hospital in India.

After a delicious lunch in the hospital's cafeteria we went to visit Sahara
Transgender Project, where we met with and had a conversation with
transgender and homosexual commercial sex workers. Their story is at
once sad and fascinating at the same time. They are highlymarginalized
as a community and often face beatings from both the police and their
clients. We were told that their clients include priests, mullahs,
foreigners, and members from every other sector of society. I
thoroughly enjoyed our visit and came away educated and more sensitive
to their plight.

The founder of the project whose name now escapes me was truly inspiring in his devotion to provide a safe environment for this marginalized community. STP provides primary care, treatment of STDs and peer educator training in HIV/AIDS awareness and activities to provide these men with access to health care and social services.

While talking with the group I was stung by either a bee or a wasp and one of
the men immediately came to my aid by rubbing a key on the injured
sight to counteract the toxin, took me to see the physician on site,
and gave me cortisone creme to relieve the pain, which I thought was
incredibly thoughtful. I hardly feel the sting now.

On our way out, we were caught in a thunderstorm and while it is yet early for the Mansoon rains, it was quite an adventure trying to hail a rickshaw in that downpour. Fortunately, our local coordinator Shalini Vias spent the entire day with us and was able to quickly find transport. So five of us (Farah, Sejal, Shalini, Paul the pre-med student in our group and myself-rickshaws usually accomodate
three people but you will often see people hanging out of them and
sitting on top of each other)climbed on top of one another and took
about a 45 minute ride from old Delhi to East Delhi. Paul's behind was
hanging out of the side of the rickshaw and in the insanity that is
Delhi traffic, where you canliterraly reach out and touch the person in
the next car, bumped into a man on a motorcycle, who almost fell of it
and proceeded to follow us for the next 10 minutes fighting with our
driver, but finally gave up after our driver apologized several times.

So ends another adventure filled day in India. We've been here for three
days and in that time I've slept a total 2 hours, apparently one of the
lovely side effects of culture clash is insomnia, lucky me. But I am
having a ball despite the sleep deprivation. Tomorrow we're visiting an
outreach program in the slums of Delhi, which should be quite
interesting.