To bargain or not to bargain, this is the question

McDelivery, yes McDonald's delivers here. Lovely


June 7, 2007

Today was our last day at Sahara Michael’s Home Care, we had our usual rotations with Dr. Gupte and he gave us a presentation on Mother to Child HIV transmission and Tuberculosis. I mentioned in my blog yesterday that TB is an opportunistic infection in HIV patients but today Dr. Gupte clarified that it’s actually a co-infection, but commonly referred to as an opportunistic infection.
Since we don’t have TB in the US all of us are pretty ignorant of it, so it was interesting to hear about a disease that just about every Indian is affected with at one time or another. Obviously TB is endemic in India and according to Dr. Gupte 40% of the population has the bacteria, 10% of whom have the disease at any time, and that number climbs to 60% for HIV patients.

In India they conduct a sputum test not the skin test for TB and apparently one sputum positive patient can infect 10-15 other people in one year. Pretty scary. The treatment consists of antibiotics for a 6 month course with strict adherence for a first infection and goes up to 8-9 months for subsequent infections. There’s also the concern for multi-drug resistant TB (MTB) and the treatment consists of 4 drugs, most of them highly toxic on the liver. India participates in the WHO’s DOTS program, Direct Observation of Treatment Site to make sure patients adhere to the drugs because once they feel better after a month or two of taking the drugs they stop taking them thinking they’re better, but they’re not. Let’s just say I’m crossing my fingers that I don’t test positive when I get home, the treatment sounds worse than the disease.

With program coordinator Philip and program manager Doi

In the afternoon, we accompanied a couple of the staff to a nearby village to purchase rations for the center, including lentils, oil, rice etc. Since today was our last day at Sahara, Aunt Jennie organized a devotional where we all sat in a circle, one of the patients played a guitar and we all sang Amazing Grace. They thanked us for our contribution to their organization, but really it is we who are grateful to have been allowed to see their work and dedication to the community.
In the ambulance on our way to purchase rations.


After work we went to a Lajpat Nagar, an open market but it was extremely busy, hot and once they see a foreigner the price goes up triple fold and my bargaining skills were wasted on a fellow who wasn’t willing to budge for a pair of cute shoes. A part of me wants to pay full price because it’s so little to us in American dollars and it means so much to them, but Sej and others tell me they are ripping me off because I’m a foreigner so I suppress my overgenerous side and bargain. Anyway, I walked away from the pretty shoes, but it was painful. Maybe in Jaipur.

Namaste from Delhi.