Golconda Fort and Laundry Detergent

Today I went on a outing with Jann, and her 10 year old daughter Natasha.  We visted Golconda fort, which was built in the late 15th century, and is very cool.

Natasha is a really cute girl.  She reminds me of Sophie in alot of ways.  She is smart as a whip, extremely articulate, and loves to read.  We had many long conversations about Harry Potter during the car ride.  This was Natasha’s third visit to Golconda, so she was very familiar with the tour and had lots of interesting stories and facts to share.

The fort is a huge stone structure, designed by Persians and built by slaves.  The acoustics are amazing, and were used as a security measure.  At the gate  a guard can clap, and alert a watchman over a kilometer away on the side of a cliff of who has come to visit.

We also saw a crazy weight in the slaves quarters.  If a slave could lift it with one hand, he was promoted to the rank of solider.  Natasha and I threw our combined weight into it, and it didn’t budge.

Natasha and I unsuccessfully try to upgrade our rank

My favorite room in the fort was the queen’s bathroom.  It had a really advanced water system that included sewage removal, drinking water and even hot water.  Additionally the walls have intricately carved patterns in them, with holes ranging from the size of a marble to the size of my fist.  Once upon a time, these holes were filled with jewels and an light from oil lamp would reflect through them and illuminate the room.  I’m thinking about implementing a similar lighting design back at guest house one.

After touring the fort, we went to Q-mart which is my own personal oasis in the desert.  Jann was apologetic to take me on her errands with her, but when I saw Q-mart I literally almost cried.  It is a very nice grocery store (the Whole Foods of India, if you will) and had American imports!  I was able to purchase a small box of oreos, cheese, flour, Honey bunches of oats and (wait for it) Tide!!

Prior to this I’ve been washing my clothes with this sketchy little soap bar that I bought here in Kukatpally.   The women here have been trying to teach me how to scrub my clothes with the aforementioned bar, and then smack them on a rock. I’m not sure what role this plays in the cleaning process, but they are very insistant about that step. Then the clothes are rinsed in a bucket, and smacked on the rock again. I’m convinced this is not effectively cleaning anything, but rather decreasing the lifespan of my jeans (maybe its a bad attitude, but my heart is just not in the smacking).  Additionally, sitting out in the hot sun fully dressed, throwing wet shirts around is really just causing the clothes I am wearing to get more dirty.  So in order to have net laundry gain, I have to clean more clothes than I am wearing–which doesn’t always happen.  Clearly, I have been failing miserably at laundry, and I was just about to run out of clothes.  Chorus of angels! Hallelulia! Tide has come to deliver me!

After grocery shopping we went back to Jann’s house to meet up with her husband Dayrl and go to dinner.  Their flat is in a very beautiful compound with lush gardens and millions of flowers.  We hailed an auto (yess! I love the autos!) and rattled our way over to the new cineplex, which they tell me is THE hotspot in town.

The four of us had dinner at TGIFridays which is the place to see, and be seen in Hyderabad (not kidding).  Dayrl told me that people came from all over the city to see the escalator when the complex first opened last year. Dayrl and Jann are a very intellectual couple, so I can see where Natasha gets it from.  We discussed Indian politics, books we’re reading, HIV, and Lebron James.  Dinner came, and  I had a chicken sandwich and french fries.

It was quite possibly the best meal of my life.



My Fellow Countrymen (and women)

Today, three Americans came to visit Sivananda!

Jann, who I spoke to on the phone yesterday, is living in Hyderabad for one year with her husband and ten year old daughter, Natasha.  She is a friend of Mrs. Rao’s (who’s mother in law founded SRH. Dr. H. is the boss, but she’s sort of the executive, if you will).  Jann helped raised some money for medications, and wanted to drop off the donation and visit the HIV kids.  She brought with her two friends from Seattle, Diane and Diane’s nephew Simon.  We met in Dr. H’s office.

Jann is a lovely, fit, middle-aged, cosmopolitan woman.  She looks a little bit like Francis McDormand (you know, Margie from Fargo).  She has a master’s in public health, and lived in Cambodia for a little while in addition to traveling all over the world!  She’s really good with people–doctors, leprosy patients, children, American post-graduate students.

Diane is Jann’s close friend from Seattle, and she is a smaller woman with brown hair.  Diane loves children, and they gravitate towards her.  She is gentle and friendly, and has a kind smile.  Simon, her nephew, is younger, in his early 30s or so, with fair skin, a long sharp nose and curly dark hair, like a Greek statue.  All three people were very warm and interested in the work going on here. I was really really happy to spend the afternoon with them.

The four of us went on a walking tour of the compound. I was so excited to show them around, and speak in full, unadulterated sentences.   In the past two weeks I’ve eliminated most adjectives, adverbs and almost all the prepositions from my speaking repertoire.  I’ve been down to monosyllabic nouns, and simple declarative subject-verb sentences (I go. Lunch, eat, 12:30. Thank you.) You can’t imagine how much I’ve missed conversing in English (well, yeah, you probably can).  Jann had visited Sivananda before, but this was Diane and Simon’s first time.  We saw the HIV clinic, the outpatient clinic, leprosy, guest house 1, and ended up at the children’s home.

Simon brought a storybook to read the children, and was very captivating with his animal voices and animated expressions.  He is a trained actor who studied in California, and brought a book for the children about an artist titled “That’s How I see Things.”  In the story the artist paints pictures of imaginary animals like a pig with peacock feathers, or a lion with blue bird wings.  When the story was over, Simon passed out sheets of paper and markers and we all drew our own animal creations.

The markers were a big hit, and the kids were very enthusiastic.  I was really impressed with the children’s artistic skills.  Some of them drew the animals from the story, but others were quite inventive.  Its funny, in America if you give a child some markers and ask him or her to draw an animal, they often come up with cats and dogs, maybe a rabbit for good measure.  Give child in India the same, and he or she will produce an elephant, tiger or peacock.  Sometimes a cobra.

I drew a tiger with butterfly wings and a penguin wearing ballet shoes, just for fun.

When it was all over, Jann and I traded cell numbers and she suggested we go out to dinner sometime.  Diane and Simon are leaving for the states (tomorrow actually) but Jann will be here for as long as I am.  I have lots of amazing friends here at SRH, but getting to know Jann was a great comfort.  She shares my America/India perspective, and she is an amazing role model and she reminds me of my friends back home.

I have been so blessed in my stay in India thus far to meet such amazing people.  Being away from everyone and everything really helps me put the value of kindness into perspective.  From doctors who take me under their wing, to kitchen staff who make my food less spicy (Sunita calls it “chili, zero-zero”) to fellow Americans who reach out to me– I have been treated with unparalleled hospitality and warmth.  It reminds me of the passage in Matthew’s Gospel, “I was a stranger in a foreign land, and you welcomed me.”  I never really understood its importance until now.

lots of love,





New game

Today I had my first day in leprosy outpatient. I’m shadowing Dr. Bhaskarao, who is in his later 60s I would guess, and has a very fun personality. He is short, round, wears wire-rimmed glasses and has a white mustache. I think he feels cool having me follow him around and ask a million questions. He is very patient with me, a good teacher, and loves to tell everyone “this is my assistant. She is from America.”

Leprosy outpatient is unlike anything I’ve ever experienced of medicine in the states. The patients shuffle in and produce pressure ulcers ranging from the size of a quarter to the size of my fist. Most of them are kind of green and oozy (ack! gangrene!), while others are dry and resemble holes. The ulcers and infections are not painful. In fact, the lack of feeling caused by the nerve damage is really the reason they get so many ulcers to begin with (but if you read “the crash course” post about leprosy, you already knew that).

Dr. B. showed me how to properly palpate the ulnar (near the elbow) and common peroneal (near the knee) nerves to see if they were thickened. He also showed me how to test for anesthesia, which is the very complex process of poking the patient with a pen and asking, “can you feel that?” Many of the ulcers are treated with oral and cream antibiotics, and dressed in sterile bandages. Some need to go for debriding surgery, and those patients get admitted to the ward. I have photos of some of the more gnarly ulcers which I will not post, as they are pretty grotesque. I can certainly produce them by request if you are interested.

The nerve damage also affects the muscles. About 20% of leprosy patients experience either “claw hand” or “drop foot.” In clawing the fingers curl downward, but the palm remains open and the hand freezes in this position. A reconstructive surgery of tendon grafting can straighten the fingers and place them at an angle with the thumb to that the patient can feed his or herself, work, or even drive. In drop foot, the muscles behind the ankle contract, and the resulting position is a pointed foot. As you can imagine, this patient’s mobility is severely compromised. Reconstructive surgery, along with special boots (which are manufactured on the compound) can allow this patient to walk again. Its pretty amazing.

In some ways, working in leprosy is easier than working in HIV. While the images in leprosy are certainly more striking (deformities, ulcers etc) there is a lot that the doctors can do to help treat the patient. Some days in HIV I want to beat my head against the wall, because all we can do is treat symptoms, work against opportunistic infections, and try and prolong a patient’s life. Its certainly an uphill battle. Not to say that leprosy isn’t, but its definitely a nice change of pace.

While I was in the ward, the phone rang. A nurse popped her head into the office, and gestured that the phone was for me. Me? Who is calling me? “Hello?” I said.

“Hello” an unmistakably American voice answered! “This is Jann, I was calling to let Dr. Hrishikesh know that I am coming tomorrow at 11am to see the children.” I almost dropped the phone. I couldn’t believe how much I had missed the sound of my own language. Here I was, talking to a fellow countrywoman!

“Hi Jann” I said back, trying to sound professional, casual, and to contain my excitement. “I will let Dr. Hrishikesh know. I’m new here at Sivananda, and would like to meet up with you tomorrow as well, if that’s okay.” From there I explained my connection to SRH and found out that she is living in Hyderabad with her husband, who is here on business, and her daughter for a year. They are from Seattle. I am very excited to meet her tomorrow.

After work, I went to go play with the children–which is always the bright spot in my day. Even though we don’t speak the same language, we are communicating pretty well. Two of the girls speak English, and the rest of the children pick up on what I am saying very quickly. Its fun to learn each child’s very definitive personality. Children are children no matter where in the world they live, or background they come from. Some of the kids are leaders, some are shy. Some are competitive, while others are very creative. Each one is different than the next, but they are all really awesome.

The children were a little burnt out on “goats and tigers” today, which is reasonable because we have been playing it everyday. (Its hard to describe rules of different games, so we’ve been sticking to what we know.) Today, however, I gathered the kids around and said, “ok guys, its time for a new game.” They repeated after me, “New game.” And murmured among themselves, ” new game.” I never know if they are repeating me because they understand me, or if they are just trying to encourage me by saying whatever I am saying.

So I taught them duck-duck-goose. They are so cute, and they did really well. They haven’t quite internalized the concept of “goose” yet, so we really just played “duck, duck, DUCK!”

I think tomorrow I want to move on to freeze tag.

lots of love,