Day of Service

We are just minutes away from this year's first "Day of Service" - a time when young people from different churches are getting together to go out and make a small but real difference in the lives of people with HIV.

I will walk over from our home to the JSK to do the final set up for the day - and then at 9 AM Joash Pravin and his group will start the time of worship with which we intend to start our day together. After a time of sharing the challenge - splitting up into teams for briefing on what to do - and mutual prayer - the 10 teams will fan out across Thane to spend the day with families affected by HIV. Each home is precious - and each young person who is coming along has the potential for being a leader in touching people with HIV - and getting others involved too.

At the end of the day we will be gathering together for a time of sharing, de-briefing and celebration. It promises to be an excellent day! The sun is up - the birds are chirping - after a quick cup of chai and a bun we will be in the thick of it!

Carpe Diem!

Admission

Pankaj came to the JSK centre today with his father. An uncle of his had called up from Kerala a few days ago. Pankaj came back from Dubai 3 years ago. He was found to be HIV positive and deported.

Now Pankaj is very sick. So sick that we wonder if we can really treat him. His immunity is very low. He has pneumonia. Its likely that the has other infections too.

Pankaj clearly needs help. His father has come up from Kerala to look after him. Pankaj's father is at wits end. He wants to take his son home - but Pankaj refuses to go. He doesn't want others to know about his condition. He doesn't want people to know he has HIV. He knows that tongues will wag.

In the meantime - Pankaj has not been able to keep himself together. His skin has multiple rashes and infections. He has trouble breathing. He came with a fever of 105 degrees F.

Sheba strongly suggested shifting him to the main govt. hospital in Mumbai. Pankaj refuses to go. He went there earlier and was treated shabbily. In the mean time he has been admitted multiple times at different hospitals. He kept his HIV status hidden each time he went. He has been treated for various ailments - has had drips and drugs - but keeps getting sick.

His father is at wits end. This noble small man is heroically looking after his recalcitrant son. A laboratory technician, this dear man knows about HIV and yearns to take his son home. As a father he is getting a barrage of questions about what is actually going on with Pankaj. He cannot bring himself to tell people about the HIV status - and so is telling people that Pankaj has liver problems - and that it is not getting better quickly.

It is clear that Pankaj does not only need meds. He needs love and acceptance too. He needs courage to make a step in the right direction - and start to accept love and support from his family.

We have admitted Pankaj for treatment. Our hope is that we will be able to stabilise him. We then hope to have him go back with his father to Kerala. One of Sheba's batch-mates from the Fellowship in HIV Medicine that she did at Vellore is practicing in a large govt. hospital close to where Pankaj lives. This doctor has won a national award for his excellence in HIV medicine.

Though we have a long way to go with Pankaj we are glad that he has a safe place to be tonight. Our hope is that we will be able to start the necessary treatments, based on understanding what opportunistic infections he has. At the same time, we firmly believe what king Solomon wrote a good 3000 years ago that "a heart at peace brings life to the body" (Prov. 14.30). Would that Pankaj will find some peace here - and would that this peace will go with him when he leaves.

I have to cry when I think of the noble man Pankaj's father is. He has been through so much - and still is serving his son - hoping against hope. This is love in action. What a privilege to serve this small splintered family.

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Its the first time in a while that we have two patients admitted at JSK. They are at close quarters with only the green screen separating them. We are discharging Mrs. Shasta this evening. She will need further care at home as she still has a spiking fever, but she has been stabilised by her 10 days of care at JSK. We are really proud of our staff who make it possible to love people with HIV who are very ill in this way!

Sight

He lost his sight 8 years ago.

Lost it to HIV. The virus in his blood affected his eyes.

Detected and treated in time - there is hope. But if the eye infection is not treated the damage is irreversable.

She was pregnant with their child at the time. The child had been developing 4-5 months within her. The doctors told her to abort. They did.

They haven't had a child since. Though they now know that the chances of the child getting HIV from them is slim, he is still too scared. She dearly wants a child. He lives in sadness.

Sheba met this couple after a long time. They live well outside Thane - far from our range of home-visits.

He has a good job. Despite his blindness, he works with the govt. telephone department. During their visit calls came in - and he made calls - with a dexterity of a sighted person.

But he still wants to see. Every time they come he has this basic question. How can I see? Is there nothing that can be done to make me see?

A small celebration

After coming home from the office today we had a small celebration. Some hot dabelis and a gulab jamun each - washed down with coffee.

We celebrated:
1. Asha and Enoch's excellent performance in their first two unit tests
2. Mrs. Sashta - the lady Sheba has been looking after for the last 10 days - who is gradually getting better after being on death's door
3. The joy of being together
4. The music that is being learned in the family - Asha with her violin - and Enoch and Sheba with the keyboard

There is so much to celebrate. God is very good. In the midst of despair we see so much light. We have to - to do otherwise would be cruel.

Historical truth

The Mumbai Police Force is a pretty remarkable group of men and women. We live in an extended city where much of the law and order is due to the onerous hours that they put in.

Having spent some time recently with some of them - I recall one young policeman telling me that "if you are in the force, you may as well kiss your family good-bye. We tell them to stay in the village and not even come to Mumbai since we don't see them here anyway." The papers tell us that a full 1/4 of the police force was called out recently to protect cinema theatres who were showing the film "My name is Khan" - and then with bomb blasts in Pune taking place that weekend, they were shifted over to protecting Jewish sites...


So it was with some surprise that I saw a picture in our trusty Indian Express of the men in khaki, wearing a different kind of khaki uniforms - namely that of higher officers in the Third Reich. Alongside swastika-wearing actors were lady police wearing blue contact lenses. A number of police-persons are thespians it seems. At a theatre festival which pitted 19 groups against each other - the winner was the police production of Death of the Conqueror a 2 hour Marathi play on the last days of Hitler. The play was written by Dr. Sameer Mone, a Pune-based Ayurvedic doctor - and the whole production was managed by police personnel who worked double shifts in order to prepare for the performance.

I wonder how much of it was based on the German film Downfall (Der Untergang), which looks at the last 10 days of Hitler's life. The film was widely criticised at the time for providing a 'human' face to Hitler - but seems to have weathered the tide and is considered one of the best views of the enigma that Hitler was. One writer says that Downfall shows the wreck of humanity that Hitler was. The Marathi play apparently takes the line that Hitler was scizophrenic. How much that explains him though is a mystery.

I have to think back on my German great-grand-aunt, who when I asked her about Hitler told me: "Hitler, he wasn't even German - he was an Austrian..." I couldn't believe my ears when I heard her stunning denial of the history she lived through as a young woman - but as a green early-teen I kept quiet.

We were blessed by an exceptionally good teacher in my years at the Deutsche Schule Bombay - Mr. Walther Meister - who took us through modern German history with a fine-tooth comb. There were no cover-ups in Mr. Meister's class - we examined the horror of Nazi Germany carefully, painfully, and most of all with a passion for truth. As our history teacher I am forever indebted to "Herr Meister" for drilling in us a healthy fear of unbridled nationalism. At the same time, as our German teacher he gave us a steady dose of Berthold Brecht plays to challenge us - and we looked at post-war writers like Wolfgang Borchert to make sense of the war and its aftermath. Heady stuff for 8-10th graders - but that was it - we were being treated as adults. History and literature were real - to be grappled with. No easy spoonfulls here.

Looking back from 25 years on, perhaps the only thing missing from Mr. Meister's walking us through modern German History was a Christian perspective. I think if we had been able to read some of Dietrich Bonhoeffer and the Confessing Church materials - it would have rounded off the Marxist critiques.

And so I come back to our 30 odd Mumbai policemen/women who have so recently immersed themselves in the last days of the Reich. How did it all sound being spoken in Marathi? How much did they understand the terrible lies that the German people had chosen to build their empire on? Or what a massively efficient edifice had been built through the willing participation of so many? It is no secret that some who espouse a form of Maratha nationalism are quite vocal in their admiration of Hitler.

But let them aside. What of my own family's history in all of this? My mother tells me that my grandfather listened secretly to the BBC news during the war. But at least one of his brothers served with the German army and was taken captive in the Italian campaign. Mum remembers allied prisoners of war (mainly Russian - with a Frenchman too) being drafted to help out her father as he supplied coal during the war. How many of the family were involved at what level is a question that I still need to find out.

Each family has somethings that we may not fully want to have known. I think I need to read my grandfather Willy Fischer's diaries this summer - and have an MP3 recorder on hand to take an oral history from Mum. All truth is God's truth. We must know what has gone on - in order to live a life of forgiveness and hope. One of our great Indian tragedies is our inability to honestly say what actually happened in:_______________ (insert your favourite riot / disturbance / tragedy here).

Phone call from Kerala

The phone rang last night.

We were having supper. It was a voice from Kerala.

He was calling on behalf of a friend. A friend with HIV.

Pankaj - as we will call him - wanted to know whether we were able to help people with HIV.

His friend Nalin had been working in one of the Gulf countries. Three years ago he was found to be HIV-positive and deported back to India. Faced with the shame of HIV - Nalin did not go down South - but remained in the Mumbai area.

Now Nalin is sick. He was admitted at a private hospital and is being given drips. His immunity is very low - his CD4 count is only 70. Nalin's father has come up from Kerala to try and look after his boy.

We asked Pankaj to tell Nalin to come and see us today. As of yet he has not come...

Seeing SAABs

An age ago (ok it was the early 1990s) - during a summer I spent working at the Yale University Forests in Connecticut - I noticed something.

Being on the Forest Crew - we were responsible for managing the University Forests. The venerable University has about 8000 acres in Connecticut - and at least two smallish patches of a few hundred acres each in Vermont and New Hampshire. A dream summer of course - spent among the trees - counting and grading and helping make decisions about the next course of management - while living out in a bungalow in the middle of silence.

While driving up to visit the Vermont and New Hampshire plots for the week that we were assigned there, I couldn't help noticing how many SAABs there were in Vermont.

A small explanation. The SAABs I am talking about are not our 'sahibs'. Going by the idea that sahib=angrez then almost everyone in Vermont was a 'saab'. No - I mean the Swedish car which at that point was considered a pretty nifty piece of engineering that a person with a pretty good pay-packet would buy (i.e. core yuppy car in those days ... wouldn't know which car take that cake today).

And here I was - being driven into a state which to my low-brow understanding epitomised New England yuppydom - so was it any surprise that I kept seeing SAABs as we tooled up the highway through the beautiful low mountains of that state?

Well actually it was.

Because there really were not that many SAABs on sight. I would start each time I saw one - and rack it up as another example - but then it struck me to actually count the number of cars I was seeing in between these 'frequent' SAABs. A cold bucket of statistical reality took place. The 'overwhelming number of SAABs' were not even 1 in a 100. Compared to the huge number of other cars - the yuppy-mobiles were pretty rare. Probably as rare as what I saw around me in New Haven. The difference was what I was primed to see. Having set the internal matrix in the mind that I was going to a yuppy-country (a pretty strange thought anyway) - I could see plenty of evidence for it in the SAABs zipping by - because I was prepared to see that.

So what does that mean for me today.

Well, Sheba and I have been involved with caring for people with HIV/AIDS for the better part of this decade now.

Working in Thane - we see a lot of people with HIV/AIDS. The Jeevan Sahara Kendra home-based care team is looking after about 150 active cases at this point.

That means a lot of folks are out there. I see them everyday. The person who sells fish near our appartment. She came in with her husband a few weeks ago. Both are positive. A bus driver for the school my children attend. He came in positive. Thankfully his wife is not. The house-maid who I see when I take our kids down to their school bus. We looked after her husband till he died - and she has it - but does not want to come to see us - preferring to drown her sorrows in work - 10 hours of it every day. The lady who comes to our own house to sweep and mop the floors - her brother having died of AIDS last year. Does her alcoholic husband have HIV? She wants him tested. The lady from a near-by appartment. Her husband is taking treatment from very expensive HIV specialists. We offered to help, but they are too concerned about others finding out - and so prefer the anonymity of hi-fi corporate hospitals.

The question is this - am I seeing SAABs? Is it because I am primed to work with HIV that I am seeing so many people who have the disease. Am I seeing more than there actually is?

I don't think so.

What Sheba and I and the Jeevan Sahara team are privileged to see is a hidden underside of our society. Hidden because of the fear and shame and stigma attached to HIV. But visible to us - because we offer some hope. Because people do need help. Because we have been given the privilege of being brought into confidence by brave people who are living out their lives in the shadow of death.

Sadly, it is this very shadow of shame that continues to keep so many from further treatment - from making the best of a great battle going on in their bodies between the virus and their immune system. Further, the fear and shame directly affect the out-come. The more hiding - the darker the confusion - the poorer the prognosis. And what totally skews the whole business is the number 1 therapy that many use to escape from their problems - alcohol.

The people that I do see while walking around are those who have been able to make at least something of a fight with HIV. The people who I don't see are just as likely dead. We have had over 140 deaths among the people with HIV we serve over the last 7+ years. That's a lot. Most pass away virtually unnoticed. The surging throng of people around us don't notice the odd person disappearing. The odd family packed off back to the village.

And so when I 'see a SAAB' in the form of a person with HIV on the street - who I know has HIV - and they know that I know that they have HIV - I thank God that they are alive and working - alive and walking. More often than not quick quiet smile is passed between us - perhaps a word or two of greeting - and we carry on in our worlds.