From far-away Jharkhand comes some good news:
Our intrepid colleague Dr. Cherring Tenzing has been faithfully serving for the last 9 years with other heroes at Nav Jivan Hospital.
Cherring reports that she and her colleagues very rarely see multi-drug resistant tuberculosis in their busy TB unit. That is amazing news. A decade ago we were supposedly one of the best TB hospitals around - but our in-house research showed that only 17% of our patients were documented to have completed their treatment.
Today we see how much can be done by dedicated people. In an area wracked with tension from the on-going Naxal struggle, where power-cuts are oh-so-common, where almost everyone who can leave - does - in that place a small committed band has brought a quiet revolution in health care. Simple, comprehensive TB control has taken place - and the proof is in the pudding of not having the rampant multi-drug resistance that we see in our so-called 'sophisticated urban areas' like here in Thane.
Hats off to Cherring and her merry band of workers! To Drs. Arpit, Jeevan, Augustine - and all the educators and lab techs - and treatment supervisors and most of all - all the patients who faithfully went through the challenges of 6 or 8 months of treatment! Behind the success have been much sweat and tears - but how proud we are of you.
From a very small beginning, they have grown the programme to where the Nav Jivan Hospital is now the main TB unit supporting all the government TB control work in the whole of the Latehar district!
Thursday, 22 April 2010
Wednesday, 21 April 2010
Fading
Nirmal is fading.This young man - a father of a 5 year old girl - is in what are probably his last hours.
Nirmal has stopped talking. He is very quiet. He lies still.
In the heat of the summer the nurses and his wife have powdered him liberally. He lies in his bed at Jeevan Sahara Kendra being cared for by what can only be called angels - his wife and the JSK nurses who have been caring for him for the last week now.
There was a brief moment when he seemed to be waking out of the semi-conscious state that he was in on arrival. But that moment seems to have passed now.
Cheli, his wife, has been prepared for his death. She has called her mother, and has summoned his brothers. Some have already come, others are coming tomorrow.
As a team, the JSK clinical and nursing staff have worked hard to extend this dear man's life. The fact that it is now slipping away seems a defeat. Death is never, never easy.
But at the same time we have seen the love that our doctors and nurses have given this man reflected in the face of his wife. In all her own sufferings at this time, she has been so grateful and moved by the care our staff have taken for Nirmal.
The ravages that HIV causes continue to be played out in tiny, almost-silent tragedies. Our nation may not have the horrific levels of AIDS as some of our sub-Saharan brethren - but we have more than enough. Nirmal and Cheli and their as yet un-tested daugther are proof of that.
How soon Cheli is from being the wife looking after her dying husband, to becoming a widow living with her own HIV and caring for a daughter who has lost her father to this disease.
Saturday, 17 April 2010
Dead man walking
At 3.30 last night a man walked.
Normal stuff (though the hour is one when most people sleep).
Except that the man in question was in a semi coma for a number of days.
His wife had fallen asleep and woke up with a start.
The hospital bed where her husband should have been was empty.
Did he fall down?
She looked and did not see him.
Then she and the nurse on duty (roused too from a small slumber) went to see.
They found him trying to get a drink from a water filter.
He had taken off his catheder, picked up the bottle of saline solution that he had been hooked up to, gotten out of bed and had gone to the toilet.
Amazing stuff from a man so close to death - where the death mask had seemed to be slipping over his face in the past few days.
Nirmal is still far from healthy. But what a miracle to see him take these unexpected steps in the middle of the night.
Will he pull through? We hope so - at least for him to get better enough to go to his home village in the South.
In the meantime Cheli, the amazing wife of his - with all her tenderness and love for him - has found that she too has HIV.
Will Nirmal and Cheli ever be 'normal' again? Hard to tell. But we do know that on this day - at this hour the love and care they are receiving - and the prayers - are making slow but real progress in their life together.
Normal stuff (though the hour is one when most people sleep).
Except that the man in question was in a semi coma for a number of days.
His wife had fallen asleep and woke up with a start.
The hospital bed where her husband should have been was empty.
Did he fall down?
She looked and did not see him.
Then she and the nurse on duty (roused too from a small slumber) went to see.
They found him trying to get a drink from a water filter.
He had taken off his catheder, picked up the bottle of saline solution that he had been hooked up to, gotten out of bed and had gone to the toilet.
Amazing stuff from a man so close to death - where the death mask had seemed to be slipping over his face in the past few days.
Nirmal is still far from healthy. But what a miracle to see him take these unexpected steps in the middle of the night.
Will he pull through? We hope so - at least for him to get better enough to go to his home village in the South.
In the meantime Cheli, the amazing wife of his - with all her tenderness and love for him - has found that she too has HIV.
Will Nirmal and Cheli ever be 'normal' again? Hard to tell. But we do know that on this day - at this hour the love and care they are receiving - and the prayers - are making slow but real progress in their life together.
Friday, 16 April 2010
Spill
Yesterday morning:One minute I was scooting along on our black beauty (read: the Eicher's trusty and slightly rusty Honda Activa).
The next thing an autorickshaw had suddenly swerved in my way. I hit the brakes and found myself in the unthinkable situation of skidding and then wiping out on the road.
Bike down. Me hitting the tarmac.
Over in a split second.
Bang!
A big truck behind me mercifully pulled up well short of me.
The autorickshaw stopped 20 meters ahead. Driver and passenger looked out back at me, slowly getting up.
Gash above left elbow. No bones broken it seemed. Helmet mercifully on (it almost always is - even for short trips - which this was).
As I got up dustily and bruised I have to admit I gestured to the autorickshaw driver to come back in what must have been a bit of a threatening way.
He packed up and scooted off. Even if I wanted to I could not make out the licence plate given how illegibly it was painted on the back.
And so back to the fallen angel on the road. And another quick check of me. Both seemed more or less OK.
I puttered back home bleeding slightly from my arm and rather shaken.
A quick shower and then Sheba's ministrations to dress the wound. Mercifully other than the deep gash near the elbow, the other scratches were minimal.
I was due to go to Mumbai for the dedication of Dr. Shantanu Dutta as the new director of Oasis India Trust and the sending off of his predecessor John Nonhebel. A short think and pray, and I decided that I would go - bandage artfully hidden under a light cotton kurta.
Since the kids are on summer holiday I took them with me. It was a moving experience to be present with key church leaders as we prayed for our colleague Shantanu in his vital new role - and said good-bye to an old friend in John. The kids were the cynosure of all eyes as they quietly read their books during the talks and chatted with their 'uncles and aunties' during the lunch that followed.
At the end of the day - the bruises and the pain of the wound spoke to me. Through the night and into today, this muted conversation has continued - small comments from my 'members' telling me to take care of them and let the healing flow - and also reminding me just how close I came to having April 15th as my last day on earth.
Eternity is very, very close.
Thursday, 15 April 2010
Ambedkar iconography
One good thing about the dead - is that they don't speak. Normally that is.
The four of us were bundled on our black beauty last night (read: honda activa scooter - in proper Bharat style) and were puttering through the streets of Thane when we came up to a procession which had stopped the traffic on both sides. A marriage I thought at first. But then I saw police lights flashing. A religious procession of some sort.
It was. Amidst the drum beats and men dancing in front of the drummers - amidst the lights and sound courtesy of the generator van in tow - there was displayed on main chariot in God-like form a image of Dr. B.R. Ambedkar. April 14th is the birthday of Dr. Ambedkar - who has easily surpassed Gandhi as the first and foremost icon of backward-caste empowerment in India today.
So much has brand Ambedkar been used that we now have politicians of every hue pasting his icongraphic image on anything that they want to have take on a social justice hue. The icon is one of a plump, slightly serious bespeckled face - usually wearing a suit of some shade of blue.
What intrigues me is how a man whose in life was known for his formidable learning, keen intellect and political acumen today is revered largely as a deity. Ambedkar's choice of Buddhism as the religion to lead his followers into (one of his famous statements being that he was born a Hindu but would not die one) seems largely pragmatic in nature. He does not seem to have had much of a religious bent at all (like many of his contemporaries including Nehru and Jinnah) in the sense of personal piety and devotion. But that certainly has not stopped his own deification - especially as time flows by and the historical Ambedkar conveniently becomes fainter and fainter - while the symbolic Ambedkar continues to grow as a repository of hope.
On our journey to our weekly meeting to break bread and remember the death and resurrection of Christ, we pass through an area of Thane controlled by a local political dynasty. The whole family seems involved in politics - by the numerous banners and hoardings at least. Mother and father beam happily from various huge placards - with sons of various ages (all the way down to what seems a pre-teen local-politician-in-the-making) grinning at various strategic locations. It is no secret what party they belong to - given the generous pictures of Ambedkar who they have photo-shopped into their midst. Our dear Father of the constitution would be sadly bemused - if not outraged - to see how crassly people use his icon to further their own empires.
The question that remains is why is his image so powerful. There have been other powerful leaders of the struggle for nationhood - but we rarely see their images - and certainly not as objects of personal devotion.
I think that Ambedkar has won the icon sweepstakes because he remained true to his vision - a single-minded agenda of social power for many who were in various stages of bondage. While certainly not successful in every effort towards this empowerment agenda - he remains most clearly linked with the formation of a dalit consciousness and laid the organising framework for different caste groupings to demand rights and entitlements. Ambedkar's role as the major drafter of the national constitution is a pale second place in this light. People do not dance in front of an image because that person helped draft a constitution. Worship is always the giving of our devotion to a figure much larger than our lives.
We are hungry for worship. I remember the first experience of watching a Pink Floyd concert on video (back in 1990 or so). The camera opened up in darkness. The occasional strobe of a laser started firing. Then the first notes of shine on you crazy diamond were played, with the guitarist back lit by a coloured spotlight. The crowd roars. Roars. And the camera pans out to show a sea of light - thousands of lighters lit up across the darkened stadium as the worship is complete - individual voices melded together in a cathartic anthem that took them far beyond a set of musical chords.
Dr. Ambedkar has been deified. In big and small ways. Almost endlessly it seems across our nation. Take a look at the pic below:
We have a shot of the head of the doorway to a home. Above a set of deities is Dr. Ambedkar - with the Buddha placed in the background. Below are a set of hearts saying "Shub Dipa.." the last heart is missing to wish the people entering an auspicious Diwali. There are two other objects of devotion though. In the upper right hand corner is a small piece of a horse shoe. Put up for luck it seems. And snaking down from above - into the ventilation hole near the ceiling - is none other than the almost ubiquitous black cable that pipes Bollywood dreams into people's homes every day. Probably the greatest object of devotion in our land today is our TV.
The four of us were bundled on our black beauty last night (read: honda activa scooter - in proper Bharat style) and were puttering through the streets of Thane when we came up to a procession which had stopped the traffic on both sides. A marriage I thought at first. But then I saw police lights flashing. A religious procession of some sort.
It was. Amidst the drum beats and men dancing in front of the drummers - amidst the lights and sound courtesy of the generator van in tow - there was displayed on main chariot in God-like form a image of Dr. B.R. Ambedkar. April 14th is the birthday of Dr. Ambedkar - who has easily surpassed Gandhi as the first and foremost icon of backward-caste empowerment in India today.
So much has brand Ambedkar been used that we now have politicians of every hue pasting his icongraphic image on anything that they want to have take on a social justice hue. The icon is one of a plump, slightly serious bespeckled face - usually wearing a suit of some shade of blue.
What intrigues me is how a man whose in life was known for his formidable learning, keen intellect and political acumen today is revered largely as a deity. Ambedkar's choice of Buddhism as the religion to lead his followers into (one of his famous statements being that he was born a Hindu but would not die one) seems largely pragmatic in nature. He does not seem to have had much of a religious bent at all (like many of his contemporaries including Nehru and Jinnah) in the sense of personal piety and devotion. But that certainly has not stopped his own deification - especially as time flows by and the historical Ambedkar conveniently becomes fainter and fainter - while the symbolic Ambedkar continues to grow as a repository of hope.
On our journey to our weekly meeting to break bread and remember the death and resurrection of Christ, we pass through an area of Thane controlled by a local political dynasty. The whole family seems involved in politics - by the numerous banners and hoardings at least. Mother and father beam happily from various huge placards - with sons of various ages (all the way down to what seems a pre-teen local-politician-in-the-making) grinning at various strategic locations. It is no secret what party they belong to - given the generous pictures of Ambedkar who they have photo-shopped into their midst. Our dear Father of the constitution would be sadly bemused - if not outraged - to see how crassly people use his icon to further their own empires. The question that remains is why is his image so powerful. There have been other powerful leaders of the struggle for nationhood - but we rarely see their images - and certainly not as objects of personal devotion.
I think that Ambedkar has won the icon sweepstakes because he remained true to his vision - a single-minded agenda of social power for many who were in various stages of bondage. While certainly not successful in every effort towards this empowerment agenda - he remains most clearly linked with the formation of a dalit consciousness and laid the organising framework for different caste groupings to demand rights and entitlements. Ambedkar's role as the major drafter of the national constitution is a pale second place in this light. People do not dance in front of an image because that person helped draft a constitution. Worship is always the giving of our devotion to a figure much larger than our lives.
We are hungry for worship. I remember the first experience of watching a Pink Floyd concert on video (back in 1990 or so). The camera opened up in darkness. The occasional strobe of a laser started firing. Then the first notes of shine on you crazy diamond were played, with the guitarist back lit by a coloured spotlight. The crowd roars. Roars. And the camera pans out to show a sea of light - thousands of lighters lit up across the darkened stadium as the worship is complete - individual voices melded together in a cathartic anthem that took them far beyond a set of musical chords.
Dr. Ambedkar has been deified. In big and small ways. Almost endlessly it seems across our nation. Take a look at the pic below:
We have a shot of the head of the doorway to a home. Above a set of deities is Dr. Ambedkar - with the Buddha placed in the background. Below are a set of hearts saying "Shub Dipa.." the last heart is missing to wish the people entering an auspicious Diwali. There are two other objects of devotion though. In the upper right hand corner is a small piece of a horse shoe. Put up for luck it seems. And snaking down from above - into the ventilation hole near the ceiling - is none other than the almost ubiquitous black cable that pipes Bollywood dreams into people's homes every day. Probably the greatest object of devotion in our land today is our TV.
Tuesday, 13 April 2010
Sick
Sheba admitted a very sick man this evening.
He had come earlier during the day. We will call him Nirmal. His wife and a neighbour brought him. No papers. Critically ill. Probably a cerebral TB infection. Lots of candidiasis - so likely with a very low immunity.
We felt inadequate to deal with such a sick person - and so referred on to the main goverment hospital. We told the family to tell us what happened.
After 3 hours they called. Nirmal was still in the emergency department. Other people who had come in later were being cared for. He was not.
HIV continues to mean neglect.
What to do? We told them that we would try. No guarantee, but we will try.
They brought him back.
And so Nirmal has been started on treatment this evening. In our little centre. A very very sick man. Our nurses are on 12 hour shifts. Our prayers are going up too.
Monday, 12 April 2010
Loss
Late last night a person called up saying that his colleague was sick in a small city some hours from us. The man had been admitted at a local government hospital but was not being treated well.
He had HIV.
I say 'he had HIV' - because this morning he was dead.
Last night we had called up one of our ex-staff who lives in that town and asked her to visit the man. She went this morning and found out that he had already died. She was full of tears on the phone - since she knew this man had heard him preached in her church on an Easter Sunday.
He had told her recently that he wanted to talk with her about something. She had been meaning to talk with him - but her mother in the village became ill and she had to admit her to a hospital.
Now when she went to meet this man - all that was left was his lifeless body. And his widow and child.
Loss of any kind is hard. The shock of knowing that people we love have died - and could be living because of the fear and shame that HIV continues to have is horrible.
Please pray for the grieving wife - as she lives through these days and weeks of loss - and as she will now also have to find out her own HIV status - and all that that has in store for her.
Subscribe to:
Posts (Atom)