Tuesday 31 March 2009

Milestones


Around December 1969. A shot of yours truly in some photographer's studio. Likely in Bombay.

The 2nd and 4th of April mark important stages in our life. We both complete 40 years respectively, with Andi coming in 2 days before Sheba.

We will be meeting with some dear friends on the 2nd evening to thank God for being so good to us over the years.

Then on the 3rd we plan to go up to a Catholic Retreat center in Khandala for a weekend as a family - to enjoy each other, the beauty of the western ghats - and to spend time listening to God about the next steps he has for us a family.

Thanks for being along with us for the trip!

Monday 30 March 2009

BREAKTHROUGH Concert

There is nothing like a rock concert to get people together.

Esp. one with all the bells and whistles.

Early this month month we met some young guys who told us that they were planning a concert where they wanted good music and some solid messages addressing social issues and helping young people be free from the challenges they face.

I was hesitant and skeptical - because of how difficult we have found organising the YAA festivals so far. But also very excited about other people organizing something for young people. After a bit of prayer we told them that we were on board.

These guys really put together an amazing show. 3 bands - straddling the spectrum of growling hard-core head-bangers 24x7 (a band from Lonavala) to Hindi-oriented rock from our old friends Commonunion and finally Sheldon + band - a group of Hindi rock/worship guys.
Vijay, the frontman of Commonunion lets loose

Having organised the YAA festival so far on an absolute shoe-string, it was awe-inspiring to come to a stage flanked by a 3 story high scaffolding holding the sound and lights. During the sound testing I understand that some of the window panes in nearby buildings were shaking.

The crowd was good - a mixture of folks who had been invited and people off the streets who had seen the publicity. One of the church leaders present said that he saw a lot of young guys at the event whom he had not seen in church for a long time.

I was asked to speak on Preventing AIDS and Smoking. On one hand it was a hard sell - to talk to a bunch of concert goers. But on the other hand it was a lot of fun. There is a different atmosphere in a good concert - folks are ready to respond and we were able to put together a pretty hard-hitting set of materials which was much appreciated.

The JSK team was also present to give our literature on HIV and to counsel people. While we did not have huge numbers coming to us to talk (it was after all mainly a rock concert) a number of our staff were able to talk and pray with young people who had different personal needs.


I would say that there were at least 1000 folks who were there over the course of the evening. It was wonderful to see what can be done by young people who put their hopes and dreams into action.

Hats off to the LinkLife team - to Jobin, Blesson, Joy, Benny, Sam, Betty, Richard, Sarang, Biji and all the others who worked behind the scenes!

Steps ahead

Blast from the past - part 2. This is the very first 'office' JSK had. A corner of the Lok Hospital. Photo taken in 2003 by Dr. Bryan Sauer.

This was the place where we met Mrs. Dosti. She had just found out that besides her husband being HIV positive - that she was also HIV positive. Her husband was dying at that point and the shock that she as a 60 plus grandmother also had HIV was just too much for her. She couldn't walk anymore and her grown son had to carry her to see Sheba.

Sheba talked with Mrs. Dosti and prayed with her. She prescribed a simple medication.

The next time Mrs. Dosti came in, she was walking. Sheba was thrilled to see the change and asked her if she had taken all the medicines. Mrs. Dosti said that she had not - the prayer was enough to give her strength.

We see Mrs. Dosti every other week or so. She and her family have taken a contract to clear the garbage in a building near ours. Its been 6 years since this lady has found out she has HIV. This grannie is still going strong!

As JSK is in its 7th year now, we face the exciting opportunity of going back to Lok Hospital at beginning of 2010. This time not to just work out of a small corner of the hospital - but to actually use at least one of the floors for our work.

With great opportunities come great responsibilities. We met with the Trustees of the Bethany Trust recently and shared that we are excited about this planned shift. It offers us the chance to do 4 important things:
  1. Improve the on-going work of caring for people with HIV in their homes in the Thane urban area
  2. Further seeing local churches more empowered to welcome people with HIV into their fellowships - both caring for people in need, but also being blessed by people who have HIV and their families
  3. Becoming a centre of excellence in HIV care - one that integrates a community health focus with compassionate and bold acute care for people with HIV - and one which can serve to develop models of excellence and good practice for other areas of our country
  4. Sharing our experience with others through trainings and internships. Working out of the current Lok Hospital building would be a major boost towards allowing us to train and share practical HIV care with many others from across the country.
All of this needs immense amounts of prayer. When JSK started up we had a monthly prayer meeting at an unearthly hour - I think it was 5.30 - 7 AM on the first Saturday of the month.

We have decided to revive part of this, with a weekly hour of prayer just for JSK and guidance to move forward. We meet on Saturday mornings from 7-8 AM at the Eichers home. The first two times have been a great blessing for us all!

Next up will be a review of what we have done - and putting together an operational plan for the way ahead. Some of the keys to the whole deal are:

  1. To be clear about how we want JSK to minister to and with people with HIV - esp. for acute / in-patient care
  2. To see God bring key leaders on board. We will need at least 2 other couples who are able to move the work forward as Sheba and I are at the limits of our capacity with things as they are.
  3. To be excited and have a renewed passion to move forward.

Friday 27 March 2009

No way out?

She called Dr. Marise on the phone on Tuesday.

I am coming over and want an abortion.

We had met them last year. He was sick. She was away. His parents said that she did not love the children and that's why she left him.

We started looking after him. He got a bit better. Our staff went to meet her. She had a different story. Abuse by his parents. Neglect by him. Alcohol in the mix.

After some time she came back. We were so happy. Her parents did not agree with it. They moved to a new place outside Thane. We lost contact with them.

She came and met Sheba. She had already tried using the freely available morning-after pills. It didn't seem to work. He is sick again. She is sick too. They have 2 kids - one of whom has HIV.

'Who will touch this child?' she asked. 'I want it removed'

She also said that since she had already used the 'medicine' to get rid of it - that it would not be normal anyway.

Sheba listened. What to say?

Sheba shared lovingly and carefully about life. How precious each one is. How others have been able to carry their children to term.

We have been on this road before. Everything looks lost. Horribly wrong. No hope. But we have seen some beautiful children born.

She told Sheba that they were dead-set on having the abortion. The government hospital had told her that they would not care for her. She is afraid of telling her parents as they had told her not to come go back to her husband. She said that he had forced himself on her.

Sheba humbly said that we cannot solve all her problems, but that if she decides to keep the child, that JSK will try to help in the way it can. By going with her to the govt. hospital for her Ante-natal care. By being there for the delivery. By supervising the medications which will greatly reduce the chance of the child getting HIV (we yet to see a single HIV positive child born to parents who have been using this medication). By helping out with infant feeding formula after the child is born.

Sheba shared that we have a beautiful child whose parents had also tried to abort her - twice - and not succeeded. Her parents were so ashamed to have another child - with all the relatives mocking them. But that God had helped them - and now they are so blessed with this beautiful little girl.

Sheba also told her that removing the child will not solve all the problems.

She asked Sheba what would happen if she went ahead with the abortion. Would we still look after her.

'Of course' said Sheba. We love you.

They left. Sick and tired. Seemingly hopeless.

That was on Friday. As of yesterday they still haven't gone ahead with the abortion.

As the child of an amazing father - who would have been aborted in 1941 if the MTP act as it is today were around then - I am so grateful that Dad was given life and not death in the womb.

Our prayer is that this little child - in the womb of that hurting HIV positive woman - would also get a chance for life.

Thursday 26 March 2009

An old map

In 2003 we made a map of our work at Jeevan Sahara Kendra.

The green dots were people with HIV who were 'healthy'. The yellow ones were those who were 'sick'. Dark blue dots showed the local TB treatment centres (known as DOTS centres) we had identified.

If we were to do the exercise today, we would be putting up almost 200 coloured pins.

Looking back to our beginnings at JSK we realise again how precious each person - each contact that we make is. It is no accident for people to open up their lives to us - and the privilege we have of walking alongside our HIV positive friends during so so many of their challenging days should not be underestimated.

Of the 19 folks we had identified at that time, we have to sadly say that most of them have already died.

One of the "green dots", a man living south of the Thane railway station passed away in late 2004. He had been very bitter when we first met him, angry with life and his situation. But over time his family started participating in a local church and a great change came over him and the whole family. His body could not hold out - it was before we had anti-retrovirals at our disposal - but he died with the reality of peace in him and his family. We heard last year that one of his daughters got married to a pastor in that church.

Another one of the 'green dots' was a 10 year old boy at that time. He kept falling sick over the next few months, and in May 2003 we started him on Anti-retroviral therapy - our first person we treated with ART. This year he will turn 17! The difference that the medication (and may prayers) have made is amazing.

How will the on-going map of our relationships with people in the communities that make up Thane evolve? Here's to the desire that people with HIV will be able to be open about their status and live lives of dignity and purpose. That those who are sick will be lovingly and carefully treated. That those who do not have the disease will make wise and informed choices to protect themselves and those they love. That we will one day not have to hide names behind coloured dots.

Each person is so very precious. How quickly we forget.

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Photo by Dr. Bryan Sauer

Wednesday 25 March 2009

Beards

After many years I have grown a fullish beard again. Early attempts in my teens were largely to cover up the lunar landscape of acne that stretched across much of my face. Later it was laziness. I started shaving regularly after Asha showed up - as she did not like my bristles.


Why a beard, and why now? At least in part to see a slightly different me. An then again there are two bearded gents who were both born on the 12 of February 1809 - Charles Darwin and Abraham Lincoln. Both whom were lightning rods of change. Though the changes they were part of had little to do with their prominent beards.

My beard is unlikely to stay long - I have found the goatee quite to my liking for the last decade or so (and think I have a double in Liverpool's coach Rafael Benitez). Some folks, however, are pretty serious in things beard. The German gent below, with his bicycle beard is a contestant in the annual World Beard Championships.

Tuesday 24 March 2009

TB again

Picture of a man with extreme drug resistant TB - by James Nachtwey

It's no coincidence that there is a lot of co-incidence of HIV and TB.

With March 24th being 'World TB Day' we stop for a moment to consider that India continues to have the dubious distinction of having the largest number of people suffering from tuberculosis.

What we always knew about HIV and TB - is that in our country every person with HIV is expected to get TB sooner or later - since TB is being coughed around by people who do not have HIV - and given the compromised immunities of people with HIV.

The WHO has put out a new warning about the alarming amount of TB found in people with HIV (click here for a summary) - and the abysmal number that are being actively followed up for TB - both through detection and through proper treatment.

We know that a slew of Nobel prizes in medicine awaits whoever finally comes up with a gold-standard cure for HIV. But the story of TB is sobering - even with proven and effective drugs that can cure tuberculosis - we are still finding so many who do not take the treatment properly and end up dead - or with multi-drug resistant TB. Would the longed-for HIV drug treatment be all too different?

For a challenging look at people who are suffering with multi-drug resistant TB - take a look at: http://www.xdrtb.org

But if we are being to gloomy - lets put it away. We are so very grateful for TB medications - and for the opportunities we have to treat people with TB - be they immuno-compromised with HIV or not. While Sheba has been in Delhi I unearthed a small story I had written for Asha when she was 2 years old. It was of a little girl in Jharkhand whose mother gets sick and who is treated by Dr. Sheba for TB. Reading it to the kids last night - 6 years later - brought back the whole miracle of cure - where people who are at death's door due to this horrible bacterium - are brought back into the land of the living.

At the end of the day we are dealing with the challenge of disease. Whatever the medications available - the process of restoring and rebuilding health is always a challenge - and a miracle in progress. At the same time we also are aware of those for whom the healing processes have stopped - and for whom their bodies have given up the ghost. As we work with people - we see our own faces in them at times. How many uncertainties - and deep fears (as Yancey points out in one of his many essays on pain) - there are for the person who is made weak and helpless by illness - and being "nailed to my bed by God" which is how John Donne put it memorably.

But, oh the tangible joy of release from illness. Be it the bitter sweet one of death with assurance. Or the more shallow, but usually more exuberant one of being able to walk around again and enter the land of the normal, the daily grace of movement and eating and working and sleep.

With all the damage that TB does among people with HIV - it also proves to nadir for what end up to be amazing stories of recovery in people who have kicked the TB bacillus out of their systems (with a lot of help from loving Father).

This marriage business

a car decorated for the big day - photo by Philip B

One my church members holds a senior sales post in a company well known for the high quality fabrics they sell (hint: the name of the company is the same as my father's Christian name).

We were discussing the overall financial outlook and he pointed out that one of the advantages his company has is that it is synonymous with weddings. Whatever the religious community - the wedding in India means everything has to be the best.

On one hand this is as it should be. The joining of lives is such an amazing miracle. Two persons - separate and distinct - now vow to become one. The promise given is the beginning of a radical new life together - something that all our cultures treasure (even in the absence at times).

The rub is when the ceremony takes over - and the real audience is not the audience of two - and God - but rather the many voices in society around us who measure our weddings by the glitz and glamour.

Talking to one of our HIV positive friends some months ago, he talked nostalgically about when all was well with him before he became ill. "I was able to marry my daughter in a big 'dhoom-dham' way (loosely: with all the bells and whistles)" he said, a happy smile on his face.

How to bring sanity into the whole business is a challenge. My church friend's company makes plenty off the fact that nothing but the best has to be done. No second-hand suits please. And not cheap stuff. "A wedding only comes once in a life-time" they say. Villages in Haryana are said to have started hiring helicopters to bring the grooms to the marriage instead of the traditional white horse. ("the 1,50,000 Rs. spent for the helicopter was the best investment of the marriage" crowed one father "it meant that everyone knew about my son").

Who picks up the tab for the hordes of people who 'have to be invited' and the other hordes 'who will be offended if left off' and the third group of free-booters? Usually the bride's family. Usually with money borrowed. Usually with many - often hidden - tears.

One of the challenges for the church in India is to lovingly speak the truth into what our cultures have allowed to become a grotesque spectacle. The wedding ceremony itself is the key. Let as many people as possible come to a simple but meaningful exchange of vows. But let us then somehow have the grace to celebrate people who choose to live simply. Would that we could exult in the ceremony - and have some nice laddoos afterward and go home.

Instead , far too many of us skip the actual ceremony (too busy, not enough time) but somehow magically show up for the dinner 'reception'.

Our Lord was no stranger to weddings. His first miracle was the almost ridiculous turning of water into wine when the happy-juice had unexpectedly run out (more free-booters than expected?). And while Jesus often showed up at feasts, that was not the reason He came into this world. Paul says it this way: Christ Jesus came into the world to save sinners—of whom I am the worst (1 Tim 1.15). The joyous yet mission-focussed Jesus expects his disciples to follow him. Part of this is the willingness to be looked down on by others for the sake of the real joy found in Him.

May our wedding feasts focus on the reason for the joining of two lives - and the joyous hope of our coming union with God himself through Christ - which each marriage points too as a often small but always significant sign.

Monday 23 March 2009

Images

A few years ago I remember reading that one of the established photography companies - Fuji I think - was exiting the photo-film making business to concentrate on digital cameras.

No way - I thought - having till then been exposed to only the crudest digital cameras around - and computers where a 20 MB harddrive was considered colossal.

How quickly technology can change the rules of the game.

Images today are largely digital. I still have dreams of setting up a b/w darkroom at my parent's place in Shanti Kunj - but will anyone still be manufacturing photo-films - let alone b/w? Isn't it easier just to switch on the b/w mode on your camera?

The challenge now is the question of storage. With every event producing scores of images - all mysteriously hidden in virtual memory - how to keep track of them. Instead of an old biscuit tin box crammed full of photos - we now have various files, and how to find the one you want - when you want it?

Additional challenge - the frailty of computers. Last year our hard drive gave up the ghost. With it went all the pictures that we had of Enoch's birth. Every one of them. I tried and tried to retrieve them - and took the help of our friendly computer man - Richard Washington - too. No avail.

But hope springs eternal. Earlier this month I wrote to our good friend Dr. Bryan Sauer in the US. We had borrowed his digital camera for 2 weeks during Enoch's arrival in Feb of 2003. Would Bryan have any copies of the pics we had shot?

Amazingly the answer came as yes! And yesterday - thanks to broadband internet - the pics arrived. Here is one of them. Enoch - nestled in Sheba's arm - a few hours after he was born!

There are still hitches and lurches in the whole image storage bit. But what a miracle to have this cloud of pixels capture the very day of our son's birth. I had forgotten the reddish splotches on his face (as usual parents find their children unbearably beautiful) and the little bundle that he was.

As I put Enoch on the school bus this morning - I gave him a kiss and prayed for him. What a blessing to be a father - and what a blessing to have images to remind us of the road we have travelled so far.

------------------------------
Added bonus:

Seeing a pic that we have never seen before - this shot of us as a family which Bryan must have taken! I have somehow embedded in my memory that Asha took some time to get to accept Enoch - which certainly is true - but this shot shows another angle to the story:

Whether Enoch is laughing or crying after receiving a kiss from his big sister is not clear from this shot though ...

Sunday 22 March 2009

Bus trip

We dropped Sheba off at the Borivali railway station yesterday evening. She is off to Delhi to for a 3 day seminar on Biblical Health-care and Ethics. We need inputs in order to move forward - and it is wonderful to get quality teaching like this - so we jumped at the opportunity. Having a chance to meet our new neice Anjeli Mary Rose Eicher - and also to meet Sheba's parents sweetens the trip even more.

The three of us - Asha, Enoch and I are still in Thane. Asha's 'final exams' are underway - in which she has a mercifully easy time so far - esp. as she is only in 2nd standard. But we have finished our social capital at the school and don't dare to ask for Asha to be given holiday during the exam period. Hence the three of us at home and missing Sheba already!

After 45 mins of waiting on a urine-smelling platform, Sheba's for Delhi came in between the ludicrously over-crowded local trains. When the moment finally came to say good-bye, we could hardly see her as the film over the windows blocked out most of our vision of her. Sheba's faint sillouette waved to us as Asha cried softly.

The crying didn't last long as we headed off to the bus to Thane.

Coming out of the station and walking to the State Transport bus depot, we passed a swanky AC bus waiting for a red light. I looked at the front of it and read "Thane" - it is one of the new BEST buses have recently started to ply the route. I popped in the front and asked the driver if there was still room - 'of course' he said - and in the three of us hopped!

We settled in comfortably - it was only a third full - and I reached to my pocket for the Rs. 100 note to pay for the tickets.

It wasn't there. My mobile was. Bits of paper were. Some coins were. The note was gone.

Maybe it's in my pant pocket? I rummaged through each one. Like some kind of tacky play - I looked but come up with nothing. The bus started up and I was in a fix.

The first thought was to get down and call up a friend in Borivali to ask for some money. I was just about to do so, when a man on the opposite aisle asked what was the matter.

I told him what happened and he smiled and said he would pay.

He did.

We had a wonderful ride back - reading a children's magazine 'Magic Pot' and talking with each other. Thane came quickly enough and we got back in time to be there for the Young People from our church to have their weekly fellowship meeting at our home.

I had asked the man who was so kind to us: 'what is your name?'

He replied: "Parmeshwar"

Saturday 21 March 2009

a cloud the size of a fist

In the last two days we have gone through a small but significant shift of mood. Though each day has its own joys, Sheba and I have often found ourselves to be heavy and tired. For me at least, a part of it is just not getting to sleep early. But a goodly part goes beyond just the number of winks per night.

The sense of tiredness, which has been dogging us for months, has lifted a little - and a sense of purpose and momentum about looking with hope instead of with resignation into the next few years.

2009 is likely to be a transition year for us as we need to do justice to the opportunities we have at Jeevan Sahara Kendra and see where God is leading the work. Whatever the challenges that all of us face in ministering with people with HIV - whatever the brokenness around us and within - we know that loving Father is moving us deeper into Him.

The good book as Elijah praying and asking his servant if he sees rain. Finally the servant says that he can see a cloud, the size of a man's fist...

After quite some time, yesterday there was a spring in my step - something that Sheba noticed too.

Have we turned a corner? Time will tell (and there are sure to be some nice valleys ahead as well) - but here's to hope!

Came down from heaven

He works as a sweeper in a near-by apartment building. She is his wife. He has HIV. We don't know about her. We will call him 'Anil.' We will call her 'Shruti.'

He has had herpes zoster - and opportunistic infection which is painful but not serious - on his face.

Herpes zoster is an infection where the chicken pox virus - kept under control in most of us because of our functioning immune system - shows up - and usually causes very painful blisters on the skin running along certain nerve lines. It is most often found on the abdomen - and the "lines" of blisters are the root of the common Hindi term "Nagin" (snake). Some believe that if the 'snake' circles the body that the person will die. Some quacks make a good living off this fear.

He came to us with a letter. A polite note from a local pastor who lives in the building Anil helps clean. The note told us that Anil has HIV and needs help.

Sheba talked with him about his situation. He knows he has HIV. He is willing to take steps to live a positive life.

She asked Anil whether he had heard about Jesus. He had. Shruti was under tremendous stress last year - with many deep problems. She started praying to Jesus and has seen a tremendous amount of peace. His daughter has joined his wife in prayers to Jesus.

The man a pastor sent to us - and that too along with a letter rather than being brought personally - already has a family who love the man who came down from heaven.
Who, being in very nature God, did not consider equality with God something to be grasped, but made himself nothing, taking the very nature of a servant, being made in human likeness.
And being found in appearance as a man, he humbled himself and became obedient to death— even death on a cross! Phil 2.6-8

Thursday 19 March 2009

Family


We have a family at the JSK centre this week. A whole family. Father very ill. Has HIV. From the North. Has been working as a truck driver. Mother also HIV positive.

Our staff have been meeting this family for a few weeks in their home. Things were going from bad to worse. The government ART centre had started him on ART because his immunity was very low. But as we are seeing in many cases these days - they started him without ruling out whether he was sick with other opportunitistic infections.

Everytime our staff met him, Mr. Balbir (as we will call him) was sicker and sicker. And it looked like our old nemisis TB.

Sheba took the call to bring him and the whole family here. When we met him we found he had 4 children. After admission we heard of another child. Recently another has been talked about.
Currently we are hosting Mr. and Mrs. Balbir and 3 of their 6 children. The kids range from the almost 20 youngsters who are out on their own - to a lively 3 year old.

The day of Balbir's admission we did the tests. As expected Sheba found tuberculosis.

Now the problem - the basic TB drugs to be given will 'interfere' with the basic ART meds that the government gives. We need to shift his ART meds a bit to another regimen, but will the government centre do so?

The next day Daniel takes Balbir to the govt. centre along with a letter and the tests we did. Miracle. They shift him to the other regime.

That night Sheba starts TB meds on Balbir.

During the day we have had the children tested at our testing centre. The bad news is that the youngest one is also HIV positive. We don't give the results immediately. In this case we need an evening to pray.

On the third day we tell the family about their son. He is so lively - and hard to control at times - but here he is with HIV in his body too. Its hard for the mother to take.

One of the things that sets the JSK inpatient experience apart is prayer. Every morning we spend time worshipping God. We share from the living hope we find in the Bible. We share our lives.

Today one of our staff shared about how her father was very sick. He also has the sickness that we are dealing with in our work. Last week he was ill again. They prayed. He got better. His statement was that God had helped him. As our staff member told this I looked over and saw Mrs. Balbir's sad face. Was there some hope growing in her eyes? Hard to tell.

We do know that many who we have admitted at JSK have been blessed by prayer. And the love that they receive.

Last night Sheba came back from her nightly visit to the centre. It was almost 10 PM. Balbir was not doing well. Laboured breathing.

Its hard. But we have to move forward. A whole family is being treated.

Tuesday 17 March 2009

Chemo

Its sobering when someone younger than you has cancer.

Wungram Shishak is just the person I would never think of with leukemia - bright, complex, straddling multiple worlds - this Naga with grace - Burma-specialist - US State Dept honcho - father-of-lovely-kids - thinker and soul-traveller is now working through various rounds of chemotherapy.

Woodstock School - where Wungram and his future wife Gennie were both in my brother's class - and the years after in college where our paths criss-crossed in the joy of learning - seem all very distant today. But the news of Wungram's diagnosis have brought everything back with a new urgency. Life is real - and every bit is very precious.

For a ground view of what it means to fight through cancer - do look up his reports - the first which has just come in. You can read the low-down by clicking: here. You will need to sign in, but it is well worth it. Wungram needs prayer as he walks through these valleys. His wife Gennie and their kids and others who are working through the relentless logic of cancer. Pray dear friends.

For another amazing story, click here, to see the way that Janelle Van Beek worked through her brain tumor. God is alive and is often found in the cancer ward.

Splash

Digging up roads seems to be a perpetual hobby of whatever civic powers-to-be exist in Thane.

A small drama unfolded briefly yesterday afternoon on the shady road outside the JSK office.

Giri was had stepped out to receive a call on his mobile - and out of the corner of his eye saw the 1.5 year old son of the miller next door to draw close to a rectangle of water. The water is there because for some reason two large valve-like was protrusions from the local water-supply-mains need to be exposed to the road. Once or twice a day a loud hissing sound comes from them for a while - something to do with the local water supply towers just a stones throw away. At other parts of the day they quietly drip water - and the powers-to-be recently enlarged the space around them to form a 2 meter square trough.

Ok. The atmosphere is now set. 4 PM. Hot afternoon. No one in sight other than the odd stray dog scratching himself. Giri out on the road to get a better reception on his mobile.

He looks at this kid while talking on the phone. The kid comes to the edge of the trough. Suddenly a splash. He has fallen in. Giri looks around. No one. The kid is still under water. Struggling in what may become his little water-coffin.

A bound or two over and Giri has pulled him out. Still no one is sight. He brings the crying child and steps around to the miller who was sleeping and hands the precious - and still breathing bundle to him.

In the hot sleepiness of an afternoon a life has been saved. What will become of this little boy? Who knows. Will he be beaten as mercilessly as his two older siblings? Who knows. Will he also sleep under a vegetable-selling table, next to an old man (uncle?) while his parents sleep behind the shutter of the wheat-mill-shop?

What we do know is this. The boy was saved. He lives. He breathes.

Another small miracle as the Earth continues to spin around itself on its elliptical journey round the Sun.

Monday 16 March 2009

Blame

Somewhere in the mists of child-hood a brilliant little idea was shown to me. If you point at someone, you are pointing one finger at them - but three fingers back at yourself. Sometimes people added 'and on thumb at God.'

Would that we would heed these small lived out parables more. I still find myself inevitably blaming others - and when I am found to be wrong myself - quickly slipping out of my conscience by the old 'I didn't really mean it' bit.

The sad scene in the garden has Adam blaming God for giving him Eve - and Eve informing God that a serpent had tricked her into it. Neither of them stand up and acknowledge their own culpability.

Multiply this by a couple hundred crore people, and we have our dear fractured land of ours. Riot after riot. Commission after commission. No one steps forward. No one admits.

Its the others who did it.

Saturday 14 March 2009

Self-infliction

How to even start to describe this tragedy...

Dipu was a young man who lived near one of the families we have been in touch with for many years through Jeevan Sahara Kendra. The Nambiars are no strangers to sadness. Their father died of AIDS - and was our first contact with them. Their uncle has HIV and is taking his meds regularly. Mrs. Nambiar and Satish her youngest child both have HIV too. Besides Satish who is now in his mid-teens, the family has an oldest brother who is in and out of jobs and alcohol and two sisters in between.

Three years ago, Dipu eloped with Wani - the older sister. Last year her younger sister also eloped.

Whenever we met Dipu and his wife Wani and their child it was bitter-sweet (with more bitter than sweet). They would talk and occasionally seemed grateful for the inputs - but the violence that came out of this young boy was great. Par for the course it seems for many young semi-educated men who grow up in the slums and see an ever more aspirational world around them. A nattily dressed young man, Dipu worked on and off in odd jobs.

Two days ago we got the shocking news that there had been a huge fight in the family. Dipu in a drunken rage had beaten up his wife and fought with her other family members at the fag end of the 'Holi' festival.

The details are sketchy, but it seems that Dipu was so angry that he went inside at around midnight, poured kerosene over himself and lit it.

He was taken to the government hospital and was conscious enough to tell the police that he had done it to himself.

We did not expect him to live long. He did not. His agony lasted just over a day. Last night he succumbed to the burn wounds.

Suicide - premeditated or in a drunken rage - has no silver lining.

The whole team is stunned - sickened - and reeling from the horror of it all. We find ourselves numb, praying fragments of prayers - finding words sticking in our throats. But pray we must - especially in times like this when the raw horror sticks on like a stain.

Please remember young Wani tonight - as she and their small child spend the first night of widowhood.

Gratitude

This shot is a month old - but captures the daily joy we are blessed with in such measure.

To have and to hold. To be together as a family. To enjoy good food (here coconut on flannel pancakes with our morning chai). To have beauty around us - and in us. To know that we are loved and accepted and cared for.

We are *so* grateful for so much. May our lives be a worthy expression of the blessings we keep receiving.

Thursday 12 March 2009

ha ha

Walking back from office - in the brightly hot mid-day sun - I pass a man sleeping.

Nothing new. People sleep when it is hot.

Another man near by is shaking out flour from a big gunny sack. He is a miller.

The first man starts to speak. "I want puries and bujia!" he says.

Two thoughts crowd in - one after another in quick succession. The first is the normal - Ha, ha - look at the drunk. The second takes another look at him. About my age. Not dressed too shabbily. Lying there in the middle of the day thinking he is ordering breakfast at a roadside eatery.

My ha, ha, dies out quickly.

The man is not alone. He will have some family at least. Maybe some kids. Probably a wife. How much of the household money have gone into this latest stupor? When he 'awakes' what will he think? Will he crowd out the memory with some more smooth liquid? Will he be sorry? Will he just think that this is his own particular fate - and move on grimly?

Its easy as a kid to 'act drunk' - to move around without much control. Lots of laughs.

The sordidness of us all. The piddly, stupid brutes we become shames the bundled glory that is the human.

Where is that man tonight?

Tuesday 10 March 2009

Hope

Today we had 10 guests from Thailand. Pastors and church folks - brought here by the Full Gospel Churches of Thailand - a study tour to see what the Indian church is doing to help people with HIV.

We had told them ahead of time that we would not be able to take them 'into the field' - to meet the people we work with - the folks who have HIV - in their own homes.

Rather we invited two of our HIV Positive Friends to meet the group at our centre.

It was a blessed time - made all the more so by Mrs. Maninder's story.

Here is a piece of it:

Having found out that her brother had HIV and TB, she and her husband were looking after him when they heard about Jeevan Sahara Kendra. They brought him here and were amazed to see her brother's health improve so much.

Sadly - her brother insisted on returning to Africa where he had previously worked. When he came back he was too weak to recover and died.

Later her own husband died of AIDS - and she found out that she also had it - while in the 7th month of her second pregancy. When the first child - who had a cleft palate at that time - became very sick - she remembered JSK and brought her here.

We prayed and acted swiftly - amazingly, the child recovered.

Mrs. Maninder was convinced that the two girls also had HIV. Her husband while still living had said that they should kill their unborn child as soon as it was born - and then all die together. These suicidal thoughts continued. But when she met Sheba and was told that we would have to test whether the children were infact HIV positive - some hope started to dawn.

The older daughter - with the cleft lip - was old enough to be tested. She tested HIV negative.

Some months later we tested the younger daugther. Also negative.

Reasons to live.

Stop work


Times are tough. And become tougher if your employer knows that you have HIV. Especially if you are working for a school.

A few weeks ago a bus driver was admitted to a top hospital in Thane.

He had a fever that wasn't going away and wanted to be treated at a good place. He had mediclaim and so was confident he would be out soon.

He was, but his life is in tatters.

The hospital did a 'routine HIV test'. They told everyone about it.

The mediclaim people say that their policy does not cover people with HIV. The man was made to pay cash - which he did not have. His colleagues at work passed the hat around and got the cash to pay for him.

The school found out. Being a new-age school it has not hired this man - but rather is using the services of a contractor. The bus contractor has asked the man to stop working. One of the man's bosses came to meet Dr. Sheba. She wrote a letter stating that the man was perfectly fit to work.

But he has not been called back yet.

Meanwhile another employee of the same school - also positive is scared. She has HIV too. She has heard about this man - and that the school has brought a doctor to test all the new staff for HIV.

When will her turn come, she wonders. She has even considered quitting while she is ahead.

How long will this cruelty continue? Men and women living in fear. The medical fraternity quite willing to have people's lives crushed through their unwillingness on one hand to counsel and prepare before testing - and then their cavalier disregard for confidentiality afterwards?

Disclosure

We hadn't seen him for months. Years actually.

About 3 years ago he had been scheduled for an operation. He and his young wife were unable to conceive. They did a number of tests - and found that he needed a procedure to be done.

When he was admitted and anaesthetised, the surgeon did and unethical but very common practice. He tested him for HIV without telling him.

Most of the time the test comes back negative - and the surgeon proceeds with the cutting.

This time it was positive.

The surgery was not done. The young man was sent home with the news that he had 'AIDS'.

He came broken with his father. The old man cried. His son had HIV.

Over the next few months we tried to help this young man. After he got over the initial shock he became increasingly hostile to our team meeting him. "I am fine" he said. "I am well. Don't bother me."

We encouraged him to tell his wife about his condition, but he stone-walled. Eventually we gave in to his demands and stopped seeing him on a regular basis. The occasional look-in by our staff every 6-7 months or so got a shoo-off from the young man.

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Yesterday the young man - and his old father came to see Dr. Sheba. The man was in a miserable state - complaining mainly of rectal bleeding ('piles') for which he was very concerned. He also was running a 104 degree fever when Sheba checked. The man refused to admit that he was sick - saying that his 'jaundice' was being healed by a healer who puts drops in his nose, causing it to water profusely after which he feels very well.

Why had he come? He was afraid of the blood he was losing. Wanted that to stop.

Had he told his wife yet? No. They now have a small child. They are obviously taking no precautions to stop his wife from getting his HIV, despite clearly being told. Sheba looked up the old file - and it still was there - and saw the advice that was given when we first met him.

So here is the question. What do we do when people clearly engage in self-destructive behaviour? Should we forcefully tell the man's wife about what her husband has not told her over the last 3 years? If we do tell her, then what? If we don't, aren't we party to the injustice meted out to her but this man?

Sunday 8 March 2009

Watermelon


Round green hot-weather friend
Cut to find the red, red centre
Sweet red nectar, drips (take the shirt off that boy!)
Cool heavy sphere, now triangulated
Each bite releasing new dribbles
Till tasting rabbit-delight whiteness of the rind
The pleasant problem crops up
Another slice - or rest?

Saturday 7 March 2009

injecting

A man with HIV has just been shifted from the ICU of a big city hospital to the general ward. His parents own a flat a stone's throw from where the big cats of Mumbai hold their largest rallies - deep in the city. An aunty of his lives on a certain hill in Bandra where the film stars are clustered.

He is basically alone in his bed. Years of drug and alcohol abuse have frayed the nerves of his families. He is scared and says that he will not be accepted back to his home since he now knows that he has HIV - and so do they. He says he does not want to live on the streets.

His family members tell a different story. They claim he has been on the streets for the past decade. They say his parents want to take him home - but he does not.

Where does the truth lie?

Many years ago, while working in southern Manipur we held a meeting for parents of injecting drug users. One man stood up and said memorably: "My son has stolen Rs. 2 lakh from me. Over the years 1 lakh Rs. was shot up one arm, and the other lakh up the other arm."

Where to even start with this man. 42 years old. Educated. Articulate. HIV positive.

We were contacted by someone who saw us on the net. The hospital in question is on the other side of Mumbai. We called friends of ours who have worked with people who inject drugs and are enslaved to alcohol. A young man from the team met this man and made the first steps of friendship with him. He is now looking to try and find a residential facility to serve as a half-way home. Very very few and far between.

Meanwhile, every day we have and estimated 38,000 plus people (mainly men) service their injecting drug use addiction. For a first hand account of a group of - please click: here. Be sure to see the photos Govind has taken - eye-openers of one more hidden population who live in our midst.

Thursday 5 March 2009

Boards


There is a certain 3 letter abbreviation around with many, many lives revolve: SSC.

The secondary school certificate - also known as matriculation - is the proof of having completed 10 years of schooling. Adminstered by the State Board of Education - these 'board exams' are the bane of many a young life.

For over 1.5 million students across the state - today is the big day - as the first written exam papers will be given out and the first pens will start putting their marks on the papers. The pressures to succeed are immense, driving a huge economy of coaching-classes, study aid materials - and an underground economy of leaked papers....

Enoch and Asha's school is one of the 3500 odd examination centres. Enoch is happy - he has a holiday this morning. Yesterday evening the papers will have arrived under armed police guard - and this morning a huge throng of students from many Thane schools will descend on the school, hall tickets in hand - and will be assigned a particular desk at which they will write their answers.

We know four students intimately who are among the 1.5 million - Joash, Sanjay, Katherine and Joshua. Each one so different. Each one so precious. As they (and their families) go through this rite of passage our prayers go with them.

Sadly - for some - this year's exams will carry with it such crushing expectations that a girl here and a boy there will end their life. The papers will carry the story - a picture of a sobbing mother, a few somber students will be shown - but the system will roll on.

Our Asha has completed 2 of the 10 years. She is already a 1/5 of the way towards the SSC (if the Lord tarries - and we are still in Maharashtra of course...). Would that she and Enoch go through these years actually learning, and growing rather than fearing a 'terminal exam.'

Wednesday 4 March 2009

Result

She had come with her mother before. Today she came for her own HIV test result.

The young woman's mother has been deteriorating. The mother's HIV seems to be progressing despite being on anti-retroviral medication. The dear lady's body seems to be slowly shutting down - the kidneys are not functioning and one arm has a severe infection that needs to be drained of pus.

In the midst of this the daughter wanted an HIV test. Was it for fear of having been helping her mother? The deep terror of loving a person with HIV - which can lurk beneath the surface - even in the face of repeated assurances that HIV does not spread by touching / helping...

Or was it a reflection on this young woman's relationships? Already having lost a father - who had not been faithful to her mother. In a home with very little love as her younger brother is physically present but deeply estranged with her mother and her? Was there a young man in whose arms this young woman sought solace?

Whatever the reason for the young woman wanted to be tested was - we maintain the walls of confidentiality even among our staff - she had come for her result.

In the midst of so much decay, our counsellor was able to give a small bit of hope. The young woman's HIV result is negative. She does not have the virus in her body that is eating away at her mother's health.

Reflections

Mother, One Child Too Many - by Madhubani artist Manoj Das

Reflection Art Gallery
has a new site up and running. Click: here to see it. I like the cool, crisp look to it. Congratulations Stefan and the team from the Art for Change Foundation!

A highlight is their current set of paintings - the result of a group art workshop on violence against women.

The Delhi Times of India did a short article about the show - and I just heard from Stefan that it resulted in an interested party searching them out. Negotiations are currently on for a particular painting!

Tuesday 3 March 2009

End of innocence?

TV grab from AFP

It seems every day we discover a new level to stoop down to. A new depth of the sad South Asian limbo-pole game of what-can-brutal-evil-spoil-which-hasn't-been-spoiled-before?

Someone asked a long time ago - is nothing sacred?

Well, it seems that even cricket - that fabled game of flanneled fools (or smart-talking, bollywood-looking ueber-sportsman) - is not immune to the rat-a-tat-tat of the AK-47 and the sickening crump of the thrown grenade.

This morning 10-12 gun-men ambushed the Sri Lankan national cricket team in the heart of Lahore, just as they were about to arrive at the stadium to carry on their batting on the third day of their test match.

That result is moot now - as instead we have at least 5 policemen dead, at least 5 Sri Lankan cricketers injured - and the scene of a Pakistani military helicopter landing on the cricket pitch to evacuate the rest of the Sri Lankan team.

Who are the attackers? Who knows. Their military precision and boldness, their back-pack wearing, high-impact weapon toting audacity brings the sad memories of the attacks on Mumbai last year.

Now in the heart of one of the great cities of the Sub-continent, one of the few joys that many average Pakistanis savour has flickered out. Which country will now send their team to this troubled land?

Rushdie in one of his writings talks about "Pakistan, that strange bird, two wings without a body, broke apart" (Midnight's Children). The sad irony of the picture is only worse since Bangladesh broke off in 1971. The further disintegration of Pakistan seems sadly ever more likely with deals being made with Taleban supporting tribal war-lords on the Afghan border, and the dogs of war - the multiple Kashmir-focussed militant organisations proving that they can use their military hardware to strike at will.

In our family prayers this morning we considered the ring of nations around us. Nepal with the Maoists now entrenched in power, Bangladesh which has just seen a terrible mutiny aimed at a putsch, Sri Lanka where what seems to be an end-game with the Tamil Tigers is being brutally carried out. We prayed for the different situations - our voices a small twosome but which we believe are being joined by others across our region.

Its good to think soberly about who we are and what our countries mean to us. To root ourselves in place and relationships. To carefully query and examine the tangled strands of history that have brought us into today.

Someone has said that the wheels of history grind slowly - but they grind very finely. Nations and civilisations have certainly risen and fallen over the past millenia. What we see today is no guarantee about what we will experience tomorrow.

Amidst this gloom we have today's announcement of our general elections in India. The die is cast - from the 16th of April till the 16th of May we will have our 15th general election since Independence. Who will win? No one is sure - but one of the many fascinating aspects of this election is that both main blocks have a back-up man. Behind the incumbent Prime Minister, Dr. Manmohan Singh is scion of the Nehru line - Rahul Gandhi. Perhaps more ominously, behind the BJP led NDA block's candidate of Mr. L.K. Advani, is the current chief minister of Gujarat - Narendra Modi. Judging by the posters up already - we see a lot more of Mr. Modi in Thane town than we do of Mr. Advani. For Congress, we have always seen the Gandhis much more than our beloved Dr. Singh...

So we come back to the dangerous neighbourhood that we live in. As Indians we are very, very grateful for the basic rule of law, the apolitical armed forces, the active judiciary, our national and regional press and the basic freedoms to speak, meet, worship that we enjoy.

We may continue to live through turbulent days - and we pray that our liberties will not be reduced, but will rather be used to see God's good light shine into the often dark situations around us.

There never was an end of innocence for us - because we were never innocent. But that does not mean that we cannot see positive, real-life change take place at scales small and large.

We look forward to a day when today's attack on the cricketers will no longer be a memory - not because we have buried it, not because 'worse' things have happened, but because of the fulfillment of the Kingdom at whose centre is a tree of life whose leaves give healing to the nations.

Monday 2 March 2009

Gratitude

We have all lived such amazingly blessed times. We all still do.

Holding a book in my slightly feverish hands, I explored how an author was shaped by books. The man talked about reading Dietrich Bonhoeffer's Letters and Papers from Prison.

He was struck by the great joy that Bonhoeffer expresses at the momentary meeting with some old friends. Here is a man in prison, but who is so totally grateful for a fleeting amount of joy.

How much we have - everyday, day-after-day of grace - and how hollow and mealy-mouthed our thanksgiving.

Just look back at our own family histories.

Eight years ago Sheba and I were in Vellore. We were there because we thought our daughter Asha may be suffering from Hirshsprung's disease. Sheba and I were working at a mission hospital in Jharkhand. Asha did not pass stool for 10 days. She started to feverish. In consultation with the leader of our organisation (who was a paediatric surgeon by training) we took the call and packed up to go on a lightning visit to the best hospital in India - CMC Vellore.


Our relief was great when Asha passed stools spontaneously while we were still in the long bus-ride to Ranchi. We carried through with the trip, however, and took the train down to Vellore, where on that hot March week our beautiful baby smiled and cooed at the doctors who did their tests and told us the good news: everything seemed normal.

The barium meal X-ray (first time I had seen an X-ray as a digital image - and received it on a disc instead of a film) showed a perfectly healthy set of intestines. Was it a 'medical miracle'? Was it a clearing of doubts? Who cares - we are perfectly happy with a healthy Asha - who has never had that particular problem again.

Our smiles tell the story:

Eight years of blessings later we find ourselves in the present.

Small example of the many daily blessings: Our loving six-year-old Enoch has been showering us with little gifts that he makes. A small bag with "I Love You" written on the cover. A little set of pencils tied in rubber bands. A strip of cloth fastened to a stick, making a soft brush.

The power went out this afternoon. He was off to the fridge to get cool water with ice in it.


We are so blessed. So very very blessed.

Sunday 1 March 2009

Feverish

Day 4 of my fever.

Slight. Shows up especially in the evenings. 99 to 100 F. A bit of body ache.

Probably related to some very rotten teeth. Procrastination takes on reality when it comes to postponing the trip to the dentist.

I am reminded of an English class in High School. We were taught by the amazing Kathy Hoffman, who is finishing off a long career at Woodstock School this year. The class was one of the English electives - it looked at the European writing. The book was Arthur Koestler's Darkness at Noon. It opens with the protagonist suffering from an agonising toothache - and a splitting headache because the tooth was linked to the optical nerve.
This excerpt from later in the novel - but still packs the punch.

My own headaches are slight - but the image is so powerful it has remained in my mind a good 23 odd years after we went through the book. Great literature sticks. And great teachers open minds.

For us, whenever we get a low grade fever, the first question we ask is: "is my appetite less?" We are constantly in touch with people who are in various levels of tuberculosis. It is not a question of whether - but more a question of when one of us will get it.

Not that it would be the end of the world of course. We believe in treatment - and will be taking the same course as we prescribe to our friends with HIV.

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A final thought. Such a small illness for me ... and yet so many of our friends with HIV face this on and on. Each time a fever comes, the question arises - what is it? Each time the question of whether to carry on or to rest. How much can you rest when you have to feed a family? How many times can you go to a doctor?

The wonderful care I get from my own family doctor - my dear beloved Sheba - the caring apprentice nurses and compounders in Asha and Enoch - the prayers that surround me - are such a blessing.

Would that others would also receive this in their times of illness.

In the Bible Jesus says - I was sick and you visited me... would that we would.