Thursday 30 September 2010

Tinderbox

I was far away in America when they swarmed up like ants and pulled the Mosque down.

1992. Dec. 6th.

Months and months of Mr. Advani's yatra, years of statements drumming up the demand for the temple. Bricks being blessed and sent to Ayodhya to build the temple.

But there was still a problem. The mosque was still standing. Police barrackaded the site.

That did not stop them. They swarmed. No unplanned swarm this. Some one was there to take the idols out. The whole structure was torn apart. Then the idols were brought back.

Since then my taxpayer money has been paying to keep 'the disputed structure' open. Anyone, rich or poor can go to pray there. You have to leave all your possesions that could be used otherwise (pen, waterbottle, belt etc), but you can go for the darshan.

Later today at 3.30 PM the Allahabad high court is to deliver its verdict on a century old set of cases - as to who owns the land where the idols are currently installed.

The whole nation is carefully, carefully holding its breath. Security is high. No one knows what will happen. Most expect that whichever religious community feels that 'they have lost' will react violently.

When the mosque was razed in 1992 it led to blood baths. The worst was the sectarian riots in my beloved city of Bombay. It has never been the same since. There were always certain areas where more Muslims lived. Now we have ghettos. In Thane, our suburb of Mumbra is now synomous with Muslim. A huge change in the way we live. Tragic because it means that we are now living in different worlds.

Our housing society has an 'ustav mandal' which comes around collecting money for the festivals. 'We celebrate all the festivals' they say 'and patriotic days too.' 'Christmas' is included in the list. Eid is not. We do have Muslims living in our housing society - but they are largely invisible. I have many reasons why I do not want to give money to these guys - one of them being that I don't have much regard for hoary Mr. Santa Claus. I have always told the merry men who come asking for donations that 'we don't donate.'

So why is everyone so uptight about the verdict later today? We know that whoever is considered the 'loser' will promptly appeal to the supreme court. We will then have another who-knows-how-many-years of 'deliberations'?

What our uneasyness tells us is that ultimately we are very, very far from reconciliaiton of any sort. We try to brush aside the past, turning a blind eye to what has gone on. No riots means peace. 'Aaaal izzz well' is our motto.

But the reality is that below the surface of normalcy lies the fear. Things have never been properly settled. We have had riot after riot after riot. Some months after each new flare-up, the occasional retired judge is called in to make a report. People are quizzed. Suggestions are given. Most of the time even if cases are filed they are dragged on so long that the accused die of old age.

The message is clear. Do what you want when you can. The law will take its course.

That's why everyone knows that we are in a tinderbox. People are scared. Very scared.

Our prayer is that the verdict will be fair and clearly expressed.

Our prayer is that whoever is the unhappy party will not decide that burning their neighbour or bombing the local market place is best way to express their displeasure.

Our prayer is that our much-maligned paramilitary forces will be marshalled and cohesive - esp. if mobs appear and their superiours are hesitant to deploy them.

But deeper than all this... we want a country where we can believe in the rule of law. Where we are free to worship and share our views without fear. Where there is no doubt about the execution of justice towards one religious group or the other. Where past wrongs can be genuinely explored and true reconciliation take place.

Will September 30th 2010 be a step in that direction.... or a step, or two... away?

Wednesday 29 September 2010

New JSK Poster


Thanks to Martin Abraham and 'Jiju' (Abraham Mathew) for their continued excellence in helping us out with promotional materials at JSK.

This poster is one of a set of 3 that the 'terrific two' have designed for us - along with a superb brochure and a display stand that I will be taking with me to Vellore.

Tuesday 28 September 2010

Art for TB - Exploring the Human Face of a Disease


Stefan writes about the just concluded "Art for TB workshop" that the Reflection Art Gallery and Global Health Associates India have organised as this year's 'Creative Conscience' experience.

Our introduction to the human face of TB started with two visits to Asia's largest TB hospital here in the heart of New Delhi. The good doctors gave us an overview of the disease, a tour of the hospital, and then we walked into the wards to meet the patients.

At the OPD I remember being struck by the fact that so many people were covering their faces with handkerchiefs and pieces of cloth, I presumed out of fear of contracting the disease. When someone asked the doctors how they keep themselves safe from this primarily airborne disease I got the fuller picture: "We make sure all the patients where masks".

As we talked with patients from all walks of life, students, homeless, mothers, taxi-drivers, government employees, even a convict in a ward with bars and a policeman on duty, the breadth of the disease's reach struck us, along with the humanness of each tragedy: an old man lying in a bed abandoned by his family, a woman turned out of her home and planning her divorce on getting better, a boy asking us to photograph the man in the next bed, rather than him, as he fears being recognized locally.

And yet at the same time we could not avoid the light shining through, the sanctity of each life, the sparks of dignity: the young girl, hair immaculately combed, who walked into the hospital garden to pluck a rose for each visitor, hand shaking as she handed each one out; the optimistic young man seated on his bed with a pile of books, studying for exams to become a doctor; the old muslim man, who as he talked kept pulling at his face mask until by increment his smile was revealed in all its fullness and generosity, and a passing nurse had to chide him to put it back on again.


With these memories we went to work in a 2-storied house that had been fully set aside for the 5-day workshop. Armed with canvasses, easels, a table full of paints, and many cups of tea we spent the next 5 days ideating, painting, discussing. How to even begin thinking about solutions? Is it just about access to medical services? What are the roots of this problem? What to do with the stigma? How can a painting bring about change? How do we not just make poster-art, but maintain the integrity of art while causing deeper reflection? Why target corporate leaders rather than paint for the man on the street?

In the end many of us didn't complete our paintings during those five days, but as the exhibition is slated for November we still have time. What did happen was a remarkable engagement with a problem that although being so enormous, is so easy to ignore. Having seen the human face of the disease, and having wrestled with the size and complexity of the problem, we took ownership of it. And having done so in community, as artists jointly trying to make sense of it, something special happened: a renewed sensitivity to others' suffering, a bonding with each other, and a sense of purpose in seeing art meaningfully engage our context.

Monday 27 September 2010

Planning

I head off South later this week. Its been a while since I was south of the Vindhayas.

The destination?
The hallowed halls of the Christian Medical College - Vellore. A 3 day medical missions conference for students called "Shiloh" is being held from the 30th of Sept till the 3rd of Oct.

The goal?
To meet fresh excited medical students (and student nurses) who want to serve God.

The hoped-for outcome?
A person who will want to serve as a medical officer with the Jeevan Sahara Kendra as we expand to become a Community Care Centre and a Link ART centre.

The tools?
Stories, dreams, thoughts, ideas...

We have made a new brochure about JSK, a set of posters and a 'standee' - a large vinyl sign that can be unrolled to a 3x6 ft size!

Underlying all of this is the ever shifting topography of our 'plan.' The plan for how the Jeevan Sahara is going to play itself out in the new set up. The plan which seeks to find staff for new functions - while at the same time trying to balance the different areas of work that clamour for attention. The plan that seeks to strike that hard balance between making do with all that is available and dreaming the seemingly impossible.

Well, we have an ever-growing set of papers and want to take things forward. But the already sparse hair on my head is growing sparser as we try to hammer out the slippery details!

Prayers very much needed.

Friday 24 September 2010

HIV testing camp in Airoli

It has already been a week - but we are still recovering from the aftermath of an excellent HIV testing camp that we conducted together with the Dayasagar Baptist Church and the Kingdom of God Church in Airoli on the 18th of September.

We walked into this with a lot of questions.

It was going to be our first camp where we tested and gave the results on the same day. The location was a bit far from our centre. We were working with 2 different churches. They assured us that many would come - but who could be sure. Would we be sending our staff and just seeing them twiddle their thumbs?

We needn't have worried.

Came the day - came the people. Dozens of them.

The folks in both churches had spread the word. Literally. Some were brought from distant places - having left at 6 AM to be there for the 12 PM start of the camp.

All through the afternoon we had a series of prevention presentations and films being shown in the meeting hall of the Dayasagar Baptist Church.

A few doors down in the home of Bro Guy Rodrigues - a pastor at KOGC - we had the counselling and testing going on.

Each person was met by a trained counsellor and given pre-test counselling. They were explained about HIV and what it does to the body. They were assured of confidentiality. The counsellor explored with them how the would feel if the test showed they were HIV negative - and how they would feel if they were positive. After the session, they were asked whether they would like to go ahead with the test.

In another room, the blood samples were collected and processed. It was a blessing to have hard working staff who really did an excellent job throughout the day.

By 2 pm we had already registered 30 people. At the end of the day a full 81 people had been counselled and tested for HIV!
Vinod, our lab tech was glued to his spot doing the different tests.

And our team was strengthened by the presence of our old friend (and trained counsellor) Daniel Kautikkar who came up for the weekend from his MSW studies in Ahmednagar.

Since we had so many people coming for testing we were unable to give all the reports and post test counselling on that day. It was a blessing that Daniel was able to provide this to 20 odd people on the next day.

Of the 81 people tested, we had 4 who tested positive for HIV. One was a couple who did not want their partner to know about their status. A lot of counselling is needed there. Another was a young man whose wife and children he sent back to their village in north India. A final was a young widow who thought she might have it, but was confused.

Though we are never happy that people are HIV positive - we are glad that we were able to meet these dear people. Our prayer is that they will be followed up and helped to make real positive steps in their lives. Our prayer is also that the 77 people who tested 'negative' will take this as a real God-send to make real changes in their lives.

Wednesday 22 September 2010

Help

our beds at the current Jeevan Sahara Kendra

We got a call at 4 AM from Leena. Her husband Sanjay is very sick. Vomitting. Has been so for some time. Could we admit him. We told Leena to bring him to Jeevan Sahara Kendra at 11AM when Sheba will come.

When I arrived for staff prayers at 9AM I could see that they had already come.

Another call had come in the meantime. Mira and Santosh are desperate for help. They went all the way to Sion hospital where we had referred him - but were not given a bed. The hospital said that they did not have space and that the doctor who would be treating was not there - and so to come back later.

During our prayers Sanjay started vomitting. We had called Sheba. Then the sound of an autorickshaw outside. Mira had arrived with Santosh. Our JSK men put him in a chair and carried him in.

We have 3 beds in a 25 square feet space. 2 of them have 2 very sick men lying on them. Both have some cerebral infection - due to their immunity being ravaged by HIV.

We don't have the lab support, the nursing staff, all the bells-and-whistles to care for such sick men. We currently have 1 (moderately pregnant) nurse and 1 nurse aide. Our one other qualified nurse is on her way back between Orissa and Thane - and due to arrive at 3 AM tomorrow morning.

But we have few options. Today is the Ganesh Visrajan festival and the whole city will grind to a stop. Even thinking to taking these men to a govt. hospital is foolish. They will just not be admitted.

Help.

So Sheba is now with the two families. Doing what can be done. We feel weak but know that we have to trust that God will help us minister to our desperately ill friends. The public health system - as decent as it is here compared to our Jharkhand days - has failed. The family resources of these two couples are scant. We are all that they have right now.

We prayed this morning that God will help us through the day.

So we go forward on a wing and a prayer.
We go in faith, our own great weakness feeling,
And needing more each day Thy grace to know:

Yet from our hearts a song of triumph pealing,

“We rest on Thee, and in Thy Name we go.”

Tuesday 21 September 2010

Deal with it later

Mira attends a local prayer fellowship. Santosh has come irregularly. He has been sick for some months. One of their pastors was concerned and tried to approach Santosh about it. Santosh brushed him off.

Yesterday they brought Santosh to JSK. The pastor, Mira and another man. Santosh was not himself. He curled in a small ball. He got up and acted without control. He lay down again.

He has been suffering with headaches and nausea for a month. The couple has been medicating using head-ache pills for this time.

Yesterday Mira admitted to the pastor that Santosh was HIV positive. And when they brought Santosh to the centre Mira told Sheba that she was positive as well.

Its a crying shame. The pastor was so willing to help. He thought that HIV may be involved at some level. He tried to get Santosh to come to JSK for a checkup.

The family was just too scared. It was a family of two - with Santosh and Mira against the world. Too afraid to let her parents know lest they be disowned completely. Too afraid to let the pastor know.

Sheba feels that Santosh may have a lesion on his brain. Or it may be an untreated syphillus. Treatments are possible but need an immediate MRI and hospitalisation. We are unable to monitor Santosh in our present set up. We had to refer to one of the large government hospitals in Mumbai.

Thinking back on this dear tear-stained couple we realise 2 things.

1. We don't see this kind of neglect among the Positive Friends we are working with - because our staff and other church members are quick to pick up when something is going wrong - and able to treat or get treatment quickly.

2. As we move towards providing a wider suite of inpatient care services - beyond the rudamentary that we have on offer now - we are going to meet many, many more Santosh and Miras. People who are coming into contact with HIV care at a very critical and late stage in their infection. And the main reason is because of years of neglect. Years of fear. Years of hoping that things-will-work-out-and-we-will-deal-with-it-later.

Lord, help us.

Do say a prayer for Santosh - and for his brave and lonely wife Mira - and for the loving pastor who are trying to help in this complex situation.

Monday 20 September 2010

Scrap books

We are seem to be grinding through a slow but real change in our educational system. But plus ça change, plus c'est la même chose ...

The state government has decreed that exams are bad and put too much stress on kids. Henceforth - no exams in schools. So our kids (who study in a school affiliated with the state board) are now freed from 'exams.'

Instead they get weekly 'assessments.'

The advantage - as we can see it - is that they are bite-sized and regular - so Asha and Enoch are always ready for them. This instead of the omnibus monsters that lurk at the end of term (which our 2 have so far been able to conquer pretty well all things considered).


There are to be no 'failing' of students from now on. Everyone is to be promoted. Regardless of how much they know and how much they can show.

What this will lead to is anyone's guess, but that's the party line from above.

One of the ladies who we work with has 2 daughters. Both are in pre-school. The older one goes to an 'English-medium' school. Our friend - Mrs. Maninder - is passionate about education and making sure her girls do well. The little twosome are often seen with books in hand - writing out English alphabets.

The school has told the older girl to maintain a scrap book. Every 2 weeks or so a topic is given. One day it is modes of transport. On another it is kinds of food. A third may be carnivorous animals.

Now as I understand it, a scrap book is supposed to foster creativity. The kid is supposed to look through stacks of old magazines and cut out images and then paste it into an old book in an artistic way. Mini collages anyone?

Fed into the great Indian educational sausage factory the hallowed scrap book comes out like this:

Teacher decrees what the topic is. Children write it down dutifully. Parents read it. Parents take children too nearby shop. Shop-keeper opens a drawer with multiple sheets of stickers. "National heroes? We have it here. Nutritional foods? Yes, madame. Space objects? No, problem." Parents fork out cash. Kids take sheet of stickers home and paste into multicoloured 'scrap book' which has been purchased for the purpose.

Creativity value? Nil.

Expense? Not too much for middle and upper class. Rs. 5 per sheet is not going to eat into the pockets of people living in flats that cost Rs. 25,00,000.

But for a family where the head is a widow. Where they live in a tiny room that the landlord pockets Rs. 1500 a month for. Where 5 Rs. is what will be used for the evening's vegetables. For them that is a lot of money.

And so Mrs. Maninder goes to the shop and asks the shopkeeper to make a photocopy of the stickers.

He does. She comes back and cuts out the pictures and pastes them into her daughter's scrap book.

Scraps.

Sunday 19 September 2010

Searching for a cure

'Minni' came to meet Sheba at the clinic today. Minni's name is (of course) a pseudonym. Sheba's isn't.

Minni is seriously depressed. Her husband died of HIV. She has the disease. Her daughter has been taken away from her - 'for her daughter's good' and is now in the UK.

Minni stays in the police lines. Her husband used to be in the force. Her friend 'Shobha' who is also an AIDS-widow (albiet HIV negative) and whose late husband was also a policeman - brought her today.

When Sheba asked Minni what was on her mind - Minni wanted to know about the new cure for HIV that she had seen on TV.

"Which cure?" asked Sheba.

"The one that they said was 91% effective" said Minni.

"Our anti-retrovirals are already 99% effective if you take them right" said Sheba as the conversation wound on.

Minni wants to get rid of the HIV in her body. Her immune levels are really good. She has a CD4 count of 1300 - very much in the normal range for most people who do not have HIV.

But Minni desperately wants to 'get better.'

She has been going to an 'ayurvedic' doctor to boost her immunity. He has told her that if she takes his medicines her CD4 counts will go up. She has been giving him Rs. 4000 per month for his 'meds.'

Money down the drain. Or at least put it this way - money that goes straight into that greasy man's pockets.

She has been checking her CD4 counts every month. "Its going down" Minni said sadly.

Hardly.

As she was leaving she took out a large black cloth and tied it tightly around her head like some kind of a scarf.

We invited Minni to a Family Bible Camp that we are running for and with our HIV Positive Friends early next month. We expect about 80 or so folks to be there. Last year's time was tremendous encouragement for many.

Sheba talked with Minni and prayed with her.

Depression doesn't leave easily. Its not like you can lean it against the door like you do your multi-coloured umbrella.

What a person hopes for - and their ways coping - are just not things that we can peel off like you shuck an ear of maize.

We are grateful that Shobha brought Minni to meet us today. The next steps are not going to be easy - but we know that it is possible to live with hope.

In the mean time - we do so very much want to see a complete and final cure for HIV.

We are blessed to have Anti-retrovirals (ARVs). Last month and the month before we did not lose a single one of our HIV Positive Friends. We hardly see TB in the 100 odd folks who we are following up on ARVs.

But we still need more. Anyone fancy a Nobel prize in Medicine? Its up for grabs for whoever can show us how to completely rid the body of HIV. So completely that we can stop whatever the treatment it is - and get on with life.

Saturday 18 September 2010

Recipe

Recipe for a great evening:

0. Finding ourselves all at home - without having to go out for some worthy cause!

1. Hot alu-parathas (or is it paronthas?) With dahi! Punjabi cuisine (at least the dhaba variety) rules.

2. Baking chocolate cake with the kids (licking of the bowl is an 'of-course')

3. Text and phone-calls from the JSK team who are doing an amazing job with an HIV testing camp with two churches in Airoli - 80 plus people tested! Thats more than we did last year!

4. Sheba working on her cross-stich

5. A spirited Bible-quiz game with Asha coming trumps (handicaps given based on age)

6. Another spirited memory game using cards we made from photos of the family taken over the past years. Serving fresh chocolate cake muffins - on chocolate icecream!

7. Lots of great conversation - ranging from the silly to the enlightened (sometimes swinging wildly between the two).

8. Finding out the washing-machine is still working properly - only an indicator isn't

9. Praying together - a number of times over the evening - for friends in challenging situations - for Sheba's parents as they are on the train between Vizag and Delhi

10. About to go to bed - warm with the joy of being together

All experienced in the last 5 hours.

Its a very good life.

Totally grateful to God.

Onward into the next week!

HIV Testing Camp



Today we are running an HIV testing camp.

Its the second time Jeevan Sahara has been asked to do so. We organised an HIV awareness and testing camp last month together with a local group called BIDS.

Last time we did an awareness meeting in a 'pandal' - a temporary shed which was constructed for the purpose - and local young men (mainly) came and listened to presentations about HIV - and a film that describes the way a person with HIV lives out his life - and the friendship another couple has for him.

The confidential counselling and blood taking was then done in the BIDS programme room. The picture on the right shows the blood taking equipment on a manual sewing machine stand that BIDS uses to help rehabilitate some of the women they are working with. We then took all the samples to our centre and processed them there. The post-test counselling was given the next day as people came to collect their samples.

Today's camp is different.

We are doing it quite a distance away from us - in the Navi Mumbai suburb of Airoli.

The programme is organised by two local churches. We are holding the public awareness meeting and movie show in one church - and doing the couselling, blood-taking, testing and post-test-counselling in the home of the pastor the other church. Since the location is far from our centre we will be giving the reports and doing the post-test counselling 'on-the-spot.' We expect that within 2-3 hours of being counselled, the person who gets tested will have been given their report and counselled about their next steps.

some of the participants in the awareness programme organised with BIDS last month

Its a new venture for us. New because the logistics of it all are quite different from what we have done so far. New because we will be using test-kits that have been given by the government as we are now a recognised local partner in the governments HIV testing programme. New because we have 2 amazing churches who are gung-ho to help out - who want their church members and others to be tested. And most importantly - who are ready to love and care for people with HIV.

We have seen these 2 churches in action already - and are proud to be able to help them out a bit with our expertise in this crucial area.

How many people will be tested today? We don't know. Its going to be a learning experience - but it will also be a life-changing one.

We were visited earlier this week by Dr. Shidabaram Nadesan (a.k.a. "Tygie") who is a senior consultant at McCord Hospital in Durban S. Africa. He told us that a quarter of the population is HIV positive. That 60% of the people admitted to his hospital are sick with HIV as well as the other infections they are being treated for. Though HIV is a terrible challenge in our country - we are still far from this situation - and by God's grace want to move farther and farther away from it.

Today's HIV testing camp - and the way that the churches are moving forward - are a small step in the direction we want to go!

Sunday 12 September 2010

Jesus has HIV

I remember my first friend who died of HIV.

He was a small shrivelled man with clunky black glasses through which he looked at me and talked during his last days.

His name was Vanlalringa

I am using a real name for a change. I can't hide my friend's identity with a pseudonym.

I knew Ringa for a few weeks in 1995. It was the first time I really got to know someone living with HIV. Ringa was my first friend to die with HIV.

Ringa was an all out follower of Jesus. He had been to a prestigous Bible college. I won't name it, but when he got sick he had to leave. A past history of drug use caught up to his body. The virus that had entered him so long before was doing its nasty work when I met him. Those were the days before ART was commonly available. Most of what we did was try and deal with opportunistic infections - and try and make things as comfortable as possible.

My memory clouds now 16 years later about when I last met Ringa alive. But I still remember the rainy days I would walk over to his little home. I still remember is small silent mother - and the look of sadness and love on her face as she cared for her seminarian son dying of AIDS.

I remember the funeral wake - locally called a lengkham. After a person dies the house is cleared out of furniture - benches are brought in and the whole community comes to sing songs all night before the funeral. I think it was my first lengkham that I attended. It was the first where I knew the person. I said some few words during the time.

Does Jesus have HIV? He does. His body here on earth - the flesh and blood followers who have been touched by His love have HIV. So many of them. Some like Ringa have already passed on to glory. Others are living through the days and weeks and months and years alloted to them. Many with hope. Many with tears. Many living out the love that their Lord showed to them.

Dan Turello (a good friend of mine who I would love to have living next door instead of in Boston MA) sent me a gentle nudge to look at an article about a South African pastor who preached a sermon called "Jesus had HIV".

I was surprised that people were upset at the statement - specifically because they thought it implied that Jesus slept around.

But look at what Isaiah says about our Lord:

Surely he took up our infirmities
and carried our sorrows,
yet we considered him stricken by God,
smitten by him, and afflicted.

But he was pierced for our transgressions,
he was crushed for our iniquities;
the punishment that brought us peace was upon him,
and by his wounds we are healed. Isaiah 53.3-4

Christians through the ages have been given glimpses into the awesome mystery of the Lord of the universe suffering physically. Some eras saw this clearer than others. With the swirl of antibiotics on one hand and the name-it-claim-it-heal-yourself folks on the other, we in the church seem to have forgotten about Jesus who "surely took up our infirmities." He did not lift them with a forklift and dump them in a trash can. He bore them on Himself. Phillip Yancey footnotes his The Jesus I Never Knew with the statement that some of the Crusaders in the middle ages returned being convinced that Jesus actualy suffered from Leprosy (what we call Hansen's disease today). So much so that those who returned from the holy land with leprosy were considered to have been given the 'holy disease' and looked after in Lazar-houses (named after the beggar Lazarus in the parable Jesus told). One of the German words for 'hospital' - Lazarett - springs from this tradition.

Jesus has HIV not only because His body on earth has it. He also knows the shame and disgust that people treat the disease with. Born of parents who were pregnant when they were married - he knows the scorn of being called a bastard. I had always wondered why a certain band was called Pantera. I now know. Early Greek opponents of the fledgling Christian church (such as the philosopher Celsus) lost no time in painting a scurrilous picture of Jesus' father. They claimed that Jesus was born to Mary after she had an illicit relationship with a wandering Roman soldier named Pantera. His growing up in the small village of Nazareth would have had plenty of opportunities for people to abuse him. All the more likely since we do not hear about Joseph after Jesus' 12th birthday. You can just imagine the talk: "An early death ... what could that mean but God's punishment for a man who sinned?"

Jesus was stripped naked and hung to die by asphixiation on a set of crooked pieces of wood - a curse in Jewish law and an abomenation to everyone who passed. He was spat upon, abused by all and sundry, abandonned and betrayed by his friends. He if anyone knows what suffering is like. He has been through it all.

I don't like pictures of Christ on the cross. Because they are always too Barbie for me. They are too washed-in-Rin-soap safe. They are not the bloodied corpse that still breathed that bore the filth and shame of all my sin upon Him.

Does Jesus have HIV? Yes He does. And everything else that we find loathesome. And more. Much more. HIV would be one of the least of His issues. The true scandal of the ages is that He who knew no sin, who was spotless in this maculate world that He trod - was coated, cloaked, smeared and covered with it. So much so that Father turned away His holy face and prompted Jesus to cry out in the darkness - "My God, My God, why have you forsaken me?"

We have become so sanitized in our faith - so neat, peppy and perky - so spiffy and sparkly that we choose the gloss over the vast tracts of anguish that the good book lays out for us.

The part of Scripture that brought us to the Mumbai area to work with people with HIV was this:

The high priest carries the blood of animals into the Most Holy Place as a sin offering, but the bodies are burned outside the camp. And so Jesus also suffered outside the city gate to make the people holy through his own blood. Let us, then, go to him outside the camp, bearing the disgrace he bore. For here we do not have an enduring city, but we are looking for the city that is to come. Heb. 13.12-14

It struck us that HIV/AIDS was and is a disease linked with shame. There may be many reasons for this - but no matter which society we are in - we see the deep stigma people living with HIV face. God's people are not to shy away from this - but rather embrace it. Our lives should be sharing in the shame of Jesus - the shame and disgrace that every person with HIV is living through in greater and lesser measure as they live through today.

But there is one other thing to remember. Jesus may have HIV now. But He will not be bearing it forever.

Though He did not flinch from suffering. Though He chose willingly to pay the cost for me. Though He expects nothing less from us - and our lives should be marked out with shame and suffering if we are really 'taking up the cross and following Him' - Jesus does not put suffering into a holy box and make a religion out of it.

Instead we look forward to the fulfillment of His kingdom when there will be no more sorrow, no more shame, no more death, no more pain. This is no pie-in-the-sky-in-the-sweet-by-and-by. This is the real hope that each humble follower of Jesus Christ has. Eternal, unending, unbounded, complete, fulfilled, life-as-it-should-be, and life-overflowing-spilling-over-into-forever-and-ever.

If we do look back from whatever time-state eternity is in - we will see that Jesus had HIV - but not-anymore.

My friend Vanlalringa will agree to that. I look forward to talking to him about it - and not having to leave after 1.5 hours like I used to back in Churchandpur, 16 years and a death ago.

Nathaniel

Nathaniel went South. Far South. Almost as South as you can get in India.

His family took him. They wanted him sober. They checked him into a mission hospital with the hope that Nathaniel would stop abusing alcohol.

While at the hospital (which as far as I know is not a rehab centre) he was tested for HIV. He was found to be HIV positive.

We got a call from Nathaniel's doctor - who happens to be a friend of ours. Since Nathaniel lives in Thane, he was referred to us for further treatment - of his HIV that is.

Turns out Nathaniel is more a neighbour than we may have guessed from the phone referral. His father is the chairman of a prominent local church. The family is very afraid that others will find out about his HIV status. They do not want home visits.

About his drinking, however, I am sure most local people will know. It would be unusual if someone who was an alcoholic for over 13 years would escape the notice of people around.

How much the family is co-dependent in this cycle is not clear yet. We are just making contact with them.

His brother and sister brought Nathaniel. He was sullen. We explained about HIV and did a confirmatory HIV test. We talked about deaddiction treatments. We talked about how he needed to bring his wife for testing.

Nathaniel did not come with his wife. She came alone for her test. She looks barely out of school. When we asked about Nathaniel we were told that he was drinking again.

On Saturday Nathaniel came unexpectedly to the clinic. He wanted his wife's report. She had picked up his HIV test - which was positive - and he had come for hers.

By God's grace she is - still - HIV negative.

Now it is Nathaniel's turn to make a change. AIDS kills - but not as quickly as people think. We can drink ourselves to death - but after 13 years of it - the body can manage to chug along pretty well.

It is possible to make a change though - as gloomy as a situation may be.

In talking to Nathaniel, he has at least showed that he is open to be visited at home - something his relatives were dead against. We do know of some of our friends who have been able to get out of the grip of the bottle - and make real changes in their lives.

We are exploring options for places where Nathaniel can go if he is really convinced that he wants to change. But it all turns around the question of whether he can summon up the will to do so. As miserable as his life may be at this point - it has a certain set of sureties. He knows that his family is trying to do something for him. He knows where to get the next shot. He has his pals and the days move forward.

Change is hard.

But change is possible. There is hope. And that's why we are here. Because as long as we have breath there is still hope for change.

We see in the life of Christ that He kept giving second chances to his disciples when they messed up. But we also see the deep sorrow that Jesus had when people walked away from Him. He never forced them to follow Him. But was always willing to give people another opportunity to let them be more like Him.

Say a prayer for Nathaniel. I think we have a long walk ahead with him and his young wife.

Wednesday 8 September 2010

Vada pav

Tarun's mother has HIV. His father does not. His uncle died of AIDS last year. Its complicated.

Tarun has the disease as well. He is 15 years old and struggling to take TB medications. By God's grace he has completed (with much encouragement) the basic course. We have asked his mother to have him take an additional 2 months of anti-TB meds.

When Sheba wrote out the medication, Tarun's mother asked how much it would cost. The course that he completed was free from the government - but they do not give the extension of treatment.

Sheba said it would be about Rs. 200 or so a month.

"Oh Doctor, don't give cheap medicines, please give something expensive that will make Tarun fully better" said his mother.

Sheba explained that this was the best medicine to take.

Tarun's mother is sad because Tarun is still sick and repeatedly gets diarrhoea.

Sheba talked with Tarun's mother about why this was so.

Tarun's family sell 'Vada Pav' on the roadside. Commonly called 'Bombay Burger' this tasty snack is wolfed down in huge amounts across the city. The potato and gram flour dough - seasoned with mustard and green chillies - is deep fried in oil and the hot round balls are then tucked into the 'Pav' - a Mumbai bun and garnished with more fried chillies and spice.

It tastes great. But is not for the faint of stomache. What actually lurks in the oil is a big mystery. How old the wadas actually are is another. How many flies have sat on them before eating is a third. Whether the cheerful vendour has washed his hands after he last wiped his bum is a fourth. The list goes on.

We strongly suggest that our HIV positive friends do not eat 'anything outside.' With weakened immunities eat stuff like these beloved Bombay Burgers is an invitation to diarrhoea.

Tarun's family makes these tasty treats for a living. They get up at 10 am and work the streets late into the evening - rarely sleeping before 1 AM.

Breakfast for Tarun is a cup of tea and a few biscuits. Lunch and dinner are usually wada pavs.

Sheba sat with Tarun's mother and charted out a diet plan. Chappatis with subji for breakfast. Something nutritious for lunch.

Day before yesterday Tarun came by. He has not grown fat overnight. But he has eaten chappatis after a very long time.

If only getting better was a matter of swallowing expensive medicines. How often we forget the greatest medications given to us. Food.

Tuesday 7 September 2010

Testing times

This month we did something new. Giri Nayak, our HIV counsellor, attended a meeting held at the government hospital of all the govt. HIV testing centres in the Thane District. He attended it because we are now one of those centres (called ICTCs - integrated counselling and testing centres).

We have been running our ICTC for over a year now. But for most of the time we have been limping along. One month would see 10 people tested. Then another 6. And so it went.

In early August Giri shared these figures with the government official in charge of the centres. He said that we needed to see more people tested.

We agreed.

So during August we ramped up our testing work. We printed a small handbill and had it added to the morning paper runs in some key neighbourhoods. We gave handbills to autorickshaw drivers. We held an awareness and testing camp with BIDS - a local NGO. We had Naveen visit local medical stores and doctors and tell about our programme. Naveen and Nimit also visited a local industrial area and talked to workers there.

The numbers of people being tested increased. On the 31st of August I asked Giri how many people had been tested so far.

He said 35 had been tested.

I was a tad dissappointed as we had put ourselves a mental target of seeing 50 people tested.

Wouldn't it be nice, I thought, if we could at least make it to 40?

I asked the Peter to spare the home-based care team at lunch - and requested that they make a short outreach programme to the industrial area. Who knows - maybe we will reach 40! We prayed.

Later in the afternoon I came to the centre and saw chappals lined up outside the door. I walked in to see young men whom I had not seen before. In the lab a row of test-tubes stood - each labelled and containing a blood sample. There were 11 test-tubes of blood. We cracked 40 - and ended up with 46 people tested during August!

Why is it important to get numbers?

One is for credibility with the government. We know that we are doing good work - but it is important to be partners in the continuum of health. If for some reason we have to shut shop tomorrow, we do not want our friends to be treatment orphans. We are working towards becoming a partner in ART therapy with the government - and the succesful running of a testing and counselling centre is a first step towards this.

Another is because when we test people - they have a chance. A chance to change. A chance to face up to reality. A chance to take charge of their lives. And the more people at risk (which is a very very large number) who are tested - the more options they have.

For every 'negative' result we get - we let out a happy sigh of relief. But it is so important that the young man or woman understand that they now need to see real changes in their behaviours or we will not be giving a happy sigh anymore. HIV infection is like a light switch - its either 'on' or 'off'. There is no inbetween. And once its 'on' - there is no 'off' left. The switch is stuck permanently 'on.'

For those with HIV. We are glad that we can test them here. And then be able to directly counsel them about fighting the infection - and prolonging their lives. We are glad that it is us talking to them - though it is hard for us to share the news - rather that them getting the result in some little lab where the technician just gives them a slip of paper with 'HIV antibody reactive' printed on it.

And so we plunge into September. Will we be able to test more people than the 46 that we did in August?

We hope so.

Sunday 5 September 2010

single-day seminary sojourn

Its not often that I get to visit seminaries. But the visit at the end of August to the Union Biblical Seminary in Pune was special.

Special in part - because it gave Lun and I amazing glimpses of God's grandeur in the lush monsoonal landscape between Thane and Pune.

Looking out of the train window gave us visual treats like this:

I am always glad to see paddy sown - it means golden harvests later when the rich husks of rice are cut and the farmer rejoices in the yield. For a hungry land we need these harvests so much - and when the monsoons are good (like they are this year in our area) it is a cause for joy!

A few minutes later we were climbing the Western Ghats. Lun - one of this year's UBS interns (and who is from Manipur) was buried for some time in the paper catching up to the daily happenings.

Later we had an animated conversation with a retired bank manager who now travels the world and had a goodly stock of opinions (sample: Moses, Abraham and Ibrahim are the founders of the three main religions - but why are the followers fighting with each other?).

Outside the scenery continued to stun:

Check out the monkey on the right side of the frame - neither he nor I knew that he was in the picture when it was clicked.

The monsoons do such magic to the hills. What is dry and brown come alive with greenery and waterfalls.

A sight for sore urban eyes like those in the sockets of yours trully. I just couldn't stop myself from exclaiming at the sheer beauty of it all.


The main purpose for the visit to UBS was to talk in a special Current Concerns chapel in the afternoon about HIV/AIDS in India and what work we are doing at Jeevan Sahara Kendra.

I had had minimum sleep the night before in preparation for the day - but it was all worth it.


We were greeted by the three interns who had been with us last year - John Jeebaseelan, Binson James and Ashis Karthak. What a joy to see these wonderful men again. It really warmed the cockles of my heart to see their enthusiasm and the love that they poured on us to make sure that our time was as comfortable as could be.

We were joined at lunch by Rev. Premanand Bagh - the coordinator of the internship programme. It was also good to meet students who are looking into working with us next year for their 7 months practical training.

The chapel was a great opportunity to meet with the students and staff and share our heart. I talked about the scenario of HIV in our country and what Jeevan Sahara is doing. Lun shared about the experiences of working as an intern at JSK.

The talk was well received with good questions afterwards. The conversations that were started continued over tea (bless the Lord for that wonderful drink). It was heartening to meet pastors in training who really seem interested in having their churches a places where people with HIV are loved and in speaking out to help prevent the further spread of HIV.


Lun and I left the greenery of UBS in particular and Pune in general - to come back to the greyness of Thane - grateful for the opportunity to meet some wonderful people - and challenged to keep going forward!

Trafficking

Late Sunday afternoon lethargy. We tried to visit a family - but found out that tomorrow is better.

What to do together?

Asha says: "Lets read a book or see a movie that we have not seen."

Things click in this Daddy's mind. Maybe the time is now to unveil what has been hidden for some time...

Down comes a DVD which had been purchased a few weeks prior. A condensed - but still very watchable version of Herge's classic Tintin adventure The Red Sea Sharks.

I had not read the comic for years - and so was pleasantly surprised. Herge tells a cracking good yarn - I now remember why this was a favourite for me - given the prominence of the Mosquito fighters and the action invovled. But Herge also weaves in his old special brand of slap-stick with a virtual rogues gallery of past 'baddies' showing up (Allen, Rastapolous, Mueller and more) as well as our beloved incompetents (the Thom(p)son twins, Nestor, Castafiore, Alcazar and Haddock of course).

What surprsed me was the nature of the adventure. It is about human trafficking - in the book mainly black Africans (if my memory is correct) - in the film there seem to be a variety of folk (including Desi looking types) who are being smuggled for immigration purposes.

People are not for selling - but they continue to be smuggled - with various levels of connivance - and deep pockets who are making profits from the horrible business of slavery.

The fact that the story ends in the comforts of Marlinspike (and the Emir safely back in the saddle) doesn't mean that this is the situation for most people who are being trafficked today.

Our friends in programmes who are involved with rescue and restoration of girls sold into prostitution (like Freedom Firm, Oasis India Trust and IJM) know how difficult it is - and how costly and heartbreaking the process of rehabilitation can be.

After the excitement and glamour of 'rescuing' the girls from the brothel - comes the years of work of walking along side these young women and helping them blossom into the women that God has created them to be. The long-term carers are few. The funds meagre. The challenges great. So much more needs to be done.

Hats off to the few who are making a difference though.

Bread and circuses

They brought in the child.

He was 7 - maybe 8.

They were a group of muscly men. All clad in identical t-shirts. "There is nothing wrong with him" - they said "only a small cut."

Sheba looked at the child lying on the bed. He was dazed. The boy had been climbing up one of the human pyramids that characterise the festival celebrating the birth of Krishna.

The pyramid had collapsed. He was crushed in the melee.

Our staff were passing the spot and said that the men had not paid attention to the boy. The music had started again and the men began dancing with abandon. Unsurprisingly, the men who came in reeked with alcohol.

The staff had brought the boy in. Sheba checked his hands and torso for injuries. There did not seem to be any. "Does it hurt here?" she asked, softly pressing different parts of the boys body. "No" came the soft reply. The eyes looked vacant.

The boy seemed to have escaped serious trauma to his body. There was a small cut on his foot which was dressed by our nurse.

There was not much else to do but release the boy.

He was swallowed up into the afternoon.

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Later that night I had to do some shopping. The cross roads near our house was a mass of humanity. Truck loads of teams coming and going - aiming to build the pyramid and smash the pot of dahi - and collect a large cash prize in the process. Hundreds of people looked on eagerly at the spectacle as a massive sound system growled out hybrid twitchy beats.

All around were immense hoardings - of the local political party that was organsing the show in this pocket. Advertisements of the local sweet shop and other local businesses also featured prominently - with more surface area devoted to them than to the diety for whom the festival is held. The other money - money that had been extracted out of countless local folks - big and small - by the 'volunteers' did not get mention - other than the obvious costs incurred in putting the spectacle together. As before - electricity comes free from the power grid - its the local godfather who is organising the spectacle after all.

As I passed a token policeman did some traffic directing - a truckload of pyramid climbers was just pushing off - while others were coming in. Buses and cars which had been waiting to pass inched by.

I was struck by the masses of young men - wearing T-shirts with a prominent regional politician on the front - and a local politico on the back - driving scores of motor cycles festooned with their party flags.

There is so much energy and potential in these young men. But 2 days after the spectacle is over - the pot-holed roads and gloomy monsoonal skies have hardly a memory of them.

Would that we could see each young man doing daring things that have long-lasting fruit. The bread and circuses that our local parties vie in out-doing each other in (which are far less bread and far more circus of course) are not in any way building our country.

As for the boy. May he fare well. Will he grow up to be one of the reeking men who 'accompanied' him to our clinic. Remember that each one of them used to be a small boy of 7 or 8 years of age.