A Very Indie Thanksgiving

Often when I travel, I struggle when asked to share examples with my new friends and local colleagues of things that are “truly American”. The US has never been a monoculture; our food and daily practices are modified hybrids, borrowed and adapted from other countries and regions of the world due to our collective history of being a nation built and defined by successive waves of immigration. 

When asked to share a concrete example of “what do Americans eat for breakfast”, or “who decides how an American family spends their money”, I am struck that the answer I would comfortably give, “It depends, everyone does things differently” is in itself, a very American response. We prioritize individualism, choice, and variety.

It seems unfair to those who share their home or meals with me, who sit me down on brightly colored cloth mats to view framed photographs of ancestors, who provide endless examples to help me learn and get to know their experience. I know they want me to open and share a glimpse into life across the world. What can I offer for images or description? Cornflakes and orange juice? Starbucks in hand for the morning commute? My practice of going out of the way to get to the local co-op for organic muffins and free trade coffee,  and the reality that  I can make this decision because I can make the extra time? I don’t need to pump or heat water for my morning shower, and so I can focus on the implications of my breakfast choices. What to say?

Travel provides the perspective necessary to notice. If one is willing to consider and perhaps even become a little uncomfortable, the dominant, unifying aspects of one's home culture slowly emerge and become evident. This requires us to reflect, to angle the anthroplogical spot light away from the place we visit, and turn it towards ourselves.  Through our interactions “outside”, we begin to notice what we don’t even know is within. The way that we conceive of the world, of right and wrong, of the way that we assign value to things, begins to reflect back. Insight shows that a unifying home culture does exist. What do our beliefs and actions say about where we come from?

Fortunately, while traveling this time with Rally for Health in India, I was able to share a great example of my own home culture, by sharing an all American holiday with new friends, American, Canadian, and Indian. At the end of our incredibly long last day of rickshaw driving, we were able to share an incredible meal together. It was a transcultural experience, and it happened in a very special place.

Faripur is located about an hour from the city of Bareilly, in the north western state of Uttar Pradesh. This region reports some of the worst health and demographic indicators in the country. There is an old Methodist mission site and hospital that was initially founded by Clara Swain, the first western trained female physician to practice in Asia. What remains is a small health clinic which struggles to cover expenses and stay afloat, a kind and committed staff of Indian nationals, and Babyfold, a lovely school and dormitory for orphan children that exists within the mission compound.

The Clara Swain clinic was to be our last care delivery site, the crowning jewel in the Rally clinic roster as it is a place that our rally founder had come to as a volunteer three years ago. For him, this visit was a return to people whom he knows, has worked with, and cares about very much. 

Perhaps because of this, our arrival felt like an uncanny homecoming. We were met by Miss Lillian Wallace, the esteemed matriarch of this former mission site.  Arrived to India by steamship in 1956 as a young lady in her early twenties, Miss Lillian has remained in India, and in Faripur, ever since. Progressing from her original role as physical education teacher, Miss Lillian eventually became administrative supervisor of the Clara Swain hospital system. In addition, she supervises Babyfold, and various other simultaneous projects. 

Miss Lillian is a powerhouse, a women of deep conviction, kindness, and unwavering gumption. At eighty three years old, she drives her SUV through rush hour traffic with a confidence and skill that puts local rickshaw drivers to shame, all the while fielding calls on her mobile and telling us the story of Clara Swain’s arrival to Bareilly region. We, her dazed and amazed passengers, can only nod, are initially rendered speechless.

Warm water does much for restoring a sense of overall wellbeing. Freshly showered, we came down the staircase and were greeted, one by one, by the flock of Babyfold. Beautiful children ranging in age from three years to seventeen smiled shyly from beneath dark bangs and heavy eye lashes, emanating sweet goodness. They stood in line and proudly presented each of us with a “Happy Thanksgiving” pendent necklace. Touched by the pureness of such a gesture, and perhaps overcome by the experiences we had shared over the past four weeks on the Rally trail, we began to embrace each other, declaring, “Happy Thanksgiving”. Our good Indian colleagues echoed back gleefully, “Happy Thanksgiving, my first Thanksgiving”.

We were ushered into a dining room and waved goodnight to the kids. The room set for a holiday meal, with embroidered napkins and perfectly aligned place settings, was lovely. But, in true Rally fashion, we immediately began moving furniture to create one long, family style dining table.  The food began to arrive, piles of breaded and baked chicken, mixed vegetables, and, unbelievably mashed potatoes and gravy!

Though we have eaten our way through this trip, with no shortage of new and delicious offerings in every town and village, this meal, prepared by the Babyfold cooks with authentic Thanksgiving spice and flavoring direction by Miss Lillian linked us across the world to our various homes, families, and most of all, memories. Our conversation became a flurry of explanation, to share with our Indian friends what Thanksgiving meant, where we came from. Details about what is cooked, who is present, the Macy’s Thanksgiving Day parade floats, the joys of left overs, dishwashing marathons, family squabbles and indigestion, came pouring out. Like school children at share and tell time, we told our stories, and in doing so, showed pieces of ourselves. Tradition and ritual, and variations on such, are what make up our reality. Together we all shared the Thanksgiving tradition of expressing thanks; thanks for all we have been blessed with, and those we have each been blessed by.

The day after our Indie Thanksgiving marked the beginning of the end of our Rally. Two more clinic days in Faripur, then health screenings and well child exams for the children of Babyfold in the evening. We resumed our meals of dahl and puri, and continued to search for the right hindi words to form expressions, tilting our heads side to side for emphasis. Tikhe, and Atcha, were beginning to be more meaningful for what we wished to convey then “Okay?” or “Sure, got it”.  

With packs and supply bags on our backs and in each hand rather than tied to rickshaws, we boarded a night train, headed for our final destination, Delhi. The train station, a live organism itself at all hours, hummed with passengers, tea carts, and intermittent whistles. The platform glowed strangely in the limited florescent light. Piles of ancient looking luggage seemed to be stacked here and there, forming barricades. Monkeys scaled the rooftops and handrails in unrully, arm swinging troops.Old men pulled wool blankets across their faces or lit cigarettes against the cool night air. Mothers wielding thermoses of tea pulled their children close to them. Some squatted, some laid down together on scraps of sleeping mats, with cloth or cardboard covering their heads, a small buffer against grit, smoke, noise, foot traffic, and the scuttle of dogs, mice and cows, freely, grazing in the trash piles that lined the platforms. The smell of urine seemed particularly strong.

When it was time, we divided into groups and geared up for the process of boarding the train. I pushed, and was pushed simultaneously, as bodies of all size somehow parted enough space so that when the doors closed we did in fact find ourselves inside the train. This was just the beginning, as any experienced rider of India’s railway system knows. Fight or flight plays out in its purest form, as the entire journey becomes a jockeying for position. Space and place.  The amazing part is, everyone settles in and eventually smiles and greets you over the rim of their chai cup. The very same toothless old women who twenty five minutes ago was pushing your luggage with her feet, and using her 100lbs of bodyweight to prevent you from taking your paid for seat! No hard feelings, this is the way that things get done…Tikhe?

 Each person made sense of the experience differently. We form our thoughts, and feel our feelings, based on where we have come from, both geographically, and metaphorically, through life. None of us arrive to Delhi without a sense of being challenged, of having glimpsed at ourselves in the proverbial mirror. If we choose, we can tuck this experience away, without assigning judgment or meaning.  Attention to this train ride, combined with the cornucopia of other experiences we have had together, and individually, as we have spent a month rallying across India, can help us gain awareness. And for that, we give thanks. 

Clinic Days

Ever experienced  “When the circus came to town”? Brightly painted vehicles laden down with mysterious equipment arrive to a vacant lot or open field. A cast of exotic, oddly dressed characters jump out and begin unloading large, unfamiliar items in a somewhat systematic manner. Speaking loudly to each other, moving quickly, these visitors from far away periodically pause to survey the now off kilter atmosphere of the community they have suddenly turned upside down. The locals look on with an air of anticipation and uncertainty.

We usually arrive to our next clinic destination in late afternoon, just as darkness begins to let down and everything takes on a soft focus quality. Our caravan rolls in, often flanked by yelling, waving children who then stand in clusters, whispering and pointing as we get to work. We set up and break down with a rhythm and choreographed division of labor that improves every three days, with each successive clinic site. It is a little strange that this chain of events is beginning to feel normal to me.

We pass cargo down the line, person to person, unloading the rickshaws and support vehicles. Trunks and burlap bags, metal poster stands and health education banners, plus the endless small packs and randomly acquired items such as rope, tarp, and two embroidered umbrellas that have traveled all the way from a Jodhpur street market. Our faces are usually streaked with sweat and road dust, our hair wild and windblown.

We set up clinic in school yards, hospital campus parking lots, town halls, slum centers, or temple outskirts. Depending on the site amenities available, we move chairs and tables into a configuration that has emerged as best for crowd control. Yards of dyed fabric originating from the second or third round of turbans we received from our ever gracious host communities had been unwound and now serve as a means to divide space. Patients waiting to be registered, patients waiting to be seen by doctors, here. Line for pharmacy, here. Sometimes we circle the rickshaws to block out treatment areas underneath trees, and set up the “pharmacy” by shifting around cargo in order to dispense medications out of the hatch back of our support SUV.

Anyone who has been inside a train station in India, or any such crowded free-for-all, could perhaps imagine the manner in which our waiting and determined crowd of patients approach the clinic area. A mass of waving arms and white registration papers; rows of bodies pushing and leaning against us, imploring in various ways that their ailment is most urgent. Everyone steps in front of each other to be seen by a medical provider while grinning unapologetically. The intensity of the crowd and perhaps their sheer number immediately overwhelms, wares and disorients us personal space conscious Americans. Practicing medicine the way we do, where we come from, necessitates some degree of corresponding western based order and organization.

Fully acknowledging that I am operating through my own cultural bias, I began searching for a way to rope off designated “wait behind this line until you are called” areas by the second day. Our group wide collection of turban fabric was growing abundant and actually worked quite well. I hoped that our hosts were not offended to see the good quality fabric put to work for sheer utilitarian purposes. It became a necessity that I could not afford to analyze and risk having to give up.

Tables and chairs, two doctors to each station, one American, one Indian, a table for dispensing medicines, one for vital signs and nursing care, and our mobile clinic can be ready to churn out health care on any given day. Setting up the pharmacy is always the most tedious and time consuming. Various bags and containers often had to be consolidated during re-packing, so each time we set up at another clinic site it became necessary to divide out the drugs into categories on whatever table top or surface was available: Antibiotics, Antifungals, topical creams, eye and ear drops, medicines to treat pain and control fever, medicines to treat the lungs, to control blood pressure.

All drugs were ordered and purchased in India, and so have brand names that we are still learning to recognize. Still, the process was getting easier. We no longer  looked for Tylenol and easily pulled the large PCM  jars, filling endless plastic pouches with five white tablets, a five day course of treatment for headache or ailments with associated fevers. As soon as the pharmacy is ready to go, we begin seeing patients. By this point there is usually a hefty crowd congregating around us, an equal mixture of those waiting with medical complaints, and those who pushed to the front just to hover, inspect, and partake in the entertainment that we seem to provide.

Having a local person assist in “registering” patients is key. Give a school teacher or local village leader a pen and a touch of authority with the troop of foreigners, and we can begin the process of organizing a crowd to receive medical care. Traditionally, all men would be seen first, before women and children. Once we realized this, we couldn’t help but institute process of seeing one male, one female patient. Children get automatic priority, especially the young ones, who are more vulnerable to illness. 

This is often elicits some indignant protesting from the older men, especially in the more rural communities. Fortunately, they eventually accept this bizarre insistence made by the foreigners, and adjust. They make sense of it by separating into two lines, male and female and the drop down into a squat, hips low to the ground, and shuffle forward. The line advances in one fluid motion, the way a centipede orchestrates many legs to inch and wiggle its elongated whole in a forward direction.

People are warm in receiving us, kind, often blatant in their desire to interact in some way. Old women with earlobes stretched long by heavy hoops, their faces shriveled underneath sari silk veils, grab our hands and fold them underneath their own in prayer position. They offer us the honor of the Nameskar greeting, while at the same time launching full steam in to describing every pain or physical complaint they have ever experienced in their life time. Each clinic site made special preparations for welcoming us. There have been ribbon cutting ceremonies to buildings that have been standing and operational for many years, but that for the day would serve as our mobile clinic and so must be inaugurated, chains of strung marigolds to adorn our necks, tikka and rice for our foreheads, and burning of ceremonial incense.   

The majority of patients we see have chronic ailments. Arthritic aches and pains, gastric reflux and irritation, respiratory complaints ranging from infections with or without fever requiring antibiotics,  to ongoing lung damage from years of inhaling pollution, industrial dust or chemicals, and from tobacco. Some people are told, for the first time in their life, that they have high blood pressure.

Many women shyly complain of vaginal infections and voice basic questions and concerns about parts of their bodies that remain wrapped and covered by many layers of fabric. Some agree to exams. Some request to consult with a male member of their family for this decision. Others completely refuse.

There is an abundance of skin infection, and eye and ear complaints with drainage of every color. All children with large bellies are sent home with deworming medication. Several cases of erectile dysfunction, reported by esteemed community leaders who request a private meeting with the doctors, are referred for treatment.

Some people are acutely ill, though with the abundance of hospitals in India, access to emergency and inpatient care is quite good.  Still, a few cases of progressed Thypoid, Malaria, a man with a concerning story and symptoms of spinal compression, are treated and then transferred to the nearest hospital.  

There is a constant exchange going on between the American doctors and Indian doctors, who now have been working together in rotating teams for several weeks. The process of taking a history, diagnosing and treating illness, or lack there of, becomes a vehicle in cultural exchange, as questions and different ways of practicing emerge and are sifted through. Sometimes there are nurses, or nursing students present, allowing for the same type of exchange and cross cultural relating.

Often times my exchange involves the clinic site hosts, as I interact with them with the title nurse, but also in matters of organization, triage screening, and the general need for “getting things done”. Their reaction is initially one of concern and displacement, due to my female status of course. After being asked to “just sit down” multiple times at one clinic site when a particularly large crowd swarmed the doctors tables and began pushing each other, fighting to sit down in the designated exam chairs in a rough and tumble version of musical chairs gone very bad, I politely as I could stated that no I would not sit down, in fact I was going to stay standing and moving while I reorganized the set up of this clinic. At the end of this very hectic day, it was noted that I had had some “very cute and useful ideas”. We all shook hands and smiled at eachother over our chai cups.

Each day takes on a particular rhythm with an early morning focus on crowd control and management. Sometimes we have to stop clinic and refuse to see any patients or dispense any medicines until the waiting mass maintains some semblance of a line in the designated areas. We hold up our hand to demonstrate that we can’t, or won’t, do a single thing more until our request for “eck”, as in one, person at a time, is honored. At some point we break in shifts for water, roti, and dahl. We eat with our hands and wash our fingers, stained yellow with turmeric, by pouring a scoop of water from a designated jug or basin over one hand, then the other, and vigorously rubbing them together.

The end of the day is marked by shadows elongated across the yard or field we are working in. The line of patients finally thins, the pharmacy scrapes together the last few prescription orders amidst a chaotic pile of empty pill trays. We begin to thank our hosts, who after eight hours working together, side by side, in English and Hindi, have become our friends. They shyly ask us about their own medical complaints; most want their blood pressure checked.

Sometimes, there is something extra special. Like for instance, the impromptu drumming and dancing that broke out as we packed up our supplies at sunset in the Kinshingarh slum. Some teenaged boys began drumming. No longer needing to focus on the order necessary to do our work, we let our guard down and began to smile freely, to oblidge each child in their excitement to say “hello, how are you?” and get a response from us. We shook their hands and began to dance, clapping hands and kicking feet, with no more need for translation, in fact, very little need for words at all.

I linked hands with a cluster of six to ten year olds, most with stick legs and red tinged hair, a classic marker of malnutrition, and began to spin with them in an exuberant game of ring-around-the rosy. They squealed and I laughed. My only means of extricating myself was to convince the group to fold hands and bow together towards the sinking red sun, giving one last, simultaneous “Namaste”.

Each time we break down a clinic camp, we are usually racing against darkness. We hurry to stack bags and cartons into the vehicles, shaking hands and expressing thanks as we go. We jump, one by one into the vehicles, honk horns and start engines, then caravan off, each vehicle in line. Behind us we leave scraps of paper, empty pill bottles, chai cups so graciously offered. The ground where our mobile clinic stood is flattened from foot traffic. The local host staff stand waving as we disappear. 

I venture to guess that in the day light of tomorrow, everything in these villages will return to normal, and that this health rally will exist somewhere between memory and imagined in the minds of those who will recall the day that such a medical big top event rolled through town.

Rickshaw Ramblin

Yesterday was a driving day. A low slung sun warmed our backs as western trekking packs flashing every brand name were loaded on top of support vehicles and rickshaw roofs. We wedged and nestled them between the brightly painted metallic trunks and burlap sacks containing medicine and medical supplies. All the space inside the various vehicles was needed for human cargo. Tied with rope, wrapped in plastic tarps, the luggage clung to the rooftops like an unsteady cake topper. We each said silent prayers to the gods of our choice (Gannesh, Krishna, Vishnu, Bhudda, Allah, Johnny Cash, Jack White, and Jesus’s father among them) and loaded up, the departure call “Challo Chellie” echoing down the line.

Our rickshaw train circled a hectic round-a-bout in Marble City center. We made our way amidst clouds of white grit, our faces wrapped in bandannas and scarfs, dodging trucks, cows, children and pot holes, and took the road east. Slowly, the air cleared, the sun shone brighter, and we began to see bit of green. A collective sigh of relief was apparent; this change of scenery was, both literally and figuratively, a breath of fresh air. We all began to relax a little. Some rickshaw teams had rigged portable speakers and began to broadcast their chosen travel sound track. Through my rectangular windshield view I saw three yellow box trollies settle into a cruising cadence in front of mine. We shifted into fourth gear and bent and wound around the curved road, waving at uniformed school children, at women caring wood and water, and at old men squatting on stick legs, their heads flanked by bent knees and hands folded beneath their chins, with eyes dark and contemplative beneath marigold colored turbans.  

This particular day was typical of rickshaw travel. We inched along, stopping to visit various temples and clarify directions with bemused villagers. While driving across a salt field, flat and grey, we sunk a rickshaw tire into a soft spot and damaged the cuppler on the drive terrain. This necessitated a 45 minute repair, which required 6 people to tip the rickshaw on its side so that the mechanic could clammer and bang away to get an old part loose.

 Later in the day, back on the road, we got lost multiple times while trying to find a roadside restaurant that one rickshaw had gone ahead and encouraged to stew dahl and toast roti for our 22 person crew. The problem was, figuring out how to get there. Our way of resolving the question of directions was to stop, greet a startled shop keeper or shepherd with an urgent and apologetic “Namaste” and hand them a cell phone with the hindi speaking party at our destination on the line. We would then wait for them to point right or left, and the hand gesture “go, go, GO!”.  Three pulls of the rickshaw rope around the starter wheel, and the engine would sputter to life. Sometimes, if wedged on a hill or rut in the road, we would give a push and running start, then jump in…off to the next fork in the road where we would repeat the whole scene over again.

 At one point I bought bananas from a market cart to tide us over. We changed the music multiple times. There were also some practical questions like…If I need to pee near the temple, how far away should I go and not be visible to the road but also not be desecrating the temple grounds. My driving posed an added obstacle for my rickshaw team in that every car, bus, and motorcycle that came within view felt it necessary to slow down, usually after pulling directly in front of us on the narrow two lane road, just to point and oogle at the absurdity of a female driver. Foreigners driving rickshaws created enough of a stir, but a female…headscarf covered, but none the less female…was apparently, worth derailing their trip over. If it did not create such a hazard, adding to the already stressful task, I would have probably smiled back or just ignored them, but after a time I took to shouting MOVE  ON, so that my bumper did not end up intertwined with theirs.  I found myself bristling with indignance at the way that some of them leered...much the same way I do at home when the glass ceiling threatens any airspace around my neck or shoulders. I may be wrong, but I think I saw many of the Rajasthani women smiling widely underneath their veils.   

On one section of quiet road, a farmer allowed me to wash my hands and face at his well. His sons pushed and shoved, proud to show their strength by pumping vigorously so that a steady stream of cool well water rinsed the road dust and handle bar grease, revealing my hands recognizable again. I stood from my crouched position. Suddenly, my breathing slowed, and my consciousness arched an eyebrow. I surveyed the green farm land, wandering goats, and 3 young girls, their faces framed by silk fabric, peeking shyly from behind the sod wall of their kitchen, and a temporary stillness expanded inside me that I knew, even in that moment, was necessary to remember.

We ended the day by caravanning into Temple City. The name is exactly what you get. A market place square surrounds the temple and associated buildings dedicated to worship of the Hindu god Hanuman. A great warrior, and mischievous prankster, this part man part money deity saved King Ramma's wife by rescuing her from captivity in Sri Lanka. Images of Hanuman show a pointed tail and monkey ears. He seems devilish to me. That night we slept in an old Hindu monastery, the dormitory guest house for Hanuman's temple. Apparently, the worship is a twenty four hour affair. Curled on bed rolls and quilted Rajasthani blankets, we went to sleep amidst the sounds of drums and woke intermittently throughout the the night to the gentle ringing of bells.

Marble City

On the road for 5 days now. We are on to our third clinic site, in Kishingarh. I wish I had nicer things to say about this one but...the overall feel of this placed is, depressed.

This region is characterized by marble processing. Rows and rows of marble plants line a congested highway. The raw marble slabs are bought in through the side, unloaded from trucks piled high, well beyond their retaining bars. Old men with skinny legs, gnarled arms and shriveled faces under filthy turbans keep the procession going, their backs permanently bent beneath their loads. The finished products, polished and rounded statues and garden sculptures advertise in the front, many of them cherub like renditions of Hindu gods. Their pale, cold finish invoked that of an anoxic infant.

The rickshaw ride in went from looping highways of green fields, earthy hills, pastoral goat-herding families, waving school children and hidden temples, to a busy four lane pipeline, a major artery in northern India's trucking route. There was a constant berage of horns, and bus after bus overloaded with factory workers, everyone hacking from the clouds of dirt. I saw a grotesque, new construction temple "tourist village" in progress, with the golden arches signifying the arrival of McWorld,  looming in the background.

 Roadside bars, each with a lone woman standing in the doorway, beckoning the truck drivers, caused me to recall an afternoon spent in a pristine US library. In this other world, I dutifully researched the documented spread of HIV along trucking routes, and how this phenomena has significantly impacted overall prevalence rates in India. This place, apparently, was what the industrial revolution, the bridge between third and first world, looked like.

The entire town is coated in white marble dust. You feel it in your throat, on your finger tips beneath everything that you touch. You see it coating the trees and flowers, making everything look, ghostly. Not surprisingly, everyone here coughs. We immediately realized that our number one complaint at clinic would be, "coughing, shortness of breath".

Our host for this site is the Marble Hospital Of Kishingarh. A modern, well stocked and maintained hospital built by the marble production moguls, provides intermittent public service to their workers, and fee for services, on a daily basis. Apparently, workers comp claims, like amputated limbs are covered. Respiratory issues are more ambiguous. How can we assume the problem has anything to do with the marble dust? The floors of this modern building are, as one might guess, lined with marble tiles. The many exam and treatment rooms, are empty. We stay in the dormitories, keeping the windows closed to limit the layers of white that settle on our cracked lips and clothes, and set up our free clinic in the hospital courtyard, under tents.

It must be said that our hosts are incredibly kind, welcoming, and have looked after us very well. I had to take a patient inside the hospital to do a proper exam, a young woman with a large cyst/mass that almost occluded the opening of her vagina. I found one of the empty rooms to preform the exam, and then went looking for help to provide the care that this patient needed. In my pursuit, I was introduced (and invited to tea) with the chief of surgery, was introduced to one of the hospital board members, and finally arrived at the quiet office of a female gynecologist. She welcomed me in to sit at her polished wood desk, and offered a silk pillow cushion for my back. We chatted and exchanged professional introductions and courtesies. I motioned to the woman standing next to us, who needed GYN care. I explained that my feeble assessment was that there was no perineal abscess, but perhaps a glandular cysts that had grown quite large. This physician blinked her pretty eyes behind glasses and assured me in a soft voice with a lovely British accent that she would see to it at once. She promised that there would be no charge to the patient, and that I should "rest assured". I thanked her and left them, feeling cautiously pleased, but also like I was operating in the Willy Wonka world of hospitals. Everything is fine, everything is lovely...

Anyway, today we head out to work in an adjacent slum area, where the families and children of the marble factory workers no doubt live. Its been fine here and I appreciate the hospitality, but in truth I'll shed no tears when its time to leave the marble city.

Time to Rally

The few days in Jodhpur were for preparation-sorting the medical supplies and packing them into Rajastani metal trunks or pink and orange burlap packs that were stamped with curling Hindi lettering, apparently the logo and name of a tea farm. Cell phone cards were purchased and distributed, Rally for Health T shirts were allocated. Our team became complete once the Indian doctors all arrived to the guest house; their trains had been delayed and overbooked due to the Eid holiday.

Perhaps most significant was that the rickshaws arrived! We went to an open cricket field and took our first go at driving, working the hand clutch and feeling out the break. The steering was rather sensitive, a small adjustment and these glorified golf carts will pitch left or right, causing the backseat passengers to cling to the ornamental side bars or roof tops. We practiced carving tire track arcs into the dust, as the rickshaw owners nervously reached over our arms to grab the handle bars and initiate corrections. Their faces were unsmiling and we could tell they were skeptical, if not full of consternation, as to why these Americans and dignified metropolitan Indians would choose and insist on transporting across northern India in street carts with a max speed of 35k. From the edge of the field where the dust clouds merged with the sunset, school children giggled, and a lone cow regarded the entire scene with unblinking eyes.  At the end of the day, we assured the rickshaw owners that we would guard their taxi vehicles like family. We parted with instructions that by tomorrow morning all rickshaws MUST have functioning horns, headlights, and be equipped with one spare tire each. We knew these vehicles were a lone source of livelihood for these drivers and their families. We provided deposits and shook hands. Ok? Ok. Danney What—Thank you.

The next morning we were up early, crowded in the narrow alley outside the guest house entrance. It was time to go. We packed the rickshaws with supplies and began to decorate them for the launch. Each vehicle was adorned with an Indian and American flag, Rally for Health logo stickers, sari silk and garlands of marigolds. Like small children excited over a first Christmas tree, we dashed about, admiring our work, pleased with last minute additions of a trumpet horn, Rajastani embroidered umbrellas, prayer flags and hindi dieties, and cellophane flowers. Shop keepers and passersby gathered to watch the spectacle. Finally, the command "Challo Chellie" circulated. We piled into our assigned carts, and spiraled through the streets of Jodhpur, reached the red highway, and headed northeast for the desert town of Osian, our first clinic site.  

Three hours and two roadside chai stops later, we arrived at the estate of our sponsor and host. Bom Sah’s staff greeted us with flower garlands and blessed us with tikka and rice, the red thumb print between the eye brows. We were welcomed with speeches, more chai, shown our dorm style housing, and ushered into a stadium like courtyard that would be the site of tomorrow’s clinic. We were made aware that Bom Sah would visit us tomorrow, and that we could expect between 1,800 to 2,000 patients to attend. We surveyed the many bags and boxes of medical supplies arriving, to supplement the small lot we were transporting, and began to run through plans for the next day.

As I took my bucket bath, a cool breeze surprised me with goose bumps for the first time since exiting the airport 2 days ago. Night time dropped its curtain, and the sand lost it's radiant heat. I peered through the grated window and saw copper cauldrons of dhal and rice being carried from cook fires by men with creased leather faces and inky eyes. It seemed that all the women were tucked away in this town, and I wondered what they thought of me, with my uncovered hair and eyes, lifting luggage and bags of medicine, gently but firmly giving direction. I found it difficult to avert my gaze, and realized that I was somewhere between amusing and unsettling them, as it seemed I so frequently allowed my voice to be heard.

Challo Challie-Come on, let's go!

This next story will be of  Rally for Health: A medical auto rickshaw rally across Northern India. Four American doctors, one nurse, one physical therapist, six Indian doctors, two dentists, two photograpehrs, one American logistician and one Indian, one intrepid nine year old bogging his self directed study year across the world, four rickshaws, two support trucks, three trains, a mechanic and three hindi speaking support staff, four cities and six villages, 600 total kilometers and countless cups of chai, all in the name of mobile health outreach in the incredible conundrum that makes up India.

6 November, 20011

I go to meet the team, who are already 3 days in. After 26 hours of flying, I reached Delhi in the middle of the night, as most air passengers coming from the West do.We dropped through the inky sky and spilled out into the arrivals area, met by tepid air and florescent lights. Disoriented, I zig zagged through a melange of sign waving taxi drivers. With only a stolen five hour nap in the transit area, I roused, washed my face, purchased my first chai of the trip, then boarded a noon flight to Jodhpur. Immediately, a soft red dust settled into my hair, and sifted between the small openings in my sandals.

The rickshaw ride into Jodhpur proper was a fast moving kaleidoscope of color. The old city drew me in, literally into itself, down and around, through ever winding and narrowing streets. Pavement gave way to cement tile, then packed dirt. A spiraling cluster of stacked story buildings with rooftop gardens, naan dens and tea houses, all piled at the foot of the hillside. Overlooking the city structures, most painted a now sun washed lapis blue, a great chiseled wall of rock rises up to form the barricade wall of the Mehrangarh fort and palace museum. This relic of the 15th century tells the story of royals and their conquest wars. Intricate "lace" masonry walls, mirrored mosaic archways, and gilded chariots that once sat upon the backs of  elephants, all give a sense of the wealth and particular glory of the Rajastani state.


As the sun set, casting golden ribbons between the shadows across the clock tower market square, it seemed that the sari silk blazed even brighter hues of pinks and reds,  and that waving bangle bracelets glowed deeply along the arms of women, who shuffled together, their heads often covered, only a glimpse here and there of a dark braid of hair or the sparkling wink of a nose ring.. The Islamic call to prayer echoed through out the street, the chicory smell of cook stoves warming chopati wafted, all the while bicycles and rickshaws competed with market vendors, school children and long horned cows for a place on the narrow shoulder between oncoming traffic and buildings. Everyone pushed to get wherever they were going, as the day drew to a close. I had been in India for all of twelve hours, but I knew that upon reaching Jodhpur, I had arrived. 

Portland East

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