28 Jan 2014 // Clinic Day 1

28 Jan 2014 We arrived at our hotel around 6pm on Monday after a day of traveling. The Bell Hotel in the city of Sivikasi is stark but clean. My room is large with a king size bed, flat screen TV, and separate dressing/bathroom area. The fan is a constant feature that whirs consistently to move the air around the humid room. With my body is not completely acclimated to the time change, I wake at 3:30am from a heavy sleep, but am not able to close my eyes for sleep again. It looks to be another long day in which I'll want to fall asleep at 6pm.

Rising at 6:30am in order to head to the lobby, use the internet for a bit and then make it to breakfast at 7:30, I head to the bathroom to take a shower. I'm not completely sure how to work the faucet, and don't want to waste water to get it hot, so it's a cold shower for me. I thought to myself "you know what, I've been blessed to not have to take very many cold showers in my life. I can handle a few." So, I fill up the bucket, and start to dowse myself using the provided handled cup. Trying not to shiver too badly, I quickly shampoo my hair, rub soap on my body, and try to get this over with as soon as possible.

I braid my hair into two braids, don my scrubs, grab my backpack and iPad and head downstairs. The wifi connection is only available in the lobby, so as I descend the stairs, I see Joan, Mike and Deb sitting on the couches with their iPads in hand frantically typing or connecting with their families. Deb is just starting a facetime conversation with Kary. I haven't been able to connect with my family much since I've been here. I had a quick facetime call with my mom when I first got to the hotel in Delhi and had quick gchat and imessage conversations with Anna and Rebekah, but not much beyond that.

The funny thing about only have the internet sporadically is when I do have access, I find I don't have much to do on it. I check my email, see if people are available for chat, and post to my blog. I avoid Facebook for the most part -- doing nothing more than a cursory scan of the news feed until I realize nothing at all has happened, and move on. The usual blogs I visit while in the States are irrelevant now. Beyond sending a few emails, I find I'm done with my internet usage within about 10/15 minutes.

We walk the 20 feet from the lobby to Cafe Rose, the Bell Hotel's restaurant, for breakfast. We all order omelets except for Soji and Mike, who head to the buffet. Not the fluffy omelet filled with cheese and fresh veggies like we get in the States, this is flat and speckled with sauteed onions and peppers. And of course, we had butter toast jam. A staple for these Americans.

Today is our first day of clinics, and it's in a nearby village about 20 minutes away. We load up in the cars, along with a suitcase full of reading glasses, multiple boxes of medicine and countless bottles of water. I really hope India has a good recycling program because for the number of water bottles everyone goes through, especially tourists, the landfills would be full of the clear plastic.

The ride to the clinic isn't too bad. We're on the main road most of the time, and then when we turn off, we closely follow a deacon of the church on a motorcycle as street signs are nonexistent. We turn down alleys and small roads to the church, going slow as the SUV narrowly fits around some of the corners. It's amazing people can find anything in these towns.

The thing I'm loving about this part of India is the clean air! Delhi is long gone with its smoke and fog. Here we have the occasional street fire, but that's about it. This area is very different from my last visit. While two years ago we were in the mountains with lush foliage and tea plantations everywhere climbing mountain roads to get to the clinics, this year, we're in the plains. Dry, not much greenery, and completely flat. The main trade for this area is fireworks, firecrackers, and matches. I'm not sure making matches and firecrackers in the same area is the smartest of decisions, but I guess the ingredients must be similar -- you're making things that make fire. One of the pastors of the church said there was an accident a few years back that killed and injured a lot of people. Needless to say, the working conditions are atrocious and the materials are dangerous--not the best of combinations.

We pull in front of a bright blue concrete building with a covered area in front closed in by colorful fabrics billowing in the wind. Unloading from the car, we begin to make introductions. There are many deacons and fellow pastors, one of whom works in a tile store, and another prints Christian calendars. The majority of these people had to take leaves of absences from work, which in India may mean you don't have a job to come back to when you return.

One example of this is Seekam. I met him on my previous trip and remembered someone had mentioned that he had asked if he had taken time off from work to be here. He said, "Yes, I asked. I was told no, I couldn't take time off, but I took it off anyway. I was fired. I feel God needs me here." A sweet, sweet man with a baby face, he smiled and said "God will provide." And two years later has God provided! Seekam decided to go back to school and received a grant to study at Madurai University in Christian studies. While it's difficult, and requires him to be about an hour away from his wife and family during the week, the grant includes a stipend of $10,000 a year. His old job? It paid him $9,000. God indeed provides.

While we're scrambling around setting up the clinic, asking for more chairs, situating tables, Seekam interrupts and introduces the senior pastor of the church we're serving. LaMary is a woman in her 40s or 50s wearing a beautiful muted mauve and white floral sari. Her face is gentle as she silently smiles and nods to each of us as we're introduced. Her church has a main building, and several branches throughout the city. She has experienced much loss in her life including the passing of her husband and daughter. Her son too is paralyzed from a childhood infection. But her countenance is sweet as she sits and watches everyone work.

The first day of pharmacy can be a little hectic because we have no idea what drugs and medication we actually have. Not able to go through it the night before, each box holds a surprise. As we pull out boxes, Georgetta, the doctor, takes a look and quickly assesses its use as Deb scribbles it on the box. Gallons of cough syrup and pepto bismal is also brought in waiting to be poured into little bottles. The medication we have this year is pain medication (paracetamol and ibuprofen), cold medication, cough syrup and tablets, Zantac, Zyrtec, asthma pills, topical antifungal cream, deworming pills, blood pressure medication, antacids, diabetes medication and several antibiotics. The doctor PIC works with in India prescribes all the medications and then Soji and Seekam pick it up at a pharmacy. All told we have about four large boxes of medications.

Deb and I scramble to get some sort of system and organization while Joan and Georgetta take note of the medications they will ultimately be prescribing. They then head to their stations to get situated. Mike is the runner and is bringing in boxes and helping out where needed. Jim is in charge of the eye glasses and is setting up his table and explaining the process to his translator.

As we finalize our set up, Soji and Seekam call everyone over to say a prayer. Soji speaks in English and explains the work while Seekam translates. With introductions finished, Seekam begins to pray. As we bow our heads, the Indian women put shawls over their heads, and everyone immediately start murmuring praise to God. Seekam's voice rises and falls in emotion as he prays in his language. I have to say I always get a little choked up at this point. I have no idea what is being said, but it's amazing to know that this group of people in this far off country is praising the same God that I do. They are praying in their own language and God understands and hears their prayers. What an amazing God we serve!

After the prayer is over, the clinic is officially open for business. While people have to get through Georgetta and Joan prior to seeing the pharmacy, Deb and I work on our system. Not knowing what medications are going to be popular, we make a guess that pain medications and cough tablets will be used often and make those handy. As the first patient approaches the table, we have a steady stream of people coming with their prescriptions.

We have a translator, Therman, who took a leave of absence from his work in the tile store to help out in the clinics. Probably in his late-20s/early-30s, his dark skin and hair are contrasted from his bright, starched pink button down shirt and khaki pants. He sits at a table near us as we hand over the prescribed medication to him and give a short explanation of what he needs to translate. He picks up quickly and shortly we just hand him the prescriptions and he is able to decipher what needs to be said to the patient.

The patients usually approach us nervously and quietly. I'm not sure if its shyness or the fact that they know we won't be able to understand them, but they quietly hand over their sheet of paper, we smile and nod thank you, quickly fill it, and then hand over the medication to Therman to explain when and how they need to take it. It runs smoothly, but I feel bad I can't interact with them more. I usually try to nod and say thank you, and sometimes they say thank you and put their hands together to their chest and nod. I respond with mouthing you're welcome and returning the gesture.

At one point, I notice we have an audience by the door. Four or five young girls probably between the ages of 12 and 18, dressed in beautiful and colorful saris, are grouped together staring at me and Deb. I look over at them and smile and they put their hands to their mouths and giggle quietly. While I always wish I could speak their language, this is when I really wish I could. When I see the girls who are so enthralled by my white skin, I want them to know that I'm just as enthralled with them. I want to sit down with them and just talk about their life. What do their days look like? Where do they play? What is it like being a girl in this culture? So many questions that I know will go unanswered. And even if I did speak the language, would they speak to me with the openness and candor I would long for?


This culture is so very different than mine. So different. As we drive down the roads and pass the carts and stalls, I can't imagine living here. And I don't say that in a judging way like "ugh, I can't imagine living here!" but in a way that is more factual. I really cannot imagine what it is possibly like to live here. To walk in a street surrounded by cars, buses, and bikes and be fearless about not getting hit. To live in a house with either concrete or dirt floors. To have trash everywhere. To have animals just wandering down the street, whether it's a dog, chicken, cow or goat. To be the poorest of the poor. The lives here are just so different. It's no surprise to me then that when young adults go to school in America or a western country they don't want to go back.

Before too long, it's already time for lunch. We've already seen about 80 or 90 people and the flow at the pharmacy has been steady. Deb and I have a great system that fills the prescriptions quickly and efficiently. The medication of choice is paracetamol, pain rub, and cough tablets today.

We drive to LaMary's house for lunch. After a quick stop at the toilet (I got into the western toilet, which means I can give my thighs a break and not squat quite as far as if it were an eastern toilet, i.e. a glorified hole in the floor). They usually don't flush toilet paper there, because, well, they don't use toilet paper -- in each bathroom there is a bucket of water and a cup for washing. I have Kleenex, but as there was no trash bin, I don't know what to do with it! I'm in the process of trying to find a bin outside when Joan comes out of the stall and has the same predicament. We are standing near the corner of the house where there's a gap between the house and the fence. We look at each other and quickly toss our used tissue into the gap and get hand sanitizer out as quickly as possible.

We head into the main room of the church, which is right next to LaMary's house, where they've lined up a row of chairs and were in the process of setting up the tables. For lunch we usually eat our own snacks. Soji brought bread, jam, and Nutella, while the others pull out granola bars, snack packs, and trail mix. I pick out my granola bar of choice, Deb puts a few crackers on my plate and I start slathering a piece of white bread with Nutella. I was secretly hoping there would be peanut butter as nutella and peanut butter sandwiches are a treat. But alas, I settle with just plain nutella and white bread. The lunch is simple yet satisfying and as we wrap up, LaMary invites us into her home.

The home is two rooms both painted a bright sky blue and adorned with pictures of loved ones hanging on the wall. The main room is smaller than my hotel room and holds a large bed. The kitchen consists of a large two-burner hot plate with two gas tanks below them. There are a lot of silver containers used for cooking and eating and water jugs used to tote water from the well. It seemed to be a very functional and clean space. Her smile widened as I nodded and said she had a beautiful home. While modest and small, it was full of light and warmth. And a short doorway, which I hit with my head on the way out.

With the lunch break over, we drive back to the clinic to finish up the afternoon. There is a small line of people waiting as we settle back into the rhythm of the clinic. The only difference from the morning was the temperature inside the concrete building. While the morning was cool, breezy, and pleasant, the fans couldn't keep up with the afternoon heat. Scrubs are not the most breathable of clothes, either. The temperature in the building was probably close to 90 degrees, if not higher. I usually tried to stand as much as possible, but faced the wall as I wasn't sure if there was a dark circle of sweat on my rump when I stood!

We finish the clinic around 4pm and quickly pack up the medication into their original boxes and call it a day. I ask Seekam how many people were seen today and he replies with 138. Not too bad! As we head out into the sun, we say a quick prayer of thanksgiving for the people who came today as well as the workers who helped. The air-conditioned car waiting for us is a much appreciated gesture.

We head back to the hotel to call it a day. Deb and I are tired of sitting and being immobile, so we meet up to climb the stairs in the hotel a couple times. It feels great to get my legs moving after sitting essentially for the last two days (yesterday was a travel day). After our bout of exercise, we all agree to meet up for dinner at 7pm.

It's been a great day at the clinic and we're all hopeful the following three days will be just as smooth and fruitful.