Nature Walk II

Here are some photos taken on Monday, July 19th from my second nature walk just outside the SEARCH campus. Rushina and I walked the same loop, including the dirt mound, as I did on my first nature walk (see Mini Adventures).

A path and break in the fence leading to the fields.

We saw a single cow munching away on some grass.

The cow saw us and then proceeded to walk up the dirt mound so that he was right behind us. As we walked along the ridge he decided to follow us. He wanted to go on the nature walk too.

Rushina with the cow following us. Eventually we let him pass us and he went on his merry way. We saw him later munching in a new patch of grass.

Some villagers working in the rice paddies.

It had rained a lot since the first time I went on this walk a couple weeks ago. Now a pond had formed where there used to be only dirt.

Same view, just horizontal.

Some young boys were swimming in the new pond. We saw a couple riding the cows through the water. We couldn't tell if they were washing the cows or just having fun.

On the walk back to campus we ran into a group of school girls. They let me take their photo. After walking away they turned around and asked us our names. They told us theirs and we told them ours, "Mazha nav Aliza ahe".

Back near the main entrance of SEARCH, a sculpture protects the grounds.

The Food

Without a doubt, the topic that I have been questioned about the most is the food. I have put off answering everyone's questions about the food because a) it really is not that special, and b) I was planning on eventually making this post at some point. I have finally gotten around to writing this post, and I hope it fulfills everyone's huge desire to know what I am eating. Get ready, because this post has a lot of photos!

First I will start off with a little tour. For the first 3 weeks that I was here, we ate in the old mess hall, which usually serves as an overflow space whenever SEARCH has a group of trainees or youth on campus. Supposedly they were remodeling the newer mess hall for a few weeks.

Here is the exterior of the old mess hall, which I can see from my bedroom.

Here is a view of the interior of the old mess hall. Kind of bare, because they moved some of the tables and most of the chairs back to the new mess hall. The food used to be put out on a table that would sit near the counter on the back wall. The counter itself would contain all the plates, bowls, and cups, which are all made of metal. The tables used to be separated (like a school cafeteria), but as the foreigner intern group grew, and we became closer with the interns from India, we tried to keep forcing more and more people at a single table. Eventually, we pushed the tables together to make one long table.

After every meal (breakfast, lunch, and dinner) we are responsible for rinsing and cleaning our own plates. Outside on the back exterior of the building there are two rows of white-tiled taps and drains. We use this grainy green soap that works really well. I think it is special concentrated dish washing soap. Sometimes there are drainers to place our dishes when we are done, and sometimes we just stack them back up on the counter inside.

There are two lovely women who cook all our meals. Vimal tai always comes out and attempts to speak with us, and pet our hair, and sings sweet songs for us. She always asks us to come to her home village, but that is a few hours away. Instead, one Sunday when we went into town, we went with her to visit at her friend's house. I am very fond of her. It is very hard not be very fond of someone who is cooking you three meals a day. Here is Vimal tai and me in the kitchen. (My shirt looks like a mess because I just finished washing some dishes, I'm not a slob!)

Here is the other woman who cooks, Anjana tai. (Tai meas older sister.) We do not know her as well as Vimal because she does not come out to greet us during the meals. We do see her every afternoon though, when she comes to the library and research buildings to serve afternoon tea. In this photo she is refilling one of the bowls during dinner.


About three weeks ago we moved to the new mess hall. Our first meal there was dinner on the Tuesday when the monsoon started. The floor is marble and it was very slippery and I was not a fan at first of this new mess hall. However, now I really enjoy it. It is not as drab and it is a lot more airy, bright, and more beautiful to sit in. In the new mess hall the tables were already pushed together, so we can also enjoy our large group seating.

The new mess hall is V-shaped, with the food served on a central table and seating areas to the sides. The food is always put out in the same order: plates and utensils (spoons only), sides like sprouts, dal, main dish, and then a big bowl of rice. It always causes confusion in the line because most people like to put the rice on their plate before the dal and main dish.

Here is the table that we sit at in the new mess hall. You can see how much more open the new mess hall is compared to the old mess hall. You can see the old mess hall in the background.

Finally, here is the cleaning and washing area of the new mess hall. It is a narrow hallway that also serves as the side entrance.


Ok, enough with the tour, now time for the food. (Yeah, yeah, I know most of you probably skipped the boring tour and went straight the to food anyway).

The Food in General: I was very excited to come to India and eat vegetarian Indian food for 8 weeks. Overall, I enjoy the food, but it is very different from the Indian food I've had in the past. I envisioned in my head a simple buffet with a few options for each meal and in that regard, the meals are served very much how I imagined. I did not think there would be a spread of all my favorite Indian dishes at every meal. However, I had pictured the food resembling all the Indian food I eat in the restaurants in the U.S. and at home in the 90-second Tasty Bites and Trader Joe's microwaveable packets (a staple of my grad school diet!). Instead, the food at SEARCH is a lot more plain. I think the reason for the difference is that India is a very large country, and the dishes we enjoy in the restaurants are the best of each region- like "Jaipur Vegetables" and "Kerala Vegetables" and "Madras Lentils" and "Punjab Eggplant." These dishes are usually very distinct, hearty, and colorful. At SEARCH it is much more localized to just Maharashtra style. In addition to the food being regional, and not fancy, the Indian interns here say it is also very cafeteria style - made for the masses. So while it is usually tasty, we are not talking high quality Indian cuisine here.

At SEARCH, vegetarian also means no eggs. Yogurt and buttermilk are served, but there is also no paneer cheese. I have only had my favorite Indian dish, palek paneer (spinach with cheese), once at the restaurant in Chandrapur. Another one of my favorite dishes, channa masala (curried chickpeas) has only been served at SEARCH twice and it wasn't great. Sadly, there is also no naan (the doughy bread that accompanies every meal I've ever had at an Indian restaurant). It's just no where to be seen. Sona says that it's only served at restaurants, not usually at home, and special restaurants at that. Chapati, as you will see further down, is a lot more ubiquitous.

Breakfast: Here is a photo of a breakfast we have perhaps once a week, something fried. Usually it's just fried grain, although once we had fried vegetables, and one time it was potatoey inside, like a knish. It is usually served with "ketchup" and some dal or sauce.

Here is a much more common breakfast, which I don't like. It's these rice paddies that taste awfully plain and it is served with this white-green porridgey stuff that I do not like or spicy dal that you just don't want at 8 in morning. Unfortunately, this stuff gets served at least twice a week and I usually opt for granola bars instead.

Another very common breakfast (no photo) is a yellow potato/rice flakey thing with tomato, onions, and some type of green veggie in it. It's not too bad, but it is served a lot, and is of varying quality. Another similar breakfast (no photo) is a yellow wheat germ mush, sort of the consistency of mashed potatoes, with again, tomato, onion, and some green veggie in it. This is my favorite breakfast because it's the most tasty and relatively non-spicy which I prefer at breakfast time. Another less common breakfast is two grilled chipati with potato in between. It's kind of like of a non-sweet pancake filled with potato. Finally, we also had a sprout pilaf with a sweet bbq-esque sauce a couple times.

At every breakfast chai tea is also served. This same tea is also served around 3pm each day. I never had chai at home (maybe once from Kayla at Starbucks). I always thought I wasn't a huge fan, but it's actually really good. It tastes very close to coffee. The other foreign interns here say it is much better quality than the chai at home, but I really have no basis for comparison. It is served in little mugs, espresso size.


Lunch and Dinner in General: The food that is served at lunch and dinner is nearly identical. There is nothing that distinguishes the two. I have put the photos below into their respective categories depending on the actual meal that I took the photo at, but really, it could be either.

At SEARCH, we get served white rice, chapati (which is a flat bread, like you would use for a sandwich wrap), and dal (lentils, sometimes thick with a lot of lentils and sometimes just the thin yellow sauce) at every lunch and dinner. Then, we also usually get one kind of curried vegetable like okra or green beans, and sometimes another spicy dish with squash or potatoes. If we are lucky we get sprouts, boiled peanuts, and/or yogurt. In the two days that I photo-journaled the meals we were very lucky, and we got a lot of these little extras all together. But, we've also had occasional meals where the only thing put out is rice, chapati, and dal, no extras, and no vegetables, just all starch and minimal protein.

Lunch: Probably the best photo I've taken of the food here, and the most representative. Although, we usually don't get sprouts + cucumbers + yogurt at the same meal. So maybe this is not very representative of a meal itself, but of the food that is served and the portions I take for myself. In this photo you can see rice with curried cauliflower, lentils, sprouts, chapati, cucumbers, and yogurt. We sweeten the yogurt with large granules of sugar. Vimal and Anajana started serving yogurt at almost every lunch and dinner because we get really cranky if we don't get it to complement the spicy food.

Other little extras that will occasionally come up are chopped onion (adds a lot of flavor when you mix it in with your rice and main dish), roasted garlic in oil (also adds additional flavor when mixed in), bananas, tomato, and papad (spicy lentil cracker/chip). Again, it is rare for more than one or two of these to show up at the same meal.

Here is a photo of a not-as fancy-lunch, a lot more typical. Just rice, chapati, random green vegetable with dal, and chopped cucumber.


Dinner: In addition to okra and green beans, other vegetable dishes that have been served include peas, cauliflower, eggplant, cabbage, and about five different kinds of unknown green vegetable (sometime squash like, sometimes green pepper like, sometimes gourd like). The vegetable "main dish" is usually the spiciest thing served and has to be diluted with dal, which is less spicy, or eaten with a lot of rice and chapati.

Other "main dishes" have included spicy chopped potatoes (I like this the best because it's seems the most like comfort food), curried chickpeas, spicy lentils that are not "dallified", black-eyed peas, chapati or rice paddy soup, a "stuffing" made of chickpea paste, and once we got very spicy shredded potatoes.

Here is a photo of dinner being setup on the table. The white rice is not out yet.

Here is a close-up of some lentils, potato and green vegetable dish, and yellow dal.

And here is a shot of the table with the bowls lined us the way they usually are. Again, the white rice is still not out (sometimes we wait for the food like eager vultures). The chapati is kept in that container with the lid.

Here I am finally eating dinner that night. Aditi and Pawan in the background.

Here is another photo of dinner. You can see one of the random green vegetable main dishes. This one was of the green peppery kind. Again, because I happened to take photos on a pair of good days, you can see some things that we do not always get. First, instead of white rice, Sona's mom visited the campus and dropped off a huge pot of really awesome yellow rice. Second, one of my rare favorites came up: tomato, onion, and cilantro salad. One time they just happened to serve this on the same day as boiled peanuts. I took the opportunity to make a peanut burrito. The boiled peanuts resembled black beans, I obviously had rice and the burrito wrap (the chapati), and I used dal like it was salsa. It worked out really well!

Another dinner that has come up a few times is yellow rice with a thick yellow curry/dal. Usually the dal is pretty thin, but this dish is more like thick gravy. I'm not really sure what is in it, it might not even be dal. It is always served with yellow rice and not white rice, and this is usually the nights when we get the roasted garlic and oil to mix in.

Dessert: There is never dessert, although we usually turn the yogurt into a dessert by mixing in lots of sugar. Two exceptions: On my very first night we were served a warm, sweet, rice noodle soup. And one other time we were served two very very saccharine milk-product balls drenched in the most sugary liquid I have ever tasted. Oh yeah, and sometimes there's buttermilk, but I absolutely hated it during the first try, so I never take it.

Snacks: Here is a photo of some snacks I frequently eat. In it you can see the Masala Munch (like cheetos, except instead of cheesy flavor, think Indian spice flavor), golden raisins, Bourbon chocolate cookies, and I'm never without small-sized Cadbury Fruit & Nut bars. I have also bought cashews and ice cream. And of course, I came with 120 granola bars. As mentioned in earlier posts, when we go into town, we often eat at restaurants where we can get eggs, and we also frequent the ice cream store.


Cravings:
Now that I have finally described the food that I am eating, let me post my growing list of cravings:

1. Italian food, Italian food, Italian food. Far and away my biggest craving. I would do anything for a big plate of pasta with some good marinara sauce, and maybe some steamed asparagus or broccoli.
2. Chips and salsa. Specifically fresh chips and salsa from Chipotle. And a burrito to go with it.
   
3. Birthday cake. Kinda funny, since this is not one of my favorite foods, and I rarely crave baked goods. I think I just want to have a normal American dessert.
4. Orange juice. Anyone that knows me, knows I drink this stuff almost every morning. Well, I have gone over 30 mornings without it, and it's time I get my hands on some.
5. Hamburger. I would love a huge hamburger with tomato, lettuce, onions, ketchup, and mustard. And maybe some chicken too.
6. Fruit + cold in any form. I want berries: strawberries, blueberries, cranberries, blackberries. I want frozen fruit popsicles. I want cold juice. I want fresh fruit besides bananas (the one kind we get here).
7. Grilled cheese sandwich. One of the girls mentioned this the other night and I nearly passed out from the thought of a warm gooey buttery grilled cheese with tomato. Add pizza to that. And cheese and crackers as well.

Well, there it is. A monstrous sized post about the food. I hope you can all rest peacefully now!

Surgery Camp

As previously mentioned, I decided to forgo the trip to Nagpur last Saturday, July 17th. Because I stuck around campus I was able to observe the first day of the surgery camp that would be lasting for three days. Witnessing the surgeries in the clinic was a very big bonus on top of the work that I am doing at SEARCH, and in many ways unrelated. It is entirely clinical, not for research purposes, and the spinal surgery that was occurring is in no way related to my research focus. However, I found the experience to be extremely fulfilling.

Each year SEARCH organizes and holds several surgery camps. Since the hospital itself primarily deals with medical care and medical interventions, and Ama is a gynecologist/obstetrician by training, there are limited opportunities and resources for surgical interventions. Therefore, several times each year SEARCH brings in highly-trained surgeons, who bring along supplemental equipment, and villagers on a waiting list come and have surgeries. The structure of a surgery camp (often occurring in places of natural disaster, like Haiti, or refugee camps or parts of the developing world) is efficient because a team of surgeons will come in and perform the same surgery over and over. Supplies and equipment that are often not available will become concentrated in the location for the duration of the camp. Earlier in the summer SEARCH held a surgery camp for hysterectomies where over 100 patients were seen in one week!

The surgery camp that took place this past Saturday to Monday was for spinal surgery. The number one surgeon for spinal surgery in India, the premier surgeon in India for this type of surgery, Dr. Shekhar Bhojraj would be in attendance. For Jessica this was a very big deal. She is hoping to go into surgery and work in third world countries. This summer she is starting a research project to assess unmet surgical need.

During breakfast on Saturday I asked Jessica if she thought it was too late to see if I could observe the camp and she said not at all! I went over to the hospital with her in the morning to review the records of the camp's patients alongside Vaibhav, one of the Ayurvedic doctors. Later in the afternoon the team of surgeons arrived from Mumbai, headed up by Dr. Bhojraj. His wife is an anesthesiologist who would also be working on all the surgeries. There were at least four or five other orthopedic surgeons that came to SEARCH. This was not Dr. Bhojraj's first visit to SEARCH. He has been coming here several times a year for the last several years. I went around with the surgeons to meet each of the patients. Four women sat in one room and three men in another. There were seven in total, plus a few walk-ins. All the patients were dressed in green hospital outfits and each had a set of x-rays. I tried to stay out of the way because it was a very large group parading around- all the doctors, a team of aides and nurses, Ama, Vaibhav, Jessica, and myself. Not only were the patients waiting with some of their family members in rooms with no privacy, but then in walks over 15 people to assess their situations! I think Dr. Bhojraj had already reviewed the cases before meeting the patients because things moved pretty quickly. One or two of the patients were told that they may not be able to have surgery because of existing complications. I know this is normal procedure, and happens all the time in the U.S. as well, but I felt bad for the patients because to even be at SEARCH for the surgery camp means the patient has exhausted all medical interventions, survived a waiting list, and anticipated the scheduled camp.

After meeting the patients, the doctors broke away for lunch. Around 2pm we reconvened to start the surgeries. At this point I was still unsure if I was going to be allowed to stay or not. Since I had not received prior permission from Ama, I was very sure I would be kicked out of the operating room, or operating theater, as they call it here. The plan was to conduct two surgeries at once in the one OT that SEARCH has available. All the doctors started dressing in scrubs and masks and scrubbing in. Since Jessica was definitely going to be observing the surgeries, and possibly assisting, she asked if she should go back to her room and put on the scrubs she brought with her from Duke. Very generously, since it looked like I was not going to be kicked out, she brought me with her and gave me a pair of scrubs to wear as well.

Pause...I'm having doubts if I should continue my description of the surgical camp because I think I am going to severely disappoint those family members, who will remain nameless, who have always wanted me to go to medical school...but alas, I will continue.

I put on a green pair of scrubs and when Jessica and I returned to the OT we put on the personal protective equipment: masks and surgeon's cap. I didn't get a chance to take a photo of myself in this getup, but believe me, I looked legit. I felt like I was playing dress-up, but for Jessica this was real life, so I tried to take everything seriously. If anyone really really really wants to see me look like a doctor (the MD kind), I can maybe ask Jessica if I can borrow her scrubs again, and go grab a mask and cap from the clinic, and re-stage the event. We chose not to take any photos of the actual surgery, although the scene was amazing, out of respect for the patients (who were completely naked), and obviously the surgeons who were trying to focus.

Anyway, surgery camp began. This is what it was like: We had two operating tables with a table in the middle that was used to anesthetize the patient before they were moved to the operating table. Dr. Bhojraj decided the order in which the patients would be seen. A team of three surgeons worked at each table, and each surgery would take 1-2 hours. In addition to the six surgeons, there was Dr. Bjojraj's wife and a second anesthesiologist, several surgical nurses from SEARCH, Jessica, myself, at times Vaibhav, and even SEARCH's handyman at one point when the bulb blew out on the operating light. We were all crammed into a room that was roughly 15x15 feet. It was insane.

As the surgeries began I asked Jessica what the major differences were between the surgeries we were witnessing and the ones she had witnessed at home. The most obvious difference was the fact that two patients would be operated on in the same room. Next, not all of the equipment and tools that could potentially be used in these surgeries were available. Now, SEARCH itself has pretty modern capabilities, and this isn't one of those hospitals you hear about that reuses needles and uses unsterilized equipment. Because of proper training and funding that allows the purchase of proper equipment, the surgeries used completely sterilized draping sheets and surgical tools. But in many ways there were small differences. For instance, the anesthesiologist had to use a manual ventilator for the entire duration of the surgery which meant squeezing one of those rubber balls, the size of a soccer ball, every five seconds for the 1-2 hours of the surgery. In a completely modern, state-of-the-art hospital this would be done automatically with a machine. Another example is that because this was back surgery, the patients were lying front down, but propped up by cylindrical foam pillows. The patients were put directly onto these pillows and the pillows were reused between surgeries with no cleaning. So maybe not everything was 100% completely sterile. I think there were other ways in which the doctors had to make-do with available resources, but not being formally trained, and not having witnessed surgery before, I am unsure of what these things were.

Beyond these differences, the surgery happened as it would in any other modern institution. The actual anatomy of the surgery was not much of a surprise to me. I was prepared to see someone cut open and to see blood, and because of dissecting cats in physiology, and of course television, I had a rough idea of what the insides of a body were going to look like. The surgeons used blades and electric cauterization to open the layers of the skin, muscle, and fat. I was really surprised by how deep the surgeons had to go to get to the vertebrae and the spinal cord. The first cut into the body was not weird to me, and neither was the initial depth of a couple centimeters, but halfway through the surgery I realized that we were a good inch or two inside the person's body cavity. This was somewhat amazing.

Also to note, I was very very close to the action. For most of the surgery I was probably one to two feet from the surgical table and I could see everything! I could have stood right at the table, but I found out that while blood doesn't bother me, tiny pieces of spine falling and flying everywhere does. I really did not want to be touched by pieces of what used to be the inside of someone's body, despite wearing the scrubs.

When the doctors were deep enough they used surgical techniques that Jessica explained to be during lunch to remove parts of the spine to allow more room for the spinal cord. Most of the patients were suffering from pain and neurological issues related to reduced space in the spinal canal. The type of surgery I watched is called a laminectomy. This is when parts of the spine are removed to relieve pressure on the spinal cord. One of the techniques removes only the spinous process, which is the part of the vertebrae that you feel when you run your hand down you back. A second technique also cuts into the articular facets to create even more room. The parts of the spine were removed with special tools that had the ability to cut through the spine. At some points Dr. Bhojraj also had to use a hammer type tool. Something else that really surprised me was the aggression and force that were used to remove sections of the spine. There were parts of the surgery where I found it very hard to believe that a real person was lying under the sheets.

At the most critical parts of the surgery I was able to see the spinal cord. Again, seeing the spinal cord of a dead animal does not compare to seeing a live spinal cord of a person, who except for anesthesia, is completely alive in front of you. Jessica was really having a good time and thought the whole surgery was "beautiful" and Dr. Bhojraj's techniques were "elegant" and "like watching art." I don't think I appreciated what I was seeing to the extent that she did, but I was still really in awe.

During the surgery I had a couple chances to speak with Dr. Bhojraj's wife, the anesthesiologist about anesthesia. This was the aspect of the surgery that amazed me more than anything. I just could not get over the fact that the surgeons were doing things to a human being, that if they were alert and conscious they would be screaming and perhaps passing out in pain. The initial cut and separation of the skin and tissues alone would be incredibly painful for someone, but we were also cutting away and yanking on vertebrae, and deep tissues, and I'm pretty sure some of the tools were gracing the spinal cord. I still don't get how even the strongest anesthesia can keep someone from feeling this.

I mainly watched the surgery that Dr. Bhojraj conducted (the second patient to start), even though there was another one being conducted at the other table a few feet away. When the other team finished with the first patient, they prepared to start on the third patient. Here is another difference between the surgeries I witnessed and ones that would take place elsewhere. The staff actually had the third patient come into the OT, while the second patient was still being operated on. Let me just paint this picture for you. A middle-aged women walked into the OT, about to undergo anesthesia and invasive surgery, and the first thing she sees is a naked woman lying with her back up in the air with a huge gaping opening. To Dr. Bhojraj's defense, he was not told the next patient was coming into the room, and he expressed that if he did know, he would have at least stopped his actions for a few moments. Since I was closest to the door when the patient came into the room, I tried to shield her eyes from the operation that was underway and guide her over to the anesthesiologist waiting at the second table. Hopefully I was able to block her view, but she still seemed very scared.

I spent some time watching the first woman recover from surgery. When she was done, but still under anesthesia, they moved her out to the recovery room. She woke up at several points, but not enough to really talk or communicate. During these moments though, I realized I was very very interested in the follow-up that would occur in the minutes, hours, days, and weeks after the surgery, probably just as much so as the surgery itself. I peeked over and watched the surgeons as they waited by the bedside for the patient to become conscious. I was very drawn to this part of the process.

When Dr. Bhojraj finished his patient I decided to call it a day and not stay around to watch the third and fourth patients. I felt like I had seen my share of the surgeries, and I still could not believe that I was able to stay for as long and as close as I did. Since I have not been to medical school, I knew the other surgeries would all appear roughly the same, and I felt I had seen enough blood and body parts for one day. Jessica of course would be staying for the rest of the day, especially because Dr. Bhojraj asked her to actually assist in the last surgery. I didn't stick around to see this, but I think this was a wonderful experience for her.

So, that was surgery camp. I'm not sure if I will ever get the chance to witness something like that in the United States, and again, this wasn't really within the realm of my research areas, but it was still a truly inspiring experience. I have yet to get over the fact that humans have been able to reach this level of technology and knowledge.

Taking Count at Day 30

Today marks the half-way point in my Indian adventure. It's been 30 days since I left the United States, and 30 days until my return.

It dawned on me a couple nights ago that there are major differences in the way I have lived for the last month compared to my normal life back home.

The thought that triggered this feeling was the fact that I have literally not seen a tv in 30 days. Yes, I have seen moving images on a screen- the movies I watched on the airplane and the movies on laptops here, and the occasional YouTube or CNN video if I can get it to download. But, I have not seen a television show. I have not lounged around on a couch, flipping a remote to an assortment of channels, or watching one of my favorite television programs. This is perhaps the longest I've gone without tv since I was maybe 3 years old. While TV in general, and the shows I am missing this summer (the Bachelorette, Top Chef, Mad Men, Bravo's Real Housewives series), are not always at the forefront of my mind, I feel kinda disturbed that I haven't participated in something that is part of my daily routine at home for a month now.

Here are some other things I haven't done in 30 days:
-driven a car
-turned on a stove
-used a microwave
-run a dishwasher or laundry machine
-cooked, baked, or prepared any sort of food for myself
-taken a shower that did not involve a bucket
-used a toilet that I could dispose my toilet paper into
-had an alcoholic beverage
-hugged or kissed Ben

My supplies show the signs of my trip's duration. I have now used exactly half of my toilet paper supply (3 of the 6 rolls I brought with me). This means I will definitely have enough for the trip, especially since I used one entire roll as tissues, and not for actual toilet purposes. In total I have also used 3 of my 6 tissue packets. I've used up the entire initial tub of 42 wet wipes, but I have only just started to use the 84-count refill pack. I have gone through one entire bottle of hand sanitizer, but have two more with me.

I have not used nearly the amount of sunscreen I thought I would. I do put it on in the afternoons on the very sunny days, and whenever we go out to town, but since the rains have started it is mostly overcast, and we are indoors all day. I think I brought four or five tubes along, and have only used a small portion of one. Likewise, I have only used about half of one of my four bottles of DEET insect repellent.

I know I could write more profoundly about how I have changed or grown or learned from this experience, but I just wanted to write about the more simple, less-introspective differences I have observed in the time that has gone by. Also, I'm not entirely convinced I have changed that much. Yes, I have seen things that I would never have seen if I did not come to India. Yes, I have met people and made new friends and have shared the joy of doing global health work/research with them. Yes, I have lived in a situation that I initially found very uncomfortable and have since adapted. Yet, I know as soon as I return to Chapel Hill I will be turning on the tv and watching my reality television and taking for granted all the luxuries in my life.

I will have to assess again how I feel after the next 30 Days.

Changing of the Guard

Group photo during the sendoff. From left to right: Rajnish, Amrut (the Bang's younger son, Anand is the older son), Brenna, Aditi, Kate, Marie, Me, Bhagyashree, and Jessica. At the bottom: Amy and Rushina. Miriam had already left early that morning. Once again, Sona is taking the picture.

The last ten days have seen a lot of changes in the foreigners living at SEARCH.

First of all, Rushina arrived on Thursday, July 8th. We are now roommates. This has made my room a lot more colorful and inviting. Especially because two nights ago we decided to put up mosquito nets. Since hers is green and mine is blue they give some height, depth, and color to the room. Sleeping under the mosquito net is fun. You can sleep without a blanket to protect you from bugs, you don't wake up in the morning all itchy and scratchy, and you feel like you are in your own little sleep bubble.

Picture: Rushina and I in our matching outfits today.

Kate, Brenna, and Amy were all scheduled to leave in mid-July. (I erroneously stated in an earlier post that everyone was staying until August, when really I just meant Miriam and Marie, and eventually Rushina, and of course Jessica who is here until November). A few of the interns from India also left this past week including Sagar and soon Pavan.

To celebrate the send-0ff we went out to our favorite restaurant in Gadchiroli on Saturday, July 10th. We had to get special permission for this outing because we were going on a Saturday night, before the official day off. Permission was easily granted and we scheduled some cars to pick us up. I am still getting used to the ways things operate in India. Seems like things always take forever and the lines of communication are always getting crossed. It took almost two hours for the cars to arrive at SEARCH to pick us up!- and I think they were only coming from Gadchiroli!, but who knows. We finally piled into the cars around 9pm. Going to town had an extra bonus because I only had 11 rupees left to my name and I needed to find an ATM. Sagar was very nice and walked with me a few blocks from the restaurant to the bank building. I'm glad he took the time to go with me because it was obviously dark out and there were still many people in the street, and I did not feel that safe.

Dinner was fun because our party was very large. Seems like each time we go to Rasika we have to combine more and more tables together. We always have the same server. I think there were 15 people in attendance and lots and lots of food on the table as always. This time we even splurged and got sodas for everyone! My favorite dish once again was the one that had paneer (cheese) in it.

Wednesday, July 14th was a sad day. Miriam found out her grandmother passed away. I felt very very sad for her. Miriam knew her grandmother had been sick, and she had already moved up her departure from the third week in August to July 31st. Sadly, her grandmother's health declined more rapidly than expected. Everyone was very supportive, and it was good that Marie, her long time friend, was here to comfort her. I had a quiet talk with her on Thursday afternoon to see how she was doing. Miriam had to decide if she would try to make it back for the funeral or stay for the rest of the trip. Her family chose to have the funeral on Sunday, so that she could make it back in time.

Wednesday and Thursday were a blur because in addition to everyone getting ready to leave, I developed a very bad cold on Wednesday. Seems that is my sick day! It started Tuesday evening with that warm swallowing throat feeling and by Wednesday morning it was a full blown cold. It was very runny and I spent half the day grabbing tissues. In fact, I used up an entire roll of toilet paper as tissues and one my tissue packets; it's a good thing I brought extra. I took two Benadryl on Wednesday afternoon and was completely wiped out the rest of the day. I forced myself to get good sleep on both Wednesday and Thursday, taking some naps as well, so that by Friday I no longer felt sick. I still have a residual stuffy nose though, but no more tissues every five seconds.

Miriam ended up deciding that she would go home for her grandmother's funeral and that in order to catch a flight out of Nagpur to Delhi to home, she would be be leaving on Friday at 4am in the morning! We had a special samosas and pepsi party (treats picked up in town) on Thursday evening as a second celebration to say farewell to those leaving. In Miriam's case it was very bittersweet. After our samosas and pepsi party we had one big gathering again in Kate and Brenna's room where we all exchanged photos and music files. Sufina and Bhagyashree were away at a conference and would return between 1 and 2am, so Miriam had made plans to stay up all night. I was hoping to stay up as well, but with my cold, there was just no way I could make it. Around 11pm I said goodbye to Miriam. Hopefully we will have a chance to cross paths again some day! I set my alarm for 3:45am to attempt saying goodbye again. I woke up and used the bathroom and heard sounds from Marie and Miriam's room, and a suitcase being rolled out, but I chose to go back to sleep rather than force a second goodbye.

Picture: Everyone gathered for the samosa and pepsi party

On Friday afternoon Kate, Brenna, and Amy left. They would be heading up to the airport in Nagpur and then heading to Goa (where the beaches are) and then eventually to northern India for some sight-seeing and tourism. Those of us staying at SEARCH took a nice break from work to hang outside in the central area and see them off. The group photo we took at the time is above.

For most of the day I had been working in the research building so I was not part of some conversations that were had between the girls in the library about Rushina and Marie going on an overnight to Nagpur. Rushina was interested in stopping at the airport because she needed to make some changes to her tickets and I think Marie was just itching to get out of Shodhgram. Right before the three who were permanently leaving were to get in the car, Rushina and Marie asked permission to go to Nagpur on a Friday night and miss work on Saturday. They were granted permission. They were going to hang out in Nagpur and stay in the hotel with the other girls and have a sleepover! I also had the choice to go, but I couldn't justify to myself a 3.5 hour car ride, there and back, just to sleep in a hotel. Although it sounded like fun, I was a happy camper here at SEARCH. Besides, Jessica would not be going because a surgery camp for spine surgery was to begin the next morning. I decided it would be nice to hang around SEARCH for a quieter Saturday.

Saturday turned out to be a good day and I actually had a chance to observe the surgery camp (future post). When Marie and Rushina returned they said they had fun, but that they both spent a fortune between the car rides, dinner, and the hotel.

On Sunday Sagar was leaving so we had Maggi in the morning for breakfast. Aditi and Sufina prepared a huge pot for everyone. Maggi is basically the Indian version of ramen. It looks the same and has the same texture. I think the noodles are identical. The only difference is that it is made with Indian spices, more like curry, instead of the chicken, beef, and vegetable flavorings we have at home in the United States. Maggi is a special treat here, and whenever it is made, we invite all the young kids that live at SEARCH. It is sooo cute to see them light up to eat Maggi!

With girls leaving, two new girls have arrived. Swati, a sophomore from a small private college in Michigan has arrived. She will mostly do observation in the clinic. Haley, Marie's friend from Brown, has also arrived to do a quick internship. She came from another organization in India that was not working out. We all leave the same week in August.

Mini Adventures

Although things have mostly settled down, and big adventures only happen on Sundays, we still find ways to appreciate the land around us and seek out mini adventures.

On Tuesday, July 6th, Amy, Miriam, and I went on a nature walk. In the early evenings between work and prayer service, we are allowed to take walks around the Shodhgram campus where SEARCH is located. I had no idea how much there was to see just outside the front gate. It was so beautiful!

First, still on campus, we went to the SEARCH playground:

Then we stopped by the temple of Goddess Danteshwari, located just before the front gate:

After passing through the front gate, we turned left. This early evening walk was very pleasant, relaxing, and serene! Our first stop on the walk was at a hut with additional god statues:

Then we climbed up on a dirt hill. The sun was just starting to go down:

We saw a woman working in the fields:

I made sure to get a photo of myself:

We walked far enough so that we could see one of the neighboring villages. We could hear a lot of noise emanating from the village as people returned from the fields and gathered for dinner:

I don't have photos from the next two mini adventures, but I can describe them.

Everyone here drives scooters and mopeds! On Thursday, July 8th, Sona was gracious enough to let us have a little fun with her moped. Bhagyashree supervised as we took turns learning to drive it. I myself, did not actually take control of the moped, but once Marie felt she knew what she was doing, I hopped on behind her. Woooo! We zipped down the main road of SEARCH, turned left, and drove down the road where I had taken my nature walk with Amy and Miriam earlier in the week. It was a lot of fun and a nice change of pace from sitting in front of a computer all day. Marie made me get off when she turned around because she did not want me to go flying off the side. Then we took a nice ride back to the center of SEARCH. I hope during the next five weeks here that I am able to get on the moped again.

Finally, later that same Thursday evening we took a night time adventure walk! It seems that I have been completely unaware of some special parts of the SEARCH campus. There is a lake, but it only fills up during the rainy season. Earlier in the day some of the girls visited the lake and saw the "SEARCH lake house" on the other side. Since they had seen it in daylight, they knew where we were headed in the dark. I went completely blind. Bhagyashree headed up our mission to the lake house. It was very dark expect for our head lamps. It was so dark that you couldn't see the lake, it just looked like an even darker empty space. I was worried about snakes and the like, but what kept me going is that I was not leading the pack and I was not trailing the pack. I felt safe in the middle. It wasn't that far of a walk to the lake house, really only four or five minutes. Once we got there, we took two flights of exterior stairs up to the roof. We were hoping to see stars, but unfortunately none were out. So instead, we played around on the roof, flashed our head lamps into the distance, displayed silly dances, told jokes, and got attacked by mosquitoes. We were up on the roof long enough that our eyes adjusted to the dark and we could finally see the lake. The walk back to our rooms was not as scary, since I knew what to expect and the distance we had to go. I will try to get photos of the lake and lake house in the future.

I look forward to more mini adventures in the weeks to come.

Monsoon Nightmare

Picture: One of the weird frogs we saw on the first night of heavy rains.

Last week was another typical work week, except for a 24 hour period from Tuesday night to Wednesday evening. We can call this period my first bad day. This was mainly caused by two events. First, Tuesday is what I would label as the official start of the monsoon. Although it had rained several times in the first two weeks that I was here, Tuesday was the beginning of non-stop, four-days-straight rain. Second, Wednesday was my first experience with traveler's diarrhea.

I woke up on Tuesday morning to the sounds of someone getting sick in the bathroom. By Tuesday afternoon four of the girls had fallen ill. Brenna landed in the SEARCH hospital. Only, Miriam, Amy, and I were left standing. Before dinner we made the rounds visiting each of the girls. While eating dinner, the heavy rains began. We sat in our mess hall enjoying the sounds of the rain and playing with some dogs that ran into the mess hall and under the roof of our residence building for shelter. Back in our bedrooms, I took some time learning to write my name in Marathi. I was enjoying myself and having a good time. The power went out several times, something that happens more frequently now that it is raining a lot. Then, Miriam, Amy, and Bhagyashree discovered these weird looking frogs hanging outside in our courtyard. They were very fat frogs and instead of jumping they walked on four legs. We watched the frogs try to escape the pooling waters and climb to higher ground. One after another they tried to climb up the side of our elevated landing outside our bedrooms. They were cute, but their genetic adaptations were kind of creepy. At one point, Miriam made a comment that the frogs, snakes, and scorpions come out during the rains, driven out of their underground hiding places. Amy took tons of pictures of them. My camera's charge had been used up during a nature walk we took earlier in the evening, so I had to wait a bit before it was ready. By the time I went back outside to take my own photos, the other girls were heading into their rooms and we said goodnight. I stood outside for a few extra minutes taking pictures of Mr. Fat Frog. When I stood up to go inside, I saw something jump off the wall about 15 feet away. "What a funny looking gecko," I thought. It was relatively dark, and I couldn't see that well. I moved a bit closer. "Why is that gecko carrying something on its back?" As the "gecko" turned its body so that I was no longer seeing it in profile, I was horrified. This was not a gecko. No it was not. This was a big, live, scorpion.

Time out.

I was petrified. I saw the curve of its venomous tail curled up over its body. This is what I had mistaken for the load the gecko was carrying. I saw its pincher-type claws. It started trying to hop off the elevated platform of our residence building, decided this was too risky, walked over to a wall and attempted to crawl its way down to the ground. "Guys, guys, there's a scorpion out here!" The sound of the fans in the rooms and the pounding rain easily drowned out my voice. Besides, I'm not even sure if I was speaking audibly; I was frozen with fear. For a quick second I thought about snapping some photos, but then my senses came to me, and I ran inside my room and slammed the door.

Let me just say, the image of this scorpion, with its gigantic black grasping claws, strutting across our landing is forever burned into my brain. It is straight out of my nightmares. I was severely disturbed. Although the walls are made of cement and this thing was far too chunky to ever make it under the door, the fact that I had seen something so terrifyingly nasty close to my bedroom convinced me that there was a way it could make it inside my room. On Tuesday night I felt like I was falling asleep in a horror film. In this movie genetically mutated obese frogs roam the planet on their tiny legs. Black scorpions start crawling out of the walls. Water is flooding everywhere you turn. And half of your friends are falling ill with gastrointestinal illnesses.

On Wednesday morning when I woke up, the first thing that happened is I made a trip to the bathroom with an upset stomach (and it was very very upset; I will spare everyone the details though since this is, after all, a public blog). I had braced myself for this upon arrival in India, and then I thought I had lucked out and skipped this step. On Day 17 my immune system caught up with me.

I sat down along the wall outside our bedrooms and talked with Miriam and Bhagyashree who were also up early. I felt very nauseous and was afraid I was going to vomit, like the other girls had the day before. I also had a theory that because I spent the night in such fitful anxiety that I had made myself physically sick. When Miriam and Bhagyashree went to go get tea, I went into the bathroom and got sick again. This was not good, a pattern was emerging. I decided I would not get ready for the day and instead go back to sleep. Further, since our bathrooms are only in the residence building, I did not want to be that far away from them. Around 9am Sona came to check on me. I told her I felt weak, dizzy, and sleepy, but that I thought I could start my day. She told me to rest and that she would check in again around 11am. At 10:45am I made my third trip to the bathroom. When Sona came back she said I was going to the hospital to get medication and treatment because now I was officially the fifth sick girl.

The hospital at SEARCH is a rural hospital that primarily serves the villagers, so while there is medical equipment and medications and organized surgery camps, it looks more like a school infirmary than a U.S. hospital. It is also roughly 50 feet from our residence building. I don't want anyone picturing brightly lit hallways, individual examination rooms with hospital beds, beeping monitors displaying vital signs, and doctors and nurses scuttling everywhere. This just isn't so. Ama (Dr. Rani Bang) oversees the entire hospital with the assistance of two Ayurvedic doctors. I first met with Ama who checked me out for a bit and then told me I would get an IV. She told me that we shouldn't have eaten eggs at the restaurant in Chandrapur because there could have been salmonella, especially during the rainy season. I was confused because I thought the restaurant we had gone to was one of the "safe" ones. Either way, it didn't really matter at that point.

Amita, one of the Ayurvedic doctors that shadows Ama, led me to the room I would rest in. It ended up being the same room that Brenna had spent all of Tuesday in, getting four IVs of rehydration liquid. Amita and another hospital assistant/nurse gave me three pills, two red and one white. I'm not sure what they were, but I trusted that they wouldn't harm me. They told me Marie was going to come and get an IV too. I didn't really think I needed the IV, but I had heard from others that once SEARCH is aware that you were sick, they are very overprotective. They are responsible for us, and I'm sure they do not want anything bad happening to the foreign interns because they would like to continue to have them come in the future. Since I knew that getting an IV of rehydration liquid was not going to harm me, I didn't put up too much of a fuss, although I do think this was my first time getting a real IV. Marie tried to protest, telling them that going to the bathroom several times did not warrant an IV, but in the end she was made to get one too. We hung out in the room for about 45 minutes while our IV's dripped away. There was nothing else to do, but stare at the walls and the ceiling and listen to the sound of the rain. So really, it was very relaxing. After our IV's we were given instructions to eat bananas, so we did that too. Overall, the IV was not too bad. It hurt a lot more when the nurse removed the needle than the pinch I felt when it was inserted, but I got over that as well. It was very unclear if we were supposed to stay in the hospital room or not, but seeing that we both felt fine, we wanted to leave. The only problem was that it was raining cats and dogs again, and neither of us had an umbrella. Eventually Miriam came to our rescue and we all went back to our bedrooms.

I played the rest of the afternoon slow and only had to use the bathroom one additional time. I only ate a small amount of rice and sprouts at dinner. I was in good company with the other sick girls. We all showed up in the dining hall because the cook, Vimal tai, was starting to worry that her food had made us sick and we were boycotting it. We really like Vimal tai and didn't want her to feel upset, so we went to dinner in solidarity and pretended to eat. I got very good rest Wednesday night and felt golden on Thursday morning! I did not even have to use the bathroom on Thursday (or Friday...seemed like I now had the opposite problem). I really lucked out. The other four girls who had been sick were sick for at least two days, and most of them had vomited as well. I was a mild case. I had escaped what could have turned out to be an awful week of gastrointestinal issues.

Further, on Friday, the rain eventually let up and we had two days of sunshine with some drizzle, until Sunday when it started to rain non-stop again. At least I know that it is not going to rain every minute between now and the time I leave, and that there will be moments when we see the sun.

The only nightmare I did not escape from was that of the scorpion which plays over and over in my head. Now, the spot where I saw the scorpion will always be "that place." And every time I walk by it to go to the bathroom I will nervously scan the area looking for scorpions. I will probably have this anxiety until the day I leave. Gone are the carefree days of scorpion-free housing.