June 6th: First Day in Gudalur

              We were taking a bus from Bangalore to Gudalur so we had to get up pretty early and get ready. Our bus was supposed to be leaving at 9 am so we had asked the driver to come at 7:15 so we would get there in time with all of the traffic but the taxi never came so at 8:15 we were scrambling to find an auto to take us. Nirmala and I took an auto while my cousin and Akshaya came on his motorcycle. They were probably the fastest ride that the both of us have been on. The auto driver was super nice though and knew that we had to get to the bus station so he took as many side roads as possible to avoid all the traffic. We probably would have never made it in the taxi because the cars were backed up forever but we were able to maneuver between all the vehicles in the auto and motorcycle.

                We got to the bus station with about 15 minutes to spare which was great but now we had to sit in a bus for 7 hours. I originally thought it would only take 4 hours but then I was told 6 hours and when we got to the station the driver said it would take 7 hours sitting in a stuffy bus. There weren’t too many people on the bus when we got on but quite a few people got on at the next stop and eventually there was a full bus. Unfortunately, the guy sitting in front of me apparently had not heard of deodorant and decided to lean his chair back and put his arm over his head treating me to quite a smell. I really wish I had had some Febreeze that I could have just sprayed all over him. And worse, he was going to Gudalur as well so we were stuck on the bus with him for the entire trip.

                Eventually we got to Gudalur around 4:30pm, thank goodness, and were able to get some fresh air. We managed to get an auto and stuff our luggage into the auto to take us to the hospital. The weather is super nice in Gudalur since we are in the mountains. This is a welcome change from the heat of Nagpur. We apparently are going to be here for the beginning of monsoon season so it’s going to be cool to see the rain.

                We are staying in the doctor’s hostel again and I have the same room I had last year. There are actually a ton of people that are staying here as well. Sophie from Englahd and Vivek are two doctors that are here on a long-term basis working at the hospital. Dr. Sashi and her daughter are visiting from Pune to help out for two weeks. Dr. Sashi is a OBGYN and comes to the hospital twice a year for 15 days to help out at the hospital. There are also two medical students, Anna and Hayley that are here from England as part of their medical elective. They had just arrived the past weekend so they were still adjusting to the change.

The guest hostel where we are all staying

 

My room & Hallway/Living Room with the Kitchen further in                                     

                At first we got freshened up before heading down to the hospital to see Dr. Nandakumar to find out what we were going to be doing this trip. There is one counselor, Ammani, at the hospital that pretty much sees every single patient that comes through so I was going to be following her and shadowing her throughout the visit. I was also going to be working with her to come up with some educational information for the patients. Dr. Nandakumar also wants to make health educational videos for the patients while they are waiting so I am working with Ammani to see what is important and put together the information that will be part of the video. Today was just to get up to speed on what I was going to be doing for the next week.

You can learn more about the hospital at http://ashwini.org/. There is a ton of information about the history and how everything started which I highly recommend reading. 

The hospital

          Afterwards we went back to the hostel and were invited to Durga’s house for dinner. Durga is one of the individuals that works with the hospital and the Adivasi Munnetra Sangam. I had dinner at her house last year and it was amazing. Her house pretty much resembles a story book cottage and is so unique compared to all the other buildings in the area. 

 

 It's a story book cottage

              It was her daughter’s birthday so we all went over to celebrate. It was a really nice night to meet everyone. There were a ton of people there so I’m not going to name and describe everyone but after dinner we all sat around and kind of had a group sing-a-long. Akshaya, Anna, Hayley and I just sat back and watched and listened to everyone interact. We eventually ended up back at the hostel where we all pretty much passed out because we were so exhausted. 

               All in all we are both happy to be in Gudalur. I loved my visit last year and I'm glad to be back this time. 

June 5th: Goodbye Nagpur, Hello Bangalore

            In order to get to Gudalur we had to fly to Bangalore and then take a bus to Gudalur. Instead of doing all that traveling in one day we decided to spend the night in Bangalore with our cousin and spend some time with him and his new wife. I had already told him before going that my sister and I wanted pizza or KFC or something that wasn’t chappati. We had eaten so much chappati in Nagpur that I really just wanted something different.

           We got ready in the morning and Dr. Jain drove us to the airport. That was an adventure in itself but we made it to the airport in one piece. After a short stopover in Mumbai we were finally in Bangalore. As soon as we went outside the airport the first stand that we saw was for Subway. Home sweet home but we were both holding out for Pizza Hut. It took about an hour to get to my cousin’s from the airport but our first order of business was to place our order. Oh the choices that we had. American fast food Indian style is definitely interesting. Gotta be careful or you might end up with something that would be great by itself but horrible on a pizza.

          We ended up devouring the pizza and then headed out to the shops for a bit. It was nice to just walk around and enjoy the weather. It was still hot but nothing like Nagpur. This heat we could handle. We went into a few little shops and then just walked around for the most part. We decided to just continue the fast food trend and walked to KFC for dinner. I was actually surprised at how good the food was. I had gone to the KFC in Coimbatore last year but the one in Bangalore was even better. And the food was spicy to boot. I didn’t even need any hot sauce ;-) 

Three buffalos chillin on the road. The cars just went around them

Double whammy: Two for one deal

Couldn't get a great pic of the menu

Our dinner

She was happy with her mochacchino

We made Suresh anna eat almost everything we bought

The spoils of the night

Loved this necklace and earring set!

June 4th: Last Day in Nagpur

With Amarappali and Shruti

             It was a bittersweet day. We had definitely enjoyed our time in Nagpur but we were ready to get away from the heat. We spent the last day in the hospital. I really needed to get my some updated data for the paper that I am working on with Dr. Krish. Dr. Jain has over a 1000 sickle cell patients that she cares for at the hospital and we are trying to look at all the clinical events of these patients to see if we can determine what symptoms are more common in Sickle cell patients in India. Literature states that Sickle Cell Disease is mild in India but Dr. Jain’s data shows that in the predominantly non-tribal population the disease is actually very severe and there are certain co-morbidities that we see in the Indian population but not in the African-American population in the States. The paper and information is super interesting but the data is a huge mess and I’ve been trying to sort it out for almost an entire year but coming here has helped because I can sit down with Sanjeewani, Amol, and Sheetal and get the information from them directly instead of trying to guess their thought process from the States. We basically spent all afternoon going through paper medical records trying to get missing information.

            After the hospital today we had been invited to Dr. Shrikhande’s house for dinner. Along the way we stopped to pick up our clothes :-D Pics below. But back to Dr. Shrikhande. Her house was amazing!!!! Omg. I wish I could have taken a picture of it but it was too dark but wow. Her house was huge and she had a huge garden and even a small little temple. We had yet another dinner where people tried to stuff more food than we eat but everything was delicious. We couldn’t stay long because our flight was early the next morning and we still had to pack our clothes and Dr. Jain and I still had to go over more data.

Dr. Jain tying the Akshaya's Chaniya Choli

After we got back to the house we had a little fashion show and tried on the new clothes to make sure that all the blouses fit. I love the saris that I bought but I have idea when or where I’m going to be able to wear them.

So I definitely am not the expert on tying saris but I did the best I could so you can get an idea of the pattern. There's one more that's not on here but it was a green/red/pink mix :P

The first white sari that I bought

Bandhani Patterned Sari

The Sari with the elephants on the border

All in all it has been a great and successful trip to Nagpur. Next time I decide to come here it will definitely be in Nagpur’s winter months and not in May/June.

June 3rd: Dragon Palace, Community Screening, & Dheekshabhoomi

         I haven’t been doing the best job of keeping the blog updated this trip but our internet was crappy in Nagpur and we were super busy and exhausted at the end of every day. Everyone pretty much works 24/7 at the hospital which is why we were ready to leave at 7am for a community camp in a village about 45 minutes away near the Dragon Palace Temple. Sanjeewani and Dr. Amol went to set everything up for the camp while my sister, Sheetal and I explored the Dragon Palace Temple.

       

Walking up to the entrance to the temple

         The Dragon Palace Temple is a Buddhist temple in Kamptee, Nagpur and is gorgeous! It kind of looks out of place among all the other buildings in the area but the architecture is gorgeous and so is the landscaping. Apparently at one point in time the Dragon Palace won an International Award for the best concrete structure in the world. It was super clean which is a rarity but it would be depressing if the temple very became run down and dirty like a lot of other places in India. There is a large Buddha statue inside and it is said that the statue was carved out of a single block of sandalwood and I believe it was brought over from Japan. The exterior color of the temple is white which is supposed to symbolize calmness, clarity, and divinity. The temple is also sometimes referred to as the Lotus Temple of Nagpur which I guess you can kind of see somewhat with the structure of the temple. Maybe an aerial view shows more of a Lotus shape?

This statue was off to the left side of the temple explaining why the temple was built

        Anyway, the Dragon Palace was definitely a unique place to visit during our trip. There is a large Buddhist community in this area which I’ll explain a little bit more later. After exploring the temple we headed to the village where the community screening camp was set up.

Sanjeewani talking to everyone in the community

          The Sickle Cell Team from the hospital goes to various villages surrounding Nagpur to offer community screening. Over a 3 hour period, 102 individuals were screened using a Sickle Prep test which will indicate the presence of the sickle gene but not necessarily the genotype. Around 12 were found positive so these twelve individuals then had their blood drawn for HPLC analysis. Sanjeewani started the morning by explaining to the group gathered the purpose of the visit and explaining about Sickle Cell Anemia why screening is important and the implications of a positive result. 

Our set up for the camp

It was interesting to see that throughout the screenings if an individual was found to be positive there was no private disclosure. The name of the individual who tested positive was called out and Sanjeewani would tell that person in front of everyone that they tested positive and that they needed to go get any other family members that were at home so that they could be tested. This method of disclosure meant that the entire community was privy to learn about others test results if they were around when the name was called out. Definitely goes against everything we do in the States but that is the way of life here.

Sheetal doing the initial Sickle Prep test on all the individuals

        

These screening camps kind of reminded me of the community screening events that Children’s Hospital and the Children’s Sickle Cell Foundation offer in areas with a high African American population in Pittsburgh. While we don’t do immediate disclosures we do offer free screening and offer counseling for the individuals interested in testing.

Dr. Amol drawing blood from a boy that tested positive on the prep test

       After completing the screening camp we stopped for lunch on the way back to Dr. Jain’s house for some amazing Paneer and paratha J

Dheekshabhoomi

         Dr. Jain had Rakshit, the driver, take us to a few more places in Nagpur because she got called in for an emergency at the hospital. First we went to Deekshabhoomi  which is the place where Dr. Ambedkar converted to Buddhism with close to 400,000 of his followers in October of 1956. The monument at Deekshaboomi is a pilgrimage center of Buddhism in India. The name Deekshabhoomi comes from Deeksha which literally means accepting religion and Bhoomi which means land. So Deekshabhoomi means the land where people get converted to Buddhism (Buddhism advocates the acceptance of all religions).

We got to see a gorgeous sunset

        From here we then drove to a nearby lake to watch the sunset and take in the scenery and on the drive back to the house we drove by a “pole” which represents the precise geographic center of India. It’s interesting that there are statues of Dr. Ambedkar all over the city, the airport is named after him, and so are a number of educational institutions but there’s nothing but a lousy pole to signify the geographic center of the entire country.

        It was definitely nice to do a little sight-seeing today and explore Nagpur a bit. J

June 2nd: Today I don't feel like doing anything

I just wanna lay in my bed......don't really have a Snuggie to chill with or MTV to watch but the day's events?

Lounged around, napped, watched One Tree Hill, ate lunch, read, napped, ate dinner, slept.

Eventful day right? But at least we had air conditioning and we really needed a day to regroup because everyone pretty much works 6-7 days a week.

There is something about the weather in India that makes me want to sleep all day. Not good. 

June 1st: Need air conditioning

          Dr. Jain was in charge of administering the MD Pediatrics Exams on Friday and Saturday so there wasn't a lot for us to do. Pretty much the entire department was consumed with getting everything ready for the examinations. It was kind of sad because the entire ward was cleaned solely because of the examination. The cots were given sheets and the ward was sweeped so everything would look presentable. I'm sure it won't take much before everything is back to being as dirty as it was before. In the beginning Akshaya and I were just going to stay home and I was going to catch up on some work because I really didn't want to be sitting around a stuffy hospital with nothing to do, however, in the morning Dr. Jain saw that I was up and ready and told me to come along with her. I couldn't really say no so I ended up at the hospital all day. I went to the ANC clinic in the morning with Sanjeewani but it was a pretty slow day so there weren't many people that needed to be counseled and tested. We spent the rest of the day hanging out in random rooms in the hospital/medical college because there wasn't much to observe or do. I would have loved to be sitting in an air-conditioned room but nope. We were stuck in rooms in the hospital where you were lucky to get a little bit of the breeze coming from the ceiling fans.

        We had a good time at dinner though. Ammarapalli and her husband took us to this nice place called Ganesh Sagar. They had amazing food and we were stuffed at the end of the meal. I will never get used to the meal schedule here in India. Breakfast at 9/10am, lunch at 1/2pm and then dinner at 9/10pm. I want to be in bed by that time, not eating dinner.

Masala Pappad at dinner :) 

May 31st - Wedding Festivities, Indira Gandhi Medical College, and Shopping Round 2

        Dr. Jain's niece is getting married next month and today was the start of the various functions that will be happening throughout the next month leading up to the wedding. Before the invitations are given out to everyone the first invitation must be presented to God and that was what today's function was for. The reception hall was gorgeous and we kind of forgot that we were in India for a bit until we realized that everyone was talking in Hindi/Marati and we had no idea what was going on.I wish we were going to be here for the wedding but sadly it's happening right after we get back to Pittsburgh.  

The reception hall. There was a wedding happening in the morning as we went inside

The stage with a picture of Dr. Jain's father. The bride's grandather

The crowd

Lord Ganesha (The remover of obstacles)

The cutest baby in the room. The bride's cousin

All the women in the front row

The bride with aunt (red) and mother (green)

Outside the reception hall with Dr. Jain

       After the function today I went to Indira Gandhi Medical College which is the other government medical college in Nagpur. Dr. Shrikande, the head of the Pathology department attended the Global Sickle Cell Disease Conference in Atlanta this past March and wanted me to help analyze some population screening data to publish a paper. They have screened over a 100,000 individuals in the Nagpur area to determine the sickle cell trait prevalence in the region and among the various caste groups. I spent the entire afternoon with her and her team going over the data and making a plan for what needs to be done. It was super super hot and the power kept going out throughout the afternoon making it even worse. Working in this heat is super exhausting and I don't know how they get anything done here. 

Dr. Shrikhande, Myself, Dr. Amit and Helen

           After finishing up at IGMC, Dr. Jain sent her driver and Amarapalli, one of the MD Pediatric doctors out to take us shopping. We went to Sanskruti, a shop near IGMC to find my sister a chaniya choli. I didn't end up getting a picture of the one that she bought since they kept it to stitch the blouse but the fabric below is one of the ones that she really liked. I bought a few more saris but I only got a picture of one of them but I'll put more up once we pick up the pieces on Sunday night.

Pretty blue chaniya choli fabric

I bought a couple more saris but this was my favorite with the elephants on the border

We found a cow along the entrance to the hospital

Dr. Jain had fresh lychee for us to eat. First time we got to do this. 

Fresh lychee is the way to go :-)