More dark days ahead

Energy supply can be a really good source of providing high-level, rapid assessments of how "developed" a country is. Generally, the consistent delivery of energy supply reflects the levels of infrastructure developed, the variety of financing mechanisms instituted (usually for public, sometimes private sector), the elusiveness of corruption, the length and productivity of an average workday, fluctuations in gas/diesel prices, the difficulty in storing goods (especially medicines!) in refrigeration, and so on.

I received this warning a few days ago from International SOS:

Tanzania: Electricity company announces 15-hour power cuts from 19 to 26 May
The state-owned Tanzania Electric Supply Company (Tanesco) on 8 May announced that it would impose 15-hour daily power cuts from 19 to 26 May. The power cuts will be in effect from 08.00 to 23.00 (local time), though Kigoma, Rukwa, Kagera Mtwara and Lindi regions will not be affected as their power supply does not come from the national grid.

Apparently when the lights are off, you can't see any progess...and you can't see any corruption either.

Desensitization

When you first travel to a developing country from the US, you tend to notice everything that's different - from the people to the language to the absence of toilet paper in squat restrooms to the free-range chickens and goats roaming the roads. It's part of the culture shock, but also part of the intrigue that keeps you going in global health when you first start working in the field. You tend to seek out what's different.

After having lived in a few developing countries now though, the initial culture shock that I get fades away pretty fast. So the things that now seem "normal" to me, are the things that I forget to write about. But you might still find them interesting, so here are some of my top shocks, now absorbed:

• Books: Just like new clothes, new books are ridiculously expensive. The average Tanzanian lives on less than $2 a day, and a new book is at least $10. There are only a handful of bookstores in Dar (see: A Novel Idea), and if you're coming from a big US city, these stores will look like shoe-boxes. But hey, they carry NYTimes Bestsellers!
• Energy: Like India, Tanzania suffers from a power crisis. Unlike the Philippines, they do not call them brownouts or blackouts [obviously]. We have "power outages" everyday. So you either freeze where you are until a generator kicks on (if you're lucky), or you go find a candle.
• Switches at every outlet / electrical socket: When I first moved into my living space, I didn't know how to turn my stove / hotplate on in the kitchen. I thought I was turning the knobs and pressing the button correctly, but I couldn't get the gas to ignite. So I had to call for help. When my savior came with a match (thinking that was the problem), he looked at me, and then he looked at the switches on the wall. He looked at me again, and then he flipped the switch that corresponded to the stove. He shook his head and then left.
• The absence of bathroom vents: It's not very common to see bathroom vents like you see in most suburban American homes. Although I've lived in a few old NY apartments that didn't have bathroom vents other than windows, I still think they can be very helpful. [Not for me, of course, but for others...]
• Water heaters and switches: Yes, there is an "on" switch for this too. You have to turn it on at least a few minutes before you get into the shower. It gets added into your daily routine, along with opening up windows, if you don't have a bathroom with a vent. 
• Always having to consume bottled water: It's a different situation when you're forced to drink only bottled water because you could contract an illness from regular tap water. You get used to it because you have to do it; and you slowly forget about how many plastic bottles you're throwing into the ocean. But then you think, "Well, I could save my conscience from this next plastic bottle by ordering a soda which comes in a glass bottle that will be recycled here." [Yes, they still use old fashioned, refillable glass bottles.] But that's how you start to consume more calories than you planned, which isn't good because -
• Gyms are for the wealthy: If your hotel doesn't have one, good luck trying to find a spacious facility that's reasonably priced, has a working AC, and offers machines that won't squeak or break down within a few minutes. Well hello there, spare tire...
• Stoney Tangawizi: It seemed so foreign at first sip - it's so gingery. But it's so good that I'll save a few plastic bottles here and there for this ginger ale and I won't mind the spare tire.
• Dudes whipping bulls on the roadside: That's right. In Zanzibar, just like in provincial areas of the Philippines (or any rural Asian area, for that matter), many farmers have male cows or yaks or the like that haul carts of stuff for them. To keep them in line and going at a normal walking pace, they [lightly] whip the animals.
• Giant bugs, house lizards, and other creepy crawlies: You may shriek at first, but they happen to live in your space too. So far, I've doused 2 giant roaches in mist that will float them up to heaven.
• Internet streaming: Even at the hotel with my really awesome wireless connection, I'm lucky to be able to stream a YouTube video or iTunes song in real-time. Welcome back to my life, patience.
• People sweating: It had to be said. We've become overly disgusted and overly conscious of our natural sweat in the US. When you're abroad, especially in a tropical/humid climate, everyone sweats and no one really notices...Until you're in close quarters - like on a jam-packed bus, everyone sweats on everyone else. Then you get out of the bus and dirt immediately sticks to you. You have to go about your normal day until you can get home and shower. 
• An overabundance of stray cats...and flies: Okay so I'm not entirely desensitized to these because I can't stand them...but they don't seem as bothersome as before. Now when I watch a commercial of a poor, dirty, sweaty kid on TV surrounded by flies or stray cats in Asia or Africa, I can think - ooo...I looked like her once! 

(A few credits - MH & TB for helping me remember a few of these :))

Searching for [new] Western wear

I know I’m behind on my blogging, but there’s something I want to write about before I give a meatier update on my project here. I want to tell you about shopping. Yes, shopping.

I enjoy shopping, not just for native crafts and fresh fruits at the local markets, but for regular clothes and shoes. This past weekend, I decided I would try to expand my wardrobe a bit here because I’ve been assigned to stay an additional month, but I was really surprised to find out that I had incredibly limited options here in Dar!

There aren’t really any malls here – not like the giant, air-conditioned wonderlands of the US, the Philippines or even South Africa. No, Dar only has a handful of commercial plazas that are home to a myriad of diverse businesses – restaurants, computer shops, mini-bookstores, groceries, and just a few clothing stores. There’s a small Woolworth’s department store in the City Centre, and there are a few boutique clothing stores at Shopper’s Plaza, Oysterbay Shops, and Sea Cliff Village. Most of these boutique shops cater to tourists, so the clothing here is either touristy (with catch phrase t-shirts) or very dressy and pricey (around $50 USD for a shirt!). So after a slightly disappointing trek, I wondered where everyone else shopped, only to find out that…

The cost of brand new clothes from the shops I had visited are all very expensive and out of reach for the average Tanzanian family. [I didn’t even want to pay $70 USD for a linen skirt at Woolworth’s!] So most Tanzanians shop for mitumba – secondhand clothes at the market. Mitumba is clothing that originates from abroad, like the UK or the US and is used. These t-shirts, blouses, dresses, pants, etc. are “throw-aways” from Europeans and Americans – but what I haven’t uncovered yet is if these said throw-aways were originally donated to be given away to the poor. I don’t think it’s really widely thought about (whether or not these are “intended for the poor”) because buying and selling secondhand clothes has become a natural part of the Tanzanian lifestyle. Mitumba provides many people with an easy way to begin a business and families with much more affordable clothing options.

Of course, traditional African or Indian dress isn’t included in this discussion – they’re in a class of their own (somewhat more affordable, of course, for their constituents). So I think I may just continue rotating my current set of clothes as a Westerner, until I feel more comfortable wrapping myself up in a brand new African kanga.

Explaining "purpose"

Not too long ago, Dr. Orin Levine published an article in the Huffington Post entitled, “Uncommon Rewards.” The article was inspired by a comment that Dr. Levine received from a flight attendant: “Global health? You must find your work so rewarding!”

Although I don’t have as many years of experience and I’m not even remotely close to the title Executive Director (of the International Vaccine Access Center, nonetheless) like Dr. Levine, I do seem to get this similar reaction from people when I share what I do with them. And although I can’t give you first-hand insight on things like the debut of pneumonia vaccines, Advance Market Commitments, or the GAVI Alliance (not just yet in this stage of my career, at least), I can give you first-hand accounts of what it’s like to be a peon (let’s be real here) trying to make these sorts of things happen where they’re needed the most. Sure it's rewarding and exciting. But it’s also challenging, fun, emotional, taxing, fulfilling, hopeless and hopeful all at the same time.

“Travel for work? That’s really interesting.” Even though I’m just at the beginning of my career, I’ve found that other people see global health and development with swimming goggles on – it’s strangely intriguing. I’m not sure if this is the product of globalization or just massive unrest with employment, or unemployment, but I get a lot of these follow-up questions: “How do you live in third world countries?,” “what exactly do you do there?,” “what do you generally eat then (especially when you’re in Africa)?,” and, “how do you maintain a social/personal life?” 

The simple answer is: you make it work. 

The complicated answer is: stay tuned to see how…(because sometimes it does work, and sometimes it just doesn’t).

On the Road Again...Tanzania

Since my last blog post, I wrapped up my UNICEF India research paper (which, excitingly enough for my exhausted team and I - recently got published!), consulted on a few global health projects, packed up my things, said a bittersweet goodbye to NYC, moved to warm and sunny Los Angeles, and started a new job. I'm back on the West Coast to start a new chapter in my life and revive my wanderlust.

I've been very blessed to have received the opportunity to continue chasing my dream - establishing a career in global health and making a difference in the lives of others. I'm carving out a niche now, focusing on the provision of access to medicines for maternal health with my new non-profit organization. It's innovative and exciting work, and it's put me on the road again to help launch an access to medicines / availability program.

In the global health field, you can create access to medicines in several ways - mainly though through policy change and drug registration. Creating access is like telling someone that they can have something, like they are legally allowed to drive. However, this has to be paired with availability, which means that something, like a car, is reasonably within reach. It's available (and ideally, affordable). With both access and availability, an individual can then drive themselves from one place to another - in global health terms, they are empowered to attain better health standards. Of course a person has to receive the proper education in order to know how to drive; this is addressed in global health through proper [medical] training and education campaigns.

Approximately 529,000 women - that's about 1 every minute - die from complications of pregnancy globally every year.  Postpartum hemorrhage is the leading cause of maternal mortality, responsible for approximately a quarter of these deaths - the portion even higher in sub-Saharan Africa.

In the US, we don't normally hear about PPH because the drug used to prevent it (oxytocin), is already part of the standard of care in health facilities for laboring mothers. In many developing countries, PPH occurs for many reasons - including the inability of rural women to reach health facilities for labor and delivery, and the challenges of providing oxytocin. Oxytocin is the WHO recommendation for care as a first line treatment, but it is a temperature sensitive injection (it requires consistent refrigeration). It can be unstable and ineffective in countries where there are intermittent power outages, long transport times to rural facilities, and facilities without any electricity at all, like in Tanzania. It has also been subject to stockouts - where it is simply unavailable at facilities.

So misoprostol - a heat-stable, low-cost pill, which has a comparably effective rate as oxytocin, can be a powerful solution for the prevention and treatment of PPH. This can be more easily transported to both urban and rural health facilities.

In 2007, Tanzania created access to misoprostol. It was registered in the country, but since then, the availability of the drug has not been formally researched or documented. Tanzania's pharmaceutical system has endured a myriad of challenges and changes over the past several years, and an efficient and effective supply chain system has yet to be established. This makes availability quite a challenge, but not one that can't be surmounted to save the lives of mothers.

On the road this time, my global health journey will take me through the Tanzanian system to help assess  availability and comb out the challenges to safe motherhood. It'll be an interesting and exciting experience, which I hope will be complemented with some great stories and findings. Stay tuned...

A glimpse of Tanzania thus far:

Taking the plunge…in Calcutta

This weekend, my research team and I ventured out to Calcutta (or more appropriately, Kolkata) to go on holiday. We boarded a 5 hour train ride to take a fun trip out to see one of the other UNICEF groups (BIG THANKS to you ladies for being such wonderful, hospitable, fun hosts!!!) and do some sightseeing.

Calcutta is a truly interesting city with its West Bengal influences, variety of religious institutions, and diverse markets and cultural centers. The people are all mostly very friendly (another BIG thank you goes out to all the street peeps who helped us with directions, taxis, etc.), and the food choices are endless.

I decided I would try to do Calcutta on the cheap this weekend, so I took the plunge…I indulged in some street food here in India! (And I’m not sick…not yet at least!)

So what was a day in Calcutta like? This is a glimpse of my Sunday:

• 10am – Wake up and have a fresh fruit salad breakfast [many thanks to Meg] with our hostesses with the mostess(es?). Cost: 20 rupees
• 12noon – Head out to find transportation into the city. Since the Metro wasn’t running yet [starts at 2pm on Sundays], Meg and I decided to take the bus. Cost: 8 rupees
• 1pm – One hot, sweaty, crowded bus ride later, we got to Howrah station. We stopped for lunch at a street vendor canteen. Although we [not surprisingly] got ripped off because we are obviously foreigners, hot, yummy dosas came in at 20 rupees each.
• Then we went to find the mini-bus to the Botanical Gardens. We boarded this, less-crowded one… Cost: 6 rupees
• 2:00pm – Finally at the B. Gardens where we were charged the foreigner rate to enter. Cost: 50 rupees [The Indian citizen fare would have been 5 rupees]
• 2:05pm – I opted to try three little Indian sweets and grab a cold lime soda for the walk through the gardens. Cost: 35 rupees
• 3:30pm – After a refreshing rainfall, Meg and I found the Largest Banyan Tree on Earth.
• 3ish – We got tired of wandering around the gardens and saw an exit. We decided to board another bus headed to the Esplanade for shopping. Cost: 6 rupees
• 4ish – We started wandering through the markets to shop and eat. Fresh roasted corn: 6 rupees. Soft-serve ice cream: 6 rupees. Bindis as souvenirs for my little cousins: 6 rupees. Cool looking leather Indian shoes: 300 rupees. Subji (vegetable mix) and rice dinner with tea at a small street canteen: 12 rupees. Large bottled water: 14 rupees.
• 6:30pm – We left for Swambuhmi, the cultural center which had a Sitar performance scheduled for the evening. Because we saw a concert there the day prior, we got free passes for Sunday evening (in the guest section too…not just the normal section!). Taxi to the center to meet up with our lovely hostesses: 100 rupees.
• 9:45pm – After a long, HOT, but fun day, we boarded another 2 buses to get home. 11 rupees.

• Experiencing life in Calcutta like this: 600 rupees = $12
  
• The Immodium AD that I brought: priceless.

The bandhs

Bandh is a Hindi word that originally means “closed,” and in contemporary cultures, it is used to describe a form of protest here in India.

During a Bandh, a political party or a community declares a general strike. Often Bandh means that the community or political party declaring a Bandh expect the general public to stay in their homes and strike work… shopkeepers are expected to keep their shops closed and the public transport operators of buses and cabs are supposed to stay off the road and not carry any passengers. (Wikipedia)

Bandhs have occurred for various reasons throughout the past month. Some were strikes due to Maoist threats, some were called by students who decided to protest against groups who were beating them up, and others were strikes called because of issues such as price hikes. There have been several regional bandhs that have occurred for these reasons since we got to Jharkhand, many times hindering our trips out to the field because they render the roads unsafe; so we’ve dealt with them accordingly – by rescheduling our field visits.

The first few bandhs that we encountered were pretty tolerable, as we’ve gotten a great deal of office work out of the way, but they’ve become increasingly rhythmic and rather annoying now. The regional bandhs that happened previously affected mostly our district (East Jamshedpur) or our state (Jharkhand), or a neighboring state (like Bihar). But today, there was a nationwide bandh. The Bharat bandh practically switched off India for the whole day (12 hours on Monday, 5 July), shutting down roads, highways, and transport services, consequently leaving shopkeepers and other businesses bereft of any sort of productivity. The Bharat bandh was called to protest against the hike in fuel prices (which, legitimately enough, are very high at headline inflation rates of 10.16%, reports Reuters), but one has to wonder if such a day’s loss in economic productivity is really worth it.

Is it truly worth shutting down offices and schools for the day? Is it worth canceling the much-needed mobile medical clinics scheduled to visit sick patients in rural villages? Is it worth grounding massive numbers of airline flights? And is it really worth the squatter vandalism and morbid violence that erupts in cities all across India?

The tribal visits

Over the past two weeks, my research team and I have been visiting various tribes in the rural villages of East Jamshedpur. Every day, we’ve been waking up at the crack of dawn (well, not really – once we figured out that transportation hardly arrives on time here) to travel the heavily dimpled and crater-faced roads of Jharkhand. We roll ever so slowly into the sprawling farmlands and forest areas, taking usually two (up to three) hours to reach these remote villages.

Driving into each village, I’ve noticed that the infrastructure appears to be somewhat similar in each locality. Extremely modest dwellings are made of rock or cement, and they’re capped with thatched rooftops – most of which are in the process of being covered with clay tiles to prepare for the monsoon season. The [usually] earth-colored homes are outfitted with bright blue doors and shutters, and sometimes the houses themselves sport a wide, horizontal pattern of green triangles or yellow squares against a solid black stripe so that they appear entertaining and full of life. Deep-wells with hand pumps have mushroomed throughout each village to provide a somewhat steady source of water for handfuls of families, and salmon pink government school buildings dot the towns. In the mornings sometimes, there are patches of road that are cordoned off and spotted with rows of freshly hand pressed charcoal – lumpy little black rocks recycled from ashes. Other than these temporary black spots across the dirt though, most of the villages are pretty clean. They don’t have very much litter strewn about (not like the heaps of trash you see in the towns or throughout the markets). Most of the dirt floors are swept clean, and people take pride in taking care of their communities…as well as their animals. Cows, sheep, goats, chickens and ducks usually wander around the village just as people do, until they become a roadblock and our driver honks loudly for them to scurry safely across the road.

Our journeys have been quite interesting, as each village has had something different to offer us. I’m not talking about food and drink sorts of offerings though – in fact, many of these incredibly poor towns hardly have anything to eat or drink other than rice and roti. What I’m referring to are vibrant and invaluable glimpses that they’ve offered us into their poor yet simple, humble lives.

“Namaste,” is the greeting we’ve received at each of the villages we’ve entered – it’s the traditional welcome (and goodbye) that most Hindi-speaking tribes will say, with hands clasped in prayer form at the chest and a small nod of the head. We respond as if we are a mirror image, and then proceed to talk about our research study. We interview several mothers in the villages, and we assemble large crowds (whenever appropriate) to conduct focus groups. Although I can’t share the results of the study here yet, I can share some of the insights we’ve gotten from our interactions and observations.

First, some of these villages are incredibly malnourished. There are some people, including children, who only eat rice and roti. They can’t afford and don’t have access to much of anything else – so vegetables, fruits and meats are extraordinarily special foods to them. If families can afford anything beyond vegetables (of which category they also consider potatoes), then they spring for biscuits  -not fruits or meat.

Biscuits (dense, carbohydrate cookies) are commonly given to really young children here, even though they have no nutritional value at all. It’s a really interesting find, because the popularity of the snack food just goes to show how influential status and marketing can be. The ability of a family to provide their children with biscuits is a point of pride for many…including the business people who brand these food items as such (marketing them as “good for your child” although these refined, processed carbs can actually carry addictive qualities, should be a point of contention). There is a great need for more education here, as many of the nutritional decision makers (mothers) have no formal schooling at all.

Not all villages are incredibly malnourished though. Interestingly enough, there are a handful of tribes who have accomplished agricultural skills and know how to manipulate the land to diversify their diet. These villages have beautifully healthy looking children and mothers (although we can’t say that scientifically), and they have a greater sense of camaraderie in their communities. They feel as though they have enough to eat, and they are quite self-sufficient.

Just as I had found in the slums of South Africa last year, the notion of poverty is not always a depiction of desperation. Although the remote regions we have been traveling to definitely depict poverty: they earn meager wages (an average of 3000 Rupees per month = appx $60), have difficulty finding jobs, don’t have a consistent source of clean water, wear mismatched and tattered clothing, and lack electricity – the villagers have been overwhelmingly gracious at hosting our research teams (as we drive in with our laptops and cameras and whatnot). They don’t express any sort of jealousy or desperation (except for one village); in fact, they’re very appreciative that we have come to gather their opinions and try to help make a difference for their tribes.

Many of these villagers are used to their way of living. They lead very simple lives, exchanging difficult manual labor for natural resources straight from the land. They enjoy the serenity of nature and can understand the fine print of the monsoon season. And whether or not they believe that the caste they are born into is the standard of living they should be relegated to for the rest of their existence, they exude a generously warm and gracious spirit. We’ve been lucky to immerse ourselves in a very hospitable and resourceful culture. I have to say, with as much education as I’ve received thus far, I feel as though I’m taking and learning so much more from them, as I could be leaving behind. 

Random notes on India

Over the past few weeks, I’ve been pretty busy with work because my research team has been going out to the field everyday for surveys and data collection. We’ve been traveling 1-2 hours on bumpy dirt roads to get out to the really rural, tribal areas in the forests of Jharkhand, and the experience has been amazing so far – but more will come on this in a later blog post. For now, I want to catch up on some of the more random things that have characterized our visit as quite…unique.

·  

·      Noise: Everything and everyone in India is noisy (well maybe except for the cows that are on the streets). Amongst the colorful stimuli that will cloud your senses here, it’s the noise that is truly deafening. People are loud (usually in a happy and joyous way), cars are loud (they all honk, ALL the time, because there aren’t any traffic signs here), and music is even louder (Indians LOVE their music). So when you’re in a car that’s rattling because of the bumpy road full of potholes, you will hear endless honking, and the music will be playing loudly to drown out the honking, and the people in the car will be yelling at each other so they can hear one another over the music and honking.

·      Driving: Indians drive on the left side of the road (just like South Africans – from last year’s blog). Thankfully I don’t have to drive around here though. [Note: Frommer’s actually tells travelers to hire drivers because tourist driving = inevitable accidents.] There aren’t any traffic signs or rules here really, not unless you’re in the big cities like Delhi. But even then, not all drivers follow the rules. I’ve found that everyone on the road here is in a hurry –big vehicles always try to pass smaller ones (as well as rickshaws) whenever possible. And of course, they honk loudly to signal that they’re passing. But 80% of the time, these passes are dangerous because there’s an oncoming car or truck in the same lane. So last-minute swerving happens often…and unfortunately, many overloaded trucks fall over as a result. The roads are full of these giant utility trucks, usually filled with rocks or dirt or building materials. I’ve seen four giant trucks spilled over across the roadsides over the past week; in fact, one of these accidents happened literally five minutes before we crossed paths with a truck that tipped. Thank goodness we were running late that day, because we were safe.

·      Starch and fried foods: The north Indian diet has three staples from what I can see so far: rice (bhat or chawal), potatoes (aloo), and lentils (dal). From there, meals are made up of pretty much two food groups: starch and fried foods. Obviously the starch group is made up of the white rice and potatoes – which are served at practically every meal. Hence the many big bellies you tend to see in the Indian culture are usually starch bellies if not beer bellies. (Dal is served at every meal too because it’s the main source of protein for their commonly vegetarian diet.) The other group is made up of fried foods: roti or chapatti stuffed with potatoes and fried, chapatti that’s fried, veg potato and onion balls that are fried, samosas that are stuffed with potato mixes and fried, dosas that are fried and sometimes stuffed with potatoes, and even dessert like gulab-jamon that are dough balls of super condensed milk that are fried and soaked in sugar water. It’s quite an interesting diet – of course where people can afford it, you’ll find there’s a better variety of foods which will include: green vegetables (like spinach and okra), gourds (like white pumpkin), meat (mostly chicken), eggs, paneer (cheese), chickpeas, and fruits. So it's no surprise that nutrition indicators here are commonly void of essential vitamins.

·      Monsoon season: The monsoon rains have begun…hallelujah! The roaring thunder, lightning (which apparently our town, the “Steel City”, attracts much of), and pouring rains have begun to douse the state with cooling temperatures. One of my favorite things to do is just sit and listen to the simple beauty of a tropical rain (especially when there's a brownout). It’s the sound of an end and a new beginning, one of tranquility and rejuvenation at the same time.

    Brownouts: India is one of the top countries in the world that suffers from persistent brownouts (which severely hinders productivity and economic progress). So for at least 15 minutes everyday, we are without electricity. Yesterday we lost power for 8+ hours.

o   Being in the dark: When you have brownouts in the middle of the summer, it gets pretty hot, sticky and boring. And sometimes it gets dark – which is fine until you accidentally step on a cricket while barefoot and on your way to the bathroom.

The ubiquitous head wobble

June 9, 2010

Before coming to India, many of my friends told me that within the first couple of days, I would notice the “head wobble” and before leaving Delhi, I would pick it up. Well it’s the funniest thing to me, but it’s a cultural mannerism used all throughout India…so I think I finally got it down.

The Indian head wobble is meant to connote a non-verbal sign of understanding or thinking. It isn’t a nod, nor is it a shake of the head. The motion actually reminds me of a bobblehead – if you lightly touch it on the very top of it’s head and give it a side-to-side push, it starts to wobble a bit from right to left. So the wobble doesn’t always mean “yes”, and it doesn’t always mean “no”…it doesn’t even always mean “maybe.” From what I gather, since it’s kind of a side-to-frontish-side-back-side-to-side, it mostly seems to mean, “I heard you.” So you always have to follow up your wobble with a confirmation question or statement of some sort if you want to clarify something. It’s one of the funniest things.

So if you were to ask me right now, “How’s India?” Here’s my answer:

The Mess Hall

June 9, 2010

Here in Jamshedpur, we don’t have very many commercial plazas or restaurants to go to that are within walking distance. In fact, there aren’t any real food establishments outside our Tata quarters for kilometers. We have to travel by rickshaw to get to the nearest full market (meaning one with at least one reputable café or restaurant or retail outlet) which is at least 20 minutes away in the humid heat on unmarked streets, so we usually just don’t venture out. Instead, our group takes part in the meal plan we’ve been given.

So it’s just like we’re back at college, living in a large dormitory with a pre-purchased meal plan. The only difference is that with this meal plan, each meal that is served is pre-planned (so that you only have 2 choices) and set at company-dictated times. Breakfast, lunch, snack, and dinner are all scheduled by Tata, so we have 2.5 hour windows in which we can avail of the dish(es) that are available for a meal…however, we don’t really get to choose what we want to eat from the menu; instead, we serve ourselves from the giant bowls that they place in front of us at the tables.

This isn’t a bad thing considering the fact that we get a pretty assorted menu of meals throughout the week – however, most of the foods we eat consist of a combination of rice, potatoes, chapatti (or roti), and dal (lentils which can be cooked a zillion different ways). And sometimes these 4 things are the only things served for dinner. There aren’t very many vegetables included, hardly anything fresh, there’s lots of fried snacks, and I think I’ve only seen one fruit – mango made into a chutney – since getting here over a week ago. The dishes are pretty tasty once you get used to the spices, but my low-carb, weight loss diet is now somewhat out the window.

It’s customary to eat with your hands here. However, you really only eat with your right hand, as your left hand is considered dirty. So to “blend in” as much as we can, our group of women clad in colorful American clothing, in a mess hall of usually 30+ men uniformed in blue Tata attire, eat with our right hands. It’s a pretty funny sight to see…four foreign ladies in a mess hall of mostly men; men who have (thus far) been too shy (or disinterested) to talk to us. So at every meal, we talk amongst ourselves. We’re like the random roadblock that gets in the way of worker ants, so they just carry on by going around us, not noticing that the roadblock is even there – although one ant gets curious from time to time and crawls over. But then he learns that we aren’t as interesting as he thought, so he folds back into the flow.

We have made a few women friends here in the hostel through the mess hall though, so it’s been an interestingly central part of our experience so far. We’ve learned that although pretty much everyone in this hall is single, both genders hardly interact with each other because it just isn’t the norm or custom here. [No wonder they aren't allowed to televise kissing.] 

Becoming a “Tata Princess”

June 4, 2010

My research group of four women is stationed in the city of Jamshedpur, in the district of East Singhbhum, in the state of Jharkhand in northeast India. We’ve been given more details about our task, so we are mapping and assessing the social exclusion of tribal communities into a government-run program called the Integrated Child Development Scheme (ICDS). ICDS is arguably the largest government-run child development program in the world, and since it started in the 70’s, it has helped to raise India’s child health indicators so that the country is coming close to achieving the 2015 Millennium Development Goals set forth by the United Nations.

The ICDS program is currently being implemented at several different levels across the country, and it receives major support in Jharkhand from UNICEF and some support from the Tata Corporation. For those of you who are unfamiliar with Tata, they are one of the world’s largest steel and car manufacturers. As an industry giant, the company recently unveiled the world’s smallest car called the Nano, and they bought out Jaguar and Land Rover. Everyone here in India knows the Tata brand, and they have several major factories here in Jharkhand. Tata has a big corporate social responsibility (CSR) department, which focuses on giving back to the community through the areas of health, agriculture, and water and sanitation.

Our group is being hosted by Tata’s CSR arm, so we have been charged to work in tandem with UNICEF, the Government of India (which is the main implementer of the ICDS program), and PKS (the Family Welfare Center which is the main health center of the Tata CSR projects) to provide a comprehensive assessment on the ICDS program’s nutrition strategies. Since our host institution is one of the biggest corporations in India (and worldwide), we have been given some quite surprising accommodations here at our site.

Coming to India, I thought I would have to sleep with ice water bottles next to me in a cot draped in mosquito netting in a tiny-sized hostel to battle the exhausting heat and malaria in the region. However, my roommate and I have actually been granted a beautiful air conditioner and cal-King sized bed, ceiling fans, a sitting area, a 27” TV, a desk, large closet space, a powder/changing room with fan and sitting area, and a big blue-tiled bathroom with a fancy toilet here at the Tata “hostel.” Our rooms are cleaned every day, and we don’t have to buy our own toilet paper. Our group also has a large, cold filtered water system just outside our door, so that we don’t have to purchase mineral water daily. Instead, we can just fill up our water bottles as we please because Tata wanted to make sure that everyone at this hostel had clean water to drink.

One of the reasons why this hostel has some of the cleanest filtered water in Southeast Asia is the fact that this is a Tata establishment through and through. This hostel that we’re in actually houses over 160 of its engineers who work at the nearby manufacturing plant. That’s right, there are about 160 bachelors in our hostel, and some women (though I have yet to count more than four so far). We learned over dinner conversation in the Mess Hall [cafeteria] today that these recent college grads who choose to work with Tata are given the option to live here if they have no other reasonable accommodations nearby, and only 30% of their salary is deducted for living expenses. Food is charged separately. They work seven days a week, for at least 8.5 hours a day, with only eight paid holidays off. The assistant manager I spoke to earlier had worked 20 days straight so far. It’s a completely different culture, and another guy had told me that it’s fine right now because they were told that the industry is booming…and all this hard work means that everyone is going to get a promotion soon.

Some of you may be wondering, “How are you four women safe in an environment with 160+ bachelors?!” That’s easy --- we just pretend we’re on the Indian version of the TV show, the Bachelorette. We hold rose ceremonies every evening. Just kidding… Our host institution believes this is the most safe and comfortable environment available for us in the area. We actually have guards about 50 feet away from our door (literally). Also, the people here who know the kind of work we’re in Jharkhand for, give us a lot of praise and respect for wanting to help the local children. So it’s a really neat (and clean!) situation, which is probably one of the most comfortable, secure ones to be placed in when compared to all of the other sites assigned for our program. We even have transportation arranged for us for home-office commutes. This isn’t the India that I imagined, but I’m not complaining. It’s like a working vacation so far, which is fine because we’ve been told that we’ll be working in the office six days a week. Tata, relatively speaking, thank you for treating us like princesses. Next time though, can we have a Jaguar when we head out to our site visits?

The Research Program

June 2, 2010

(Yes, this one is delayed too)

Before I left the US for India, I thought to myself, “What the heck am I doing? Why am I leaving an amazing city like New York where I have a fantastic circle of people who love me, for a city half way across the world where I don’t know anyone at all?”

I wasn’t provided very many details on my program other than the fact that I was going to work with UNICEF, and that I was going to do research in child health for them in rural India. The rest of my project was pretty vague, and I was a little nervous about traveling solo to a country I had never been to before. So as my departure date grew closer and closer, anyone who found out that I was going to Delhi for the summer compounded my anxiety with questions like, “Are you kidding? Do you know how hot it is over there?” and/or “Why exactly are you doing this?”

I started my program 2 days ago (at the time that I am writing this), and I am beginning to remember what passion for a career really feels like. I’m surrounded by some really amazing people – post-graduate students from 37 different universities all around the world who have accomplished some really admirable feats such as: establishing sanitation facilities for rural villages in other developing countries, teaching in Tibet for three years without running water or electricity to provide more sustainable futures for nomadic kids, and serving in the Peace Corps in Africa and South America. It’s pretty amazing to hear how the humanitarian heart can move mountains. And it’s such a blessing to be able to share in the same spirit of compassion to ignite my own career flame.

I met with several organization heads today, one of whom was the Chief of Child Development and Nutrition for UNICEF’s India regional office. He likened this health development internship in India to a finance internship on Wall Street. So India is my new Wall Street.

I’m headed east on Wall Street though, to the state of Jharkhand. Jharkhand isn’t covered in any of the Lonely Planet or Frommer’s travel books because “this area is not included since there is nothing for tourists here.” The state is off the beaten path. There aren’t any tourist sights there because the area is mostly covered in farmlands and forests. So we’re supposedly in for a pretty interesting experience. We’ll be staying at a hostel in the city of East Singhbhum, where we’ll hopefully be able to find the so-called “Little Italy” of the area (which is apparently the one and only real restaurant of the town). But I’m not disappointed in the location placement, because the real sight for us to see in Jharkhand is the evidence that the state has the second highest rate of malnourished children in the country. 

Post #2: What is India like?

May 31, 2010

(Posted much later due to scarce availability of internet access)

For those of you who have never been to India before, Delhi is like Manila. For those of you who have never been to Manila before, it’s humid and terribly hot.

It’s summertime in India, which means that the heat blisters in Delhi at about 89-114 degrees Fahrenheit. But it’s hard to gauge the heat just by looking outdoors because of the perpetual dusty haze that coats the air. The sky is void of any trace of blue color, and there is hardly any breeze to cool you off. Summertime is really only bearable in the shade and indoors…otherwise you’re best off carrying around an umbrella and ten billion gallons of water with you.

The people here are very friendly (usually), and they’re all pretty nice. I’ve been to markets and malls, restaurants and business centers, and they’ve all been very helpful. But one thing I should mention here is the fact that women in Delhi dress very conservatively, so I do as well. Sometimes I think I am treated better or receive lots of odd stares because I’m obviously a foreigner and obviously a woman; but I like to think that isn’t always the case. That said, despite my ability to attract odd attention and have random people ask for photographs with me, things move slower than molasses here. There are no “special circumstances” to move processes along faster for anyone in Delhi, and they’re quite unorganized (hence they’re still a “developing nation”). No one queues unless they absolutely have to, restaurants will move at their own pace (unless you’re paying top dollar), and business centers…good luck (unless you’re in IT).

Delhi is a city of vivid contrasts. From the beautiful and brilliant colors of women’s saris juxtaposed against the dry, dull dirt of the unfinished roads; to the sharp, biting tastes of sour, spicy, and sweet Delhi foods; to the massive inequities that divide the poor and rich classes, the city provides quite a sensory overload to the first-time tourist. But it is an amazing culture with so much to offer…I know I’m only discovering the beginnings of India right now…

And it begins again…

May 30, 2010

(Published much later because of difficulty finding internet access)

For those of you who followed my blog last summer, you traveled across the world with me to countries such as South Africa and Italy. It was such a fantastic adventure and the experience of a lifetime. Well I have been bit pretty hard by the travel bug, and I have become incredibly blessed with another opportunity to circumnavigate the globe this summer – this time in the opposite direction.

Although there aren’t as many stops on this trip as there were last year, this international adventure promises to be a very interesting one. Right now, I’m headed to India with UNICEF (I’m literally writing this on the plane) to take part in post-graduate research exploring the child health in tribal communities under the Integrated Child Development Scheme of India. I’ve been stationed in Jamshedpur in Jharkhand, which is in the northeastern part of India.

I’ve never been to India before, but I’ve always had an interest in the country. Why? Firstly, because it’s the most populated country in the world next to China. With over 1 billion people in such a small space, India is jam-packed with exemplary public health case studies. For example, India is where major cataract surgery camps helped thousands of poor communities see again, and where innovative models of small birthing clinics across rural areas have helped reduce maternal and infant mortality.  So India is a fantastic place to continue gaining and diversifying my fieldwork as a public health practitioner. Secondly, India is an emerging superpower. If you haven’t already heard this, you may as well have been living in a cave. The implications are enormous. Super-power. Thirdly, why not? We all loved Slumdog Millionaire, didn’t we? Jai-ho!

I’ve been incredibly busy over the last few months with work and school, so I haven’t exactly had much time to prepare, let alone get excited for this trip. So when I got to the airport earlier today, I had to pinch myself to realize what was going on. Well, that and I needed a distraction because some kid vomited in the ticketing area. But I was reminded that everything really does fall into place when I started chatting with my seatmate on the plane. The gentleman next to me actually worked with UNICEF India for 5 years, and he is currently working toward his PhD in Health Communications at a very reputable University in the US. He gave me some great advice on the research program that I’m about to experience, and he shared his optimism on the field of health communications for my future career. It was a perfect start to a quest that will hopefully help me define a fruitful and fulfilling career path.

So it has begun…post-grad life, my trip to India, and a new adventure around the world. 

The End, and a New Beginning

I've circled the world and I've met a lot of people so far on this trip - people of all ages, races, customs, religions, hair color, eye color, whatever have you. It's been quite a fantastic experience being able to glimpse into the lives and perspectives of such a variety of individuals and cultures.

One thing that I am quite happy to have discovered (or maybe just confirmed) on this trip is that there are still a lot of good people in the world. The media sometimes makes it seem as though there are horrors waiting for us outside our front doors - and of course, safety is always something that I have been aware that I need to keep in check. That's something that shouldn't be compromised, so I still carry mace around with me. Growing up as a first generation Asian American, there are a lot of cultural sensitivities to safety and discrimination that I have engrained into the back of my mind too...just a tad bit more than "stranger danger." So being able to dispel some of these notions has been quite uplifting. There is an innate good in humankind. And there are more things that bring us together, make us similar people across these continents, than what makes us different. You can feel it within the vibes of many people. You can see it in their smiles. You can feel it within their handshakes.

The spirit of the humankind in its most raw form is one that is transformative. It is founded upon something mysteriously divine, encircled with love, and has the power to affect others - whether its a simple demeanor change, an entire career change, or a total life choice change. It's a common denominator, yet we view it just as we do beauty - in the eye of the beholder.

This thing about "finding you," or really, "finding me" has become another interesting matter that I've pondered more than several times throughout my trip (hey, what else am I supposed to do through all of the transit times I've had?). One of the reasons I wanted to go on this around the world trip was to get back to my roots and find "me." I've realized that I'm a first generation Asian American who is navigating between the push and pull of opposite cultures - someone who is still figuring out where I am on all of the sliding scales of life. But I've also discovered ways to embrace my history, my accomplishments, my independence, and the strength and confidence I have as a  Filipina. I know that I still have a lot of potential ahead, but I've figured out that I don't need to search far and wide. I can keep my feet on the ground and run at the best, steady pace that I can. I don't need to win the race, in fact, I don't even need to be on the same course as anyone else. I just need to make sure that every step on this journey counts.

Peace, Love, and Wanderlust.

The Food Meter

Food. An extremely important character-building reference of a culture. I tried to make sure that I had "native" or "known" foods in each major city that I went to (without gaining 100 pounds), and have decided to commemorate their savory deliciousness with a meter of praise.

Here they are, best to worst (well not exactly "worst" but just, "I might not eat it again if I don't have to):

the Big Rig pasta and Pizzookie - Oregano's (Phoenix)

Fresh mangoes - almost anywhere (Manila)

Dad's home cooked food - Home (Manila)

GELATO - almost anywhere (Rome, Cinque Terre)

Chocolate Chip Cookies & Coconut Chocolate Chip Cookies - Paradise Bakery (Phoenix)

Macaroons - Lauderee (Paris)

Pesto & Gnocchi, Mussels - Ciak (Cinque Terre)

Pasta - practically anywhere (Cinque Terre)

Mozzarella (in Caprese salad) & Bufalo mozzarella- almost anywhere (Rome)

Grilled Prawns with dipping sauces - Theo's (Cape Town)

Carpaccio with arugula - Max's home cooked food (Rome)

Lime sorbet (after dinner dessert) - the pizza place down the street from Max & Chato's (Rome)

Really creamy ice cream - somewhere in Bath (Bath)

Pork & apple sausage - the fine sausage shop that I can't remember the name of (Bath) [with Kara's couscous, of course]

Zimbabwean Chicken - Mama Africa (Cape Town)

Pizza - almost anywhere (Cinque Terre)

Mango Bravo cake - Conti's (Manila)

Grilled Calamari - Ocean Basket (Cape Town)

Lobster Spaghetti - the restaurant with the star lanterns (Cinque Terre)

Chocolate Soufle - Vin & Maree (Paris)

Prawn Curry - Bo Kaap Koumbis (Cape Town)

Banana crunch cake - Red Ribbon (Manila)

Cappuccini - almost anywhere (Rome)

Macaroons  - Pierre Hermes (Paris)

Hummus - Hotel Intercontinental (Dubai)

Hotel buffet breakfast - Hotel Margherita (Cinque Terre)

Cheese Grillers - Finest Sausage stall in St. George's Square (Cape Town)

Creme Brulee - the Amelie Restaurant (Paris)

Boerewors - street stalls (Cape Town)

Malva Pudding - Bo Kaap Koumbis (Cape Town)

Sourdough Bread Bowl with Clam Chowder (San Francisco)

Tacos -- Mexican Food almost anywhere (Phoenix)

Frosty (Friday's) - Wendy's (Phoenix)

Fish & chips - practically anywhere (London)

Cream tea & scones with salted butter and jam (Bath)

Chicken pasty - most snack shops and Cornwall's (London)

Escargot - Vin & Maree (Paris)

Limoncello - almost anywhere (Cinque Terre)

Never go jeans shopping on vacation

Never. Well, unless you've soiled your only pair of jeans on your trip. Shopping for the right pair of jeans is a pretty interesting challenge in itself, but adding on the trouble of figuring out your size in a foreign country while converting the currency rate, in addition to realizing just how many vacation pounds you've packed on during your holiday (while there is a great Benetton sale that you want to try to make the most out of but just can't) is depressing.

Note to self: stick with dresses.

Transit Notes

Backtracking a little....The commute from Parma to Paris - London St. Pancreas - London Paddington - Bristol...

Parma to Paris was just awful. We took the night train which left at almost midnight, due to arrive in Paris around 915am. The air-conditioners weren't working, I was fighting clausterphobia in the humid and rancid-BO stinking cabin, and we arrived in Paris 2 hours late (without explanation...or maybe there was one, but I didn't understand it because it was in French). I know I blogged a little bit about this already before but I am repeating it to make a point.

In Paris, I showed up at the terminal, at the Eurostar counter, to collect my pre-purchased ticket from Paris to London. I asked if I could just get a train ticket from London to Bristol, and the Eurostar agent happily told me yes. So she gave me an insanely expensive roundtrip ticket -- which I just paid for because I didn't want to lug my bags around from train to tube to bus to bus. So I enjoyed the Paris to London trip because the three hour Eurostar ride was quite nice. They even serve you a gourmet meal complete with balsamic oil and vinegar as well as alcoholic beverages in recyclable bottles. It was better than airplane meals.

London St. Pancreas to London Paddington was fine -- I figured out the tube (subway) okay with a bit of information desk help. But then London Paddington to Bristol was weird. I found my train okay - after I was told that it was leaving in 2 minutes and I sprinted to catch it, I took whatever seat I could find on the car that the conductor scooted me into. Halfway into the ride when tickets were being checked, I was told I was on the wrong car. I was actually carrying a first class ticket (no wonder they were so expensive!)...so I got moved to first class. It wasn't worth it because it was only half the ride there. It was like I paid 50 pounds for a bottle of water and a newspaper. So I am crossing my fingers that SNCF will refund me for my unused return ticket - because I bought a MUCH cheaper one instead.