27 January 2011

one

"If you can't feed a hundred people,
then feed just one."
~ Mother Teresa





18 January 2011

feeding mohan


In India, there are very clearly defined uses for each hand. The right hand is used for eating. That’s it. Eating. Well, and perhaps writing. Eating and writing. The left hand is the “dirty” hand . . . the hand used when going to the bathroom and after going to the bathroom, instead of toilet paper (which is not used in this culture).

Like many Children in the Orphanage, Mohan has scabies. The wound on his left hand is infected; his fingers are very swollen and hot, causing a great deal of pain. Earlier this week, based on the Doctor’s instructions, we soaked his hand in a bath of hot salt water and then vigorously scrubbed the wound with an antiseptic soap in an effort to push the puss out. Yes, push out the puss. Then John, the Director of the Orphanage, crushed several tablets of Penicillin and asked that I press the fine powder into the open wound. I’m fairly certain that this was an alternative form of Penicillin application as Mohan’s reaction was extremely disturbing. Tears of torture. Misery. The wound was foaming. A memory I’d rather soon forget. Given that Mohan’s left hand is out of commission with the infected scabies wound, his right hand has now become his substitute “dirty” hand, eliminating his eating hand. And so I feed him. Every meal - breakfast, lunch and dinner - with a spoon. Sounds easy enough.

I should preface this post with the fact that eating in the Orphanage is a competitive sport. A race. A sprint. A very serious event. One serving of rice is given to each child at breakfast; however, there are second servings for a lucky few given on a first come first served basis at lunch and dinner. Still, in order to receive seconds their first serving must be finished. Completely finished, no rice remaining on their plate. Mohan is clearly at a disadvantage for a second helping because I am feeding him with a spoon. Poor kid. Not to mention that we’re on the same team, but don’t speak the same language, so there’s no strategy or words shared in this challenge. All of the other Children are shoveling rice into their mouths with their hand and Mohan is at the mercy of me and this tiny aluminum spoon. It’s more like a sword than a spoon. Nothing like the cutlery I’ve experienced in the States. The word spoon carries a blunt connotation and the edges of spoons here are sharp enough to cut fingernails - not joke, I’ve seen it happen.

Spoon-feeding a nine-year old sounds simple enough but don’t be fooled. It carries the intensity of an Orphan’s hunger. He focuses on the spoon, refusing to make eye contact with me and allow the opportunity for an error, a clumsy exchange of rice from spoon to mouth. A split lip. A bleeding tongue. Just as fast as I can fill the spoon, his mouth is open and ready. I’m trying to balance the aluminum plate full of his rice swimming in rasam (broth) in one hand, while filling the spoon and gently hitting his mouth with my other hand. He looks around at the plates of those in line near him and throws me a glance, as if to say hurry Sister. Faster Acca. I’m sweating, feeling the pressure of performing so that this little Fella can have a second helping of rice, hunger pleading in his eyes.

Children are finishing their first serving and beginning to jump up and run towards the huge pot that holds the 60 plus servings of rice. I’m literally chasing single grains of rice around his plate with the spoon, afraid that I’ll miss one and he’ll be turned away from more food. He sees grains remaining and begins urgently pointing, coaching me in the homestretch. Great, hand signals. We catch a rhythm - a pace. One, two, spoon to mouth. Okati, rendu, moodu.  Open mouth. Close mouth. Swallow. Done. He grabs the plate from my hands and runs towards the pot, obviously practiced in the art of keeping all of the remaining rasam on his plate while sliding into line for seconds. He waits, eyes focused on each second serving of rice that meets the plates in front of him. The cook is scraping the pot, not a good sign. I hold my breath and refrain from blinking. I fear I’ve failed him in a most basic way. I don’t know how I’ll meet his eyes if he’s turned away, too late for more food. I’m quite certain they won’t let me substitute my dinner for his second serving. He shifts from one foot to the other. He’s next in line, bordering bliss. I close my eyes and rely on the sound of metal on metal - serving spoon against pot - to signal our success. I open my eyes as he sits back down in front of me with a proud smile on his face. Content. Ready to slowly savor the meal in front of him, the reward for the race we ran.


04 January 2011

living with scabies








Scabies is a contagious skin infection that occurs when microscopic parasites - a type of mite - burrow under the skin and cause intense itching.  Continued itching of the lesion leads to open wounds and in unsanitary conditions, more severe infections.  Living with Scabies is a reality in the Orphanage.  Since my arrival in early November, there have been a handful of new Children with infections each week.  It is quite difficult to watch these young Children suffer through the pain of Scabies and further infections that make walking, sitting, and eating difficult.  There are many tears - for the pain and for the treatments.  Those with Scabies are given a warm water salt bath before standing in their birthday suit to fully dry in the glaring heat of the sun.  This is followed by a (gloved) scrubbing of the infected site with medicated soap.  If there are lesions on their heads - then their heads are sporadically shaved, boys and girls alike.  I've seen girls loose long, waist length locks to the razor.  Minor cases are then dressed with a paste made from Tumeric and water, while the more severe cases require a visit to the Doctor for injections and/or oral prescription medications.  With proper treatment, most of the wounds typically heal within ten days to two weeks . . . Just enough time for more outbreaks (and tears) to surface in other Children. 

28 December 2010

viral fever . . . and a trip to a nursing home!

My little hospital bed in the corner of the "Nursing Home" (Hospital) waiting room. 
Don't worry Momma, I'm still alive and well!

The Hospital Pharmacy - love the organization!

Some of the Hospital Staff who helped care for me . . .

Nalini, my favorite Nurse.  Such an Angel!

Wednesday December 15th started like every other day in the Orphanage - my alarm went off at 5:15 am and I quickly got dressed before heading to the Children’s rooms to wake them for morning exercises and stretching. The sky was still dark and the Muslim’s Salah (prayers), broadcast from an old school communication tower, echoed throughout the village. I love this time of day - it always feels like the eye of the storm in the Orphanage; the precious quiet before the eruption of energy awakes. I typically step outside for a few minutes to gaze at the sky, watch the moon descend towards the river and revel in the stillness of my surroundings, acknowledging all of the potential that lies ahead in the day that I am about to gently wake.

The Children were slow to rise. It’s their winter here and though there is no snow the average temperature at night in December is 18°C (65°F), a significant drop from their summer temperatures which easily exceed 42°C (108°F). They do not have sweaters, warm clothes or proper blankets to withstand the season and as a result spend winter nights curled into the biggest ball of kids I’ve ever seen. They’re like little sardines packed into each small room – elbow to elbow, backs to fronts, heads to feet, spooning - each Child trying to gather energy from the person above them, on either side of them, and below them. I try to wake them each by name – as I now know all of their names (no small feat) – but I’ve come to realize that Orphans can sleep through anything: sibling fights, loud obnoxious music, train wrecks, cyclones. Several of the older boys bang pots against pans next to the ear of their sleeping brothers to wake them in the morning – and still no response. The last few sleepers usually have to be lifted to their feet before they grudgingly open their eyes.

I started to feel strange when I was leading the Children in morning exercises. Just not quite right. My body felt weak – stiff and clumsy – and I had a headache. I tried to shake it off – mind over matter – but couldn’t quite get my footing for the day. After the previous week’s cyclone, fevers and colds were being passed around our encampment and I was nervous that I had caught something. I spent the rest of the day drinking lots of water but remaining pretty quiet about my concerns as Sravanthi was admitted to the hospital to be induced and I did not want to trouble my hosts during the delivery of their precious baby.

That mindset drastically changed at approximately 1:15 am on Thursday. I woke with an atrocious headache, chills, and body aches. Something was wrong, really wrong. Initially I tried to tough it out on my own until later in the morning. I figured the first adult would rise, find the Children running wild, and inquire why I hadn’t conducted my morning duties. So I waited in the dark for two and half hours on my cot – praying for relief - until I couldn’t wait another hour, let alone four. Umm, four hours, negative. Bad idea. Time for Plan B. I called Ry. Brilliant . . . because he could do so much to help me from his office in Minnesota. Clearly I wasn’t thinking straight. He convinced me to call Sravanthi’s Father, Prem, and tell him I was sick. From what I can remember, the call to Prem was brief. I said that I was really ill and needed to see a doctor, he said that he would be by the Home to pick me up between 5:30 and 6 am and take me to the hospital. Super. So I waited.

Forgive me, the rest of the details come in pieces – moments of crystal clarity and heavy haze. Sometime around 8 am patience left me. Prem hadn’t come and I was still in agony. Moving my head or turning my eyes to look around the room caused my brain in pound in pain. I was very nauseous and certain that I had a high fever. Ok, Plan C. Usually there are a few adults around at any given time, but everyone was at the hospital with Sravanthi so I called Billy Graham, John Samuel’s younger brother, in Bangalore. Eight hours away. An improvement, getting closer geographically. Billy speaks excellent English and quickly recognized the desperation in my voice. He made a few calls and immediately sent Prem and John Samuel to pick me up from the Home and take me to the hospital.

The car ride killed my head. Every bump sent black spots across my vision. I felt as though my brain was no longer attached to my skull – as if it was loose inside my head, sloshing around. Punch in a bowl. I was quite surprised when we pulled into Sravanthi’s maternity clinic - not exactly the hospital I was anticipating. They insisted that I come upstairs to see a doctor who could help me. As I’ve learned so well, some things are not worth arguing over in India. The shortest distance from A to C, in India, is through B. The Pythagorean Theorem is not applicable here. If you acknowledge and endure their direction, you will arrive at your favored or preferred destination more quickly and without a shouting match. Should you choose to challenge their commands, it will only delay the process. Best to accept and submit. (This is where you think that I should insist on being brought to a hospital where they can actually care for me . . . Hold tight, there is a fine art to getting your way in India.) Upstairs, I suffered through a nearly wordless visit with Sravanthi and with closed eyes continued to request a doctor. They responded that I could see the Gynecologist shortly. No. Negative. A Gynecologist wasn’t going to help. This was not a female problem. I explained to them the domain of the Gynecologist and asked to be taken to another doctor. No resistance. They agreed.

We visited the second doctor in his home as I was told his shift at the hospital had yet to begin. It was a nice home. Clean, orderly. He was a nice man. Good smile. Concerned demeanor. Prem and John rattled off my list of complaints in Telugu and the doctor concluded that I was suffering from a change in climate – the shifting of the seasons. He didn’t take my temperature. No blood work. He offered to give me an injection to take away the pain. Nope. Not buying it. In-home Indian injection, no thank you. We left with pain tablets and two very different opinions. Prem and John both seemed relieved with the diagnosis – headache due to change in climate. Done. Problem solved. Swell. I, on the other hand, knew that I needed to continue my plea, but with two additional key words: I need to see an English-speaking doctor in a hospital. Still, I knew it would be several hours before this new appeal was heard.

Trusting – with a capital T – I took the pain tablets as ordered with boiled buttermilk, a banana, and white bread before returning to the Home to take to my cot in an attempt to sleep off my symptoms. I woke shortly after 6:30 pm – nothing had changed. In fact, things were worse. I felt like I was on fire. Burning. And I knew if I drank water I would vomit. The headache was still crushing. I tried to recall the specifics of the travel insurance policy I purchased before I left. Malaria? Meningitis? Emergency flight? I tried to get up to go get John Samuel and things started to go black, so I laid back down and calmly accepted that there was only one thing left to do. Shout. I began shouting. And I continued shouting as they put me in the car with a puke bucket. John Samuel suggested that I brush my hair and wash my face first. I refused. English-speaking doctor. Now. No waiting. Hospital.

I am sure you can imagine my frustration when we pulled up to a building with signage declaring Nursing Home. Sadly, I was too weak from shouting to protest. Three people walked me toward the entrance. I sat on a bench with my puke bucket as my situation was explained in rapid Telugu to the receptionist at the front desk. Though the sign said Nursing Home, the line of people waiting around the outside of the building suggested that all ages were treated here. Within a few moments there was a flutter of people around me – Nurses. Bliss! I was shown, ahead of dozens in line, to a single hospital cot in the corner of the waiting room where I could lay down until the doctor came. Someone was taking my temperature. Good start. Another person put a cold rag on my head. My blood pressure was checked. Someone was holding my hand. I felt a stethoscope. Familiarity. I couldn’t understand what was being said – just simply that a lot was being said. I felt their urgency and I was grateful. Somewhere in there I asked for my Indian mobile phone and called my Momma. I had yet to speak to her since I had become sick as I was trying to avoid alarming her. She’s a little tense about me being in India and I didn’t want to get her worked up for no reason . . . but it was time. When people started saying the M word - Malaria - I needed her to know what was happening. I should have figured that she already knew I was sick as she keeps in close contact with Ry. She was remarkably calm on the phone - reassuring and positive - likely saving her angst for my father, brothers, and anyone who would listen in the States.

Finally the doctor came to see me. A gentle Hindu man with a soft-spoken voice. I wanted to kneel to kiss his feet and bow my head in honor when he opened his mouth and English came out. All I could muster was “please help me”. And he did. He gave me pain medicine for my 103°F fever and massive headache, which I immediately vomited into the bucket next to my bed. This triggered the pukes and it took awhile for me to stop. I kept going until there wasn’t anything left for me to vomit. I was empty; done. All of this in front of an Indian audience - a waiting room full of patients and their families - staring at the sick white woman in the corner of the room. Rounds of blood tests were ordered. An IV pic was placed in my right arm and fluids were administered for several hours. I loosely remember stirring at different times throughout the night as I was given multiple mysterious injections. Each time the nurse would prep my pic for another injection I would call for John and question the nature of the injection. Pain medicine to alleviate the headache. Medicine to fight the fever. Medicine to curb the vomiting. I was discharged later that night with various prescriptions, what seemed like handfuls of pills, and orders to return each morning for the next four days to receive additional injections and fluids.

Thankfully, by God’s grace, it was only a viral fever. Something like a bad case of the flu. Not Malaria, not Typhoid Fever, not Meningitis. Still, my initiation to illness in Indian was harsh. Fifteen hours to get help. Boiled buttermilk. Three doctors. A Gynecologist. A Nursing Home. Communal vomiting. Mystery gloveless injections. Almost two weeks later, I am still weak and trying to regain the strength and certainty I felt before the virus found me. But there is no time off from the Children. The sun rises and another days starts - time to wake, stretch, brush, bathe, and feed my young brothers and sisters. This is life in India. Ruthless and raw, it waits for no one to recover.




25 December 2010

all they want for christmas


Christmas Wish List
~ 51 Children ~

  1. School Bags
  2. Sweaters
  3. Blankets
  4. Pillows
  5. Towels
  6. Bibles
  7. Chocolates
  8. Toothbrushes
  9. Tongue Scrapers
  10. Sports Equipment
  11. Pencils (4) & Erasers (1)
  12. Red & Blue Pens (3)
  13. Pencil Boxes
  14. Girls – Bangles & Earrings
  15. Boys – Caps & Watches
  16. Sleeping Mats - 17 Total
  17. Iron Boxes for Storage of Clothes – 33      


22 December 2010

cyclone season



A cyclone (hurricane) hit southeastern India in early December . . . my first cyclone since living in the Orphanage started late on a Tuesday night and didn't conclude until Thursday night.  Sheets of rain and significant flooding.  I felt like I needed to build an Ark - I've never seen so much rain.  Water was everywhere.  The house was like a massive Slip 'N Slide - everything was wet.  Even the things that were supposedly dry were wet.  Blankets, towels, clothes in my bag - even a package of mints, enclosed in their wrapper and dry on my shelf, completely dissolved.  Bizarre.  I've never witnessed such saturation.  The Children are soaked - wet hair and clothes around the clock.  And everything smells like urine.  Momma, I feel like this is my payback for begging you not to work in a nursing home when I was little because I hated how they smelled like urine.  Forget working in a place that smells like urine - I live in a place that is rank with the smell of urine.  And I love it.  Crazy?!  Despite the rain, I continued with my regular routine of waking the Children at 5:30 am, leading stretching and exercises (inside due to the rain), and getting the Children to brush their teeth before giving cup baths to all 51 Children in the rain.  WET!  And cold.  I feel badly for the Children.  They were shivering - no jackets, no sweaters.  Literally drenched and huddling together for warmth.  Made me feel extremely guilty to have a sweatshirt, fleece jacket and rain poncho on . . . Several of them now have colds - green snot coming from their noses and ears (this is new to me - I've never seen green snot drip from ears before), many have fevers from being in the cold rain, a handful have infected feet from walking around in water and the blisters / open wounds that resulted.  Still, the village is in worse shape.  More than 40 died - including 12 that drown in the River that runs through town.  The rice crops are shot and there is now mud everywhere.  It really felt like camping in the rain with 51 Children.  An experience!