Five Cups of Tea Per Day Should Give You a Caffeine Addiction

So tomorrow officially concludes my first week in Jamkhed, a rural town around 8.5 hours outside of Mumbai but still packed with people. It is actually much bigger than I expected, with a nicely-sized market/town area and men hanging around everywhere (employment is not too high).
The program I am working with is called the Community Rural Health Project (more info on Jamkhed and CRHP can be found on their website here) started by two Indian doctors in the late 1970’s to bring health to the poorest of the poor. What they have succeeded in doing over the last 30 years is to create a health system that capitalizes on the innate strengths of the village that, among other things, has reduced the infant mortality rate from 176 per 1000 to 19 per 1000 births.

Much of my last week has been dedicated to visiting project villages where the health model has been established outside of Jamkhed with the mobile health team. Traveling to these villages is an awesome experience, as I see that really it is not doctors who are needed to affect health but rather health activists. As Doctor Arole pointed out, the three biggest challenges that villages face for sufficient health are:
1) Nutrition. With the limited amount of money the villagers have, most of it is spent on carbohydrates, which gets a bigger bang for your buck. Protein is much harder to get, compounded by the fact that cows are rarely killed for their meat and most people are vegetarian anyway. Thereby, many of the villagers have Zinc, Iron and Vitamin A deficiencies.
2) Environment. In the villages, many of the trees are cut down, the water is dirty and standing, and the air is polluted. Houses are also not built for living in but rather for cooking, storage and animal shelter. There were also no toilets and people would defecate outside their homes and on the roads. Because of this, water spread so much disease and was a source for many mosquito-borne illnesses.
3) Traditions. Women and children were considered lower-class citizens and would not be given rights or freedom (even today, women cannot enter a liquor store), and the fate of one usually directly affects the fate of the other. Medicine was controlled by voodoo healers (charging outrageous prices) and disease was a curse of the Gods, who in turn demanded sacrifices, prayer but no treatment.
So what CRHP has done is demystify everything (esp. medicine) and educate everyone (esp. women). By first empowering village health workers (1-2 women per community, at times illiterate, who were nominated by the community) to take the lead in learning about health maintenance and then educate their community, they have successfully transformed the health of over 50 neighboring villages. Presently, there is relatively no malaria, no diarrheal diseases, zero malnutrition, little tuberculosis, and the caste system is non-existant. Women literally run the village and run it better than before; to hear them speak about their condition 25 years ago is really inspiring.

Travelling to the villages is also a fun experience because, by this point, I have begun to get accustomed to being blatantly stared at wherever I go. There is no modesty here, as people will look at me with a face of sheer confusion and wonder, even when I look at them and ask if everything is all right. It feels as though I’m on the endangered species list and everyone wants to catch a glimpse while they can. Word also travels really fast. Yesterday Wout (a Dutch doctor who’s also at CRHP for a year) and I went to a store to buy shampoo and as we left each store that we passed along the way called out “Shampoo, Shampoo” to us. How they knew we bought shampoo we have no idea but I guess it is now known that white people buy shampoo.

Finally, what’s also fun about going to the villages is the exorbitant amount of tea that we drink. At every house that we stop in, at every conversation, meeting and get-together, tea is given and it is rather rude to decline it. So we drink around 5 cups of tea every day. The tea, though, is made from powder and is drenched with sugar, a symbol of social-status in the village. Thank God the tea is so watered-down otherwise I’d be flying high wherever I go.

So far so good here in Jamkhed. Monday starts the three month training course. They also caught a snake in a female resident’s bathroom yesterday, which is nice. Apparently cobras are everywhere, making falling asleep the most difficult time of the day (the heat helps me, though).

Also, as a side note, National Geographic visited CRHP last month to take pictures of the project and write an article that will be featured in the December edition. Pretty cool and it should be a great fundraising tool. You should check it out.

Be well,

Jeff