What makes you "talkative as a parrot and as cunning as a jackal, then roar and fight like a tiger only to end up rolling in the gutter like a pig?"

The metal trash bin was half-filled with jogri (sugar cane juice) when it was covered with a lid and put over a fire. A tube was stuck into the bin around two-thirds of the way up, connected within the bin to a metal plate that condensed the evaporated gas into liquid when water was poured on top. The liquid flowed from the plate, down the tube, into plastic bins and eventually into a glass exchanged for ten rupees (20 cents), and finally into the mouths of what seems to be the majority of the men in Indiranagar.

Alcohol-making is a job usually done by tribal groups and it is no different in the slum area across the street from CRHP. Tribals had settled in some years back and found that selling alcohol to locals was very profitable. As the villagers began to drink nightly, they wanted something that would hit them harder, that would continually take them to a place further from where they were. In response, alcohol-makers began to put all sorts of things into the alcohol to make it more potent – battery acid, trash, detergent. This local brew of alcohol, or moonshine, is very popular among drinkers, who prefer the low cost and high return to the manufactured alcohol available in town at shops, which goes for 80 rupees per bottle. One glass of this moonshine would seem to suffice for one hell of a night for a typical man, but through conversations with villagers I have found that most drink up to six glasses per day, including in the morning.

In the district of Gadchiroli, however, with the highest ratio of tribals to non-tribals in the state of Maharashtra, it has been illegal to sell any form of alcohol since 1996. A pre-ban survey from the early 90s showed that about 100,000 males in the district were frequent drinkers, 10,000 were addicts and a surprisingly high number died of alcohol-related consequences. In addition, annual sale of liquor in the district was about 200 million rupees while the government’s total annual support for all district development programs was 140 million rupees.

This survey and the subsequent community-based movement to ban alcohol were mobilized by SEARCH (Society for Education, Action and Research in Community Health), a voluntary organization started by Drs. Abhay and Rani Bang in 1986 to provide community care and conduct research on the health of women and children. SEARCH served as my last stop after visiting Sevagram.

The anti-alcohol campaign started through village-level meetings with women and youth to discuss health problems, which elucidated the destruction of lives due to alcohol addiction. Men got drunk, did not go to work, failed to support their families, beat their wives, quarreled, fought and even killed each other. Practically all women seemed to have suffered due to alcoholism among men. Many of the men did not disagree, they just didn’t have the power to stop. Using this high community interest among women and youth, SEARCH mobilized villagers to collect data on the problem and then bring it back to each village to see the response.

As awareness grew, boys in two village youth groups organized a ban on liquor – alcohol stores were closed, bottles were broken, drunks were fined. To bring the movement to scale, SEARCH helped to organize 349 villages to pass resolutions to ban all liquor. Anti-alcohol groups sprang up, including a district-level Darumukti Sangathana (Liberation from Liquor). Making of moonshine stopped but manufactured liquor shops stayed open, invariably owned by local politicians making good money. The people decided they could no longer depend on the government to control alcohol so they partnered with local experts and honest officials to start the People’s Liberation from Alcohol coalition. In 1992, they presented an anti-alcohol resolution supported by 10,000 delegates from more than six hundred villages. In 1996, the state government finally banned the sale of alcohol in Gadchiroli, banning locally-made alcohol and closing all commercial liquor shops. Follow up surveys showed that within two years alcohol consumption was 60% less than it had been before the ban.

There are multiple things that really impress me about SEARCH’s anti-alcohol work. Alcohol was a problem identified by the villagers as something that needed to be addressed and Abhay and Rani Bang took it on full-steam, regardless of if it was a problem they identified. Despite the fact that taboo associated with alcoholism and despite the numerous death threats and jailings they had to endure, they pushed on for the benefit of the community. The purpose of the movement was much larger than their reputation and they were willing to put it all at stake for the benefit of the village. In addition, although alcohol has been banned, they recognize that the problem is not solved and that alcohol can still be snuck in or made under cover. To continue to help addicts who want to quit, they run five-day deaddiction camps with detox in the villages themselves, helping people combat alcohol and/or tobacco addictions. The fact that men attend camps in their own village shows the alcohol-associated stigma has been overcome.

Visiting SEARCH and their deaddiction camp also reinforced a desire to understand the scope of addiction and alcohol abuse in the slum area across from CRHP. Along with a staff member familiar with Indiranagar and the local village health worker, we have begun a survey measuring hypertension, tobacco use, alcohol use and diet among all men in the village. Although going into the survey there was a lot of doubt as to the comfort of men to discuss alcohol, we have so far found that (similar to Gadchiroli) men recognize it is a problem and want to quit, but they just do not know how.

Unrelated, I have posted many new photos onto Webshots if you would like to take a look. Click Here to see them.

Even so, 95% of graduates return to an urban practice or hospital

Sevagram, Service Village in Hindi, is a village 12 hours away from Jamkhed. The village served as Gandhi’s ashram beginning in 1936 and also plays host to the Mahatma Gandhi Institute of Medical Science, where I visited after Kanha to learn about the Department of Community Medicine. The department is doing great work on two fronts: first in motivating and encouraging medical students to practice in more rural areas, not only by force but also inspiration, and second by working to build the capacity of the village through CRHP-similar methods. Both these endeavors breathe of Gandhi’s hope for India, and even more his message for Sevagram. In 1945 Gandhi asked Dr. Sushila Nayar to begin a clinic for small infants and women in the village, in hopes of training village health workers and empowering the common Indian village to deal with the core health problems disproportionately affecting the rural population.

The reality is that India graduates roughly 30,000 doctors per year¹ yet hardly any can be found practicing in rural areas, all choosing urban centers instead. To try to curb this trend, the government has set up primary health centers for every 100 villages, creating an auxiliary nurse midwife to provide immunizations and monitor pregnant women, and instituting village-level traditional birth attendants for deliveries not done in the hospital. While this has created more jobs and more locally-available health staff, the effects have hardly been felt. A 2003 study in rural Maharashtra showed that only 12% of pregnant women receive the minimum antenatal care package, even though this is a service provided by the ANM.

To address the inequity in infant mortality and disease transmission, doctors are needed in the rural areas. Doctors are needed where health status is at its most fragile – in the rural village, not in a private practice in Pune. Doctors are needed where the majority of patients are, not where they could travel to, forcing them to miss work and pay unaffordable fees.

The success of CRHP empowering illiterate village women to reduce the prevalence of disease and sickness in their community has been made possible by the low-cost and supportive secondary-care hospital at CRHP Jamkhed that the village health workers can refer to. Without the hospital, patients would have to be referred to the district level hospital one and a half hours away and at times 2-3 times the cost for the same operation (for example–delivering via cesarean at the district hospital: 15,000 rupees or $300. At CRHP’s hospital: 5,000 rupees).

Even with VHWs, ANMs and TBAs, doctors are needed in rural areas to provide the necessary secondary and tertiary care that untrained professionals are not able to care for. Presently, when villagers have serious health problems, there seem to be three options: either they miss work and visit a hospital, they ignore the problem in the hope that it goes away, or they visit a traditional healer or village-level medical provider with no medical training who tends to give antibiotic injections for every complaint. There is little room for easy decisions and every choice has bad implications.

The department of community medicine has responded to this need by instituting programs to orient the students and provide them with a personal experience of rural life. Immediately after admission to MGIMS, first-years have an orientation in Gandhi Ashram for 15 days. Further, all first-years have to live with a family in a village for 15 days to carry out health, sanitation and nutrition surveys, returning each subsequent year for follow up. Finally, since 1992, it has been made mandatory that after medical school, new graduates serve for two years in rural villages, working with Institute-approved NGOs or in a government rural health center.

As I spoke with med students at MGIMS, I asked them what their plans were after graduating and completing their two-year rural fellowship. The first year students expressed their interest in staying rural and practicing medicine in the village. Answers from fourth and fifth year students: two wanted to be orthopedic surgeons, one an optometrist, and practically all said they planned to live in an urban setting. The attraction for doctors to urban life is just too great. If they are originally from an urban area, than they are practically foreigners to village life. If they are originally from a rural area, becoming a doctor is viewed as their way out. Being a doctor in an urban area pays more, as the patients tend to be wealthier and the problems more specialized. Plus, for their family, money is important, as they can now put their children into a private school and “give them a better future,” as one student put it.

Dr. Garg, head of the department, admitted that there is little in the village that attracts doctors to practice there. The education system tends to be worse and the government has set up no incentives to bring doctors away from urban life and into the village. Plus, as an outsider to the village, the doctor has to either find a house (difficult in a small village) or build one (which he/she tends to have little interest in doing). Perhaps the government should set up housing for doctors and compensate them to live in more rural settings? At what cost, though, must you motivate the physician to practice morality and equity? Whatever the solution, it must be accompanied by a change in the mindset of the physician to view medicine not as a lucrative profession but as the opportunity to meet the needs of the sick and enable the village to become healthy and productive.

Dr. Bang from SEARCH-Gadchiroli put it well when he told the story of Akbar and Birbal:

Akbar asks Birbal to find the ten most foolish men from his kingdom.

Birbal went yet was able to find only nine foolish persons; finding the tenth one was becoming a difficult task.

In his search for the tenth fool, he was walking up and down the road of Delhi. The road was in darkness except for a beam of light falling out from a window of a house. A man was bending and seemed to be searching for something. Birbal approached and asked him what he was searching for.

“I have lost my diamond ring and I am searching for it, and am not able to find it.”

“I can see that you are not able to find it. Where did you lose it?”

“In the forest, on the other bank of the Yamuna River.”

“Then, go and search there.”

“There is darkness there, while here there is light.”

The ring was lost in a forest, but it was being searched on a road of Delhi. Birbal found the tenth fool.

Dr. Bang followed by saying – unluckily, most of our medical research is done in this way. Health is lost in the villages but the research is done in the city, where there is light, facilities, air-conditioned rooms, but there are no problems.

Happy Hannukah! Merry Christmas! And a very happy new years!

Stalking Tigers on Elephants

I had already broken into my packet of Tums, trying to persuade my stomach to hold out the thirteen-hour overnight bus journey, when a man plops down beside me on the bed. On overnight buses, you are give a single bed instead of an upright seat, yet as he lied down beside me, giving me the odd look customary to when most see I am not Indian, I came to realize that this small single bed was two seats. Trying to sleep on a bus that is weaving through traffic, catching every bump, with a Bollywood soundtrack blaring from the speakers and a stranger snuggled up next to me is not easy. I turned, tried to get comfortable yet lay awake, wondering how it was so easy for the guy next to me to simply lie on his back, motionless, and fall into a deep sleep. Twenty seven hours and four bus transfers later, I arrived in Nagpur, then Seoni, then Mandla, and finally Kanha National Park, in the state of Madhya Pradesh.

We hopped into our gypsy safari the next morning at 5:30am, dressed in long sleeves and ready to head into the park and hopefully see some tigers. Kanha is a 2000-square-kilometer national park that regularly tops lists of the best places to glimpse a tiger. The park also lays claim to Rudyard Kipling’s Jungle Book, which is based on a case in 1831 of the capturing of a wolf-boy in the Seoni district. To attempt to see a tiger, we were armed with Santos (our knowledgeable driver), a British couple with two cameras and four lens attachments (one of which was bigger than my arm – “just in case the lighting was right,” he said), me and my Olympus auto-focus hand-held, and a guide who was bundled in five layers of clothing and didn’t speak for the first two hours due to the cold.

The park was fantastic as we drove through a virtually-untouched and overgrown forest, searching for tigers but running into hundreds of spotted deer, langur monkeys, peacocks, gaur (big buffalo), turtles, jackals (small wild dogs) and sambar deer. The rarest were the barahsinger deer, which can only be found in Kanha, and were useful since they howled to each other when they sighted a tiger. Seeing a tiger is no easy task and our driver would often stop in the middle of the road for thirty minutes (we could not leave the jeep), waiting to pinpoint the sound of a howling deer or monkey, and then racing over to the closest area to search for paw prints or listen for another hint.

As we gave chase, we ended up running into elephants who had located a tiger within the forest, so we climbed aboard these massive beasts and trekked out in search. As it was late morning, the tiger was already beginning to relax in the heat and we found her lying under some overgrowth, trying to get some sleep despite the huge elephants gathered around her with humans clicking away on giant cameras. We watched it lie there for some minute and then wobbled back to our safari jeep to let others get goosebumps too. In our jeep, we waited for the tiger to get up and walk around, following it down the road and watching it pay no attention to the fifteen jeeps stalking it as it headed down the road.

The next morning we felt not so lucky, as Santos camped out in the road due to the howling monkeys in the trees overhead but the tiger would not come into the open and show itself. After waiting for an hour, disappointed of not seeing one, we decided to head off in search of other animals, but as we drove we nearly ran over a huge male tiger crossing the road. We stopped and for a second were too stunned to even take photos. It went back into the forest, turned to look at us, decided it wasn’t interested, and continued into the forest. Considering the disappointed state five minutes before, the excitement was similar to watching Chipper Jones hit a three-run home run in the bottom of the ninth down by two runs, when you think the game is all but over and now you have newfound life and enthusiasm.

Kanha lasted only two days and before I could regain sleep I was back on the bus, this time headed to the Mahatma Gandhi Institute of Medical Sciences in Sevagram, where Gandhi set up an ashram and where he began the ‘Quit India’ movement. Traveling through Kanha was great, though, and trekking in open-aired jeeps searching for tigers and other animals was surely an awesome experience to say the least.

He’s Acting Like a Man

To start, I want to say that I am fine and the attacks in Mumbai did not affect me as I was in Jamkhed. But they did have an effect on CRHP and some of its guests, and the attacks will certainly affect India, their international business, and relations with Pakistan (although the extent of the ISI’s involvement is not entirely clear). It is of high concern throughout the country and seems to be one of the largest terrorist attacks in a country that has among the highest number of terrorist attacks per year in the world – although Maharashtra, and especially Mumbai, are not usually the locations.

Secondly, pick up this month’s (December) National Geographic magazine! There is a nice article with photos on CRHP Jamkhed and it goes into detail on the history of the organization and its work in the area and abroad. If you’d like to see it online, click here.

This last month since the course ended has centered on the hospital – the first floor of a two-story building, complete with three wards (male, female, maternal), two operating rooms, an x-ray machine and a pharmacy. To say that CRHP and the hospital staff get by with little funding and fewer diagnostic tools does not do the work justification. It has been an eye-opening experience to watch Dr. Wout and others work through differential diagnoses and work with the patient’s family to provide the care needed.

Each hospital bed is like its own family reunion as a schmorgusboard of relatives, friends and fellow villagers sit on the floor for days, weeks and sometimes months with the patient. If transportation is too expensive or the distance too long, then the family is forced to live in the hospital for the time being. CRHP hospital takes advantage of the extra ‘staff’ in the hospital to put them to work and the family members are in charge of giving meds, bathing and feeding the patient, and informing the nurse to fever and unusual pain. This family-provided service is essential to give the limited number of nurses and fewer doctors the time they need to attend to emergencies, incoming patients or surgery.

At first the hospital was overwhelming and even intimidating. I was struck with the incredible number of patients, the variety of disease, the extent to which diseases disabled the patient before seeking care, and just the overall pain that accompanies the third-world hospital. I had never before seen deformities caused by leprosy (feet curled upward, hands = stumps and face sagged to the point of pain), the shrunken look of tuberculosis (often accompanied by HIV), the miniature size of a baby born at 1.5 kg’s (3.3 pounds), or the ease of peeling off the top layer of skin on a child with third-degree burns. The constant loss of light/electricity during surgery, the lack of oxygen tanks when they were most needed, and the absence of splints, crutches and wheelchairs made it difficult to keep sane with so much need surrounding you.

Eventually these difficulties began to fade as I got into the flow of the hospital and triumphs & remarkable patients came to the forefront. The patients are tough as hell and live with excruciating pain for months before coming to the hospital. Patients walk on fractured hips and broken legs, sit on huge pus-filled abscesses, deliver babies without anesthesia, and work in the farm with a miserably-smelling completely-necrosed foot remedied only by amputation. The joys of the patients and families become our celebrations as most recover from the problem that brought them there and they feel emotionally recharged as they have been afforded the care they need and deserve, often regardless of pay (CRHP raises funds to support poor patients). Patients who get better after receiving malaria treatment, having their cataracts corrected, or delivering via cesarean section will graciously thank you and bring happiness and smiles to the hospital and staff.

We have also adopted a new saying in the hospital – “Stop acting like a man” (comparative to the common phrase acting like a women) – when people are crying and need to toughen up. During surgical procedures or in dealing with pain, it is usually the men who whine the most and demand the most attention. In refixing a broken wrist, men will scream in pain as women grit their teeth and get through it. It has become an ongoing joke in the hospital but for me it has become a rather prevalent theme in Jamkhed and I am always humbled by the strength and perseverance of these Indian women.

Response, Reflection and the Traveler’s Dilemma

I wanted to post in response to a comment left by Sheila after the last post on the sasu. If you haven’t read her response, then you can find it by clicking here. I appreciate the feedback and do encourage honest assessment like this from all the readers. It’s not easy to write to someone (and especially on a blog) and portray a point that is counter to the writer but I do think it is important and can serve a much greater purpose than simply rethinking what it is that I wanted to write.

The fact is that all the things I see and learn here are very complex and India is much more of a new world than just a new country. The culture and history here is something that even if I had lived here for twenty years I still would not understand. The subtleties in many Marathi words spoken in Jamkhed is something that even a native Marathi speaker from a Marathi village 15 hours away would not understand. As such, there are many things that as a person who has not grown up here will never understand. This is not to excuse being culturally-ignorant and making broad judgments but it is to say that my blog is not meant to describe the complex intricacies of Indian culture and life. My blog is a method of reflecting on the experiences I am going through here and displaying my own viewpoint on issues that I am learning about and have not yet before been involved with.

I do appreciate the comments and now realize what I wrote can be construed offensively. “Terror of the Sasu” seems to be more of a horror movie than a cultural commentary and certainly there is more to the sasu than just being a terror on the family. The fact that the sasu lives with her son in the first place resembles the strength of the Indian family and the unity that family members hold from generation to generation. The assistance that the mother-in-law provides in raising the children and caring for the home also allows the wife to work/improve her life outside of the home in order to create a better life within the home for herself and her children. And in some instances the mother-in-law relates to and helps the wife in family life and if there are difficulties with the husband. In my earlier characterization of the sasu, I did mean to make it somewhat dramatic and there certainly is a fine line between being pensive and ignorant. I see how my desire to at times be descriptively-exciting can cross the line into hidden meanings and misunderstandings. But it was the radical difference in the sasu’s role in Indian families versus American families that I hoped would come across in the post.

In my three months since I have arrived in Jamkhed, I have heard and read how abusive the sasu can be to the wife. She can create an unhealthy household with a wife who feels trapped and alone, with very little room to turn and no opportunity to peacefully escape, and a husband who is stuck between choosing between his wife and mother. The sasu’s control on many aspects of family life, from how to raise her grandchild to what rooms the wife is allowed to enter during menstruation is that aspect that I do find terrifying. I also wanted to raise the point that CRHP has done great work in changing this difficult family dynamic. As was seen in that hospital experience, Dr. Arole and others seemed to realize that proper health cannot be targeted without including the mother-in-law in family conversations. Through their work they have created these women’s groups where previously-taboo and stigmatized issues like these can be raised without fear of retribution. And now the wives take oaths to be caring to their future daughters-in-law. It is that remarkable aspect of CRHP that I wanted to come across in the post.

The struggle than many visitors to CRHP Jamkhed seem to face is to continually look at the project with an observatory eye without placing our western and personal judgment on what we are seeing, even after months of being here. It is that aspect that in general is most difficult about traveling, but also what makes it so important and rewarding. Visiting new cultures and learning from other people is a fantastic way to open up your mind to new ideas, new ways of life and different forms of happiness and suffering. Traveling pushes you to be accepting of others and appreciating differences rather than judging them.

And there is a fine (but important) line between being culturally-mindful while also maintaining a critical viewpoint on universal values that need to be held by everyone. It is hard to dismiss things that I find wrong (regardless of where I am) as simply being a part of the culture, thus letting it stand as is. This happens in many cases, whether it is the abundant alcoholism in the area or throwing trash on the ground and out windows. And for me it very much held true in the case of the sasu, where it becomes an issue of the wives rights being trampled on because she is trapped to remain a part of the family. It is also that fine-line that I may at times smudge when I do not give the full background to the situation presented.

I hope this blog serves (and has served) to be both a reflection of what I’m experiencing here in India and add some explanation to some of the major differences of Indian versus American life. I try to convey my viewpoints to display my personal values intertwined with this new and unique culture, while being mindful of universal rights. It is this active dialogue with those interested that I very much love, enjoy and appreciate. And if you have any questions or feel I have offended in future posts, I ask that you also let me know so I can clarify if need be. I do enjoy the dialogue and look forward to more.

Terror of the Sasu

As if beginning a King Kong movie, there comes as large a force to be reckoned with as Godzilla… the Sasu, or Marathi for mother-in-law. Just saying the word itself sends shivers down even my own spine and I am brought back to her long and painful role in most Indian families. By mother-in-law, I mean the mother of the husband, and by role, I mean her relationship with her son and even worse, with the daughter-in-law. It is the most interesting family dynamic I have learned about since my arrival in August.

And as much as this story is about the mother-in-law, it is also about the Indian bride, who is not fully accepted in her husband’s home until she produces a male child. When he is born, she is so grateful that she indulges her son to excess (the simple dichotomy between bearing a male versus female child is evident when you see newly-born sons cuddled up with their mother while newly-born daughters are left alone on the other side of the room, distant from the bitter mother). As the boy grows up, he remains close to the mother and distant from the father and a very close-knit relationship forms between mother and son. When the son is married, he is now given to another woman, and the mother often becomes very jealous and envious of this new woman in her son’s life. Since the wife often moves in with her husband and his family, tension is instantly created between the wife and mother-in-law, with the sasu giving the wife hell for everything. The situation deteriorates so much that the son is placed in the middle of the fight, forced to choose sides on many arguments. To maintain the loyalty of his mother who has spoiled him and nurtured him his whole life, he often sides with her, estranging even more his wife who has left her family and now feels alone in her husband’s house. She is often desperate to gain the acceptance of this new family, especially the mother-in-law. And what better way than to bear a son?… so the cycle continues.

In my diploma training course, a 26-year-old Indian wife living in Chennai told me she was desperately trying to move out of her house and find a job away from her husband. They had been married for three years after being in love for eight, and had a two year old daughter. They were an atypical couple because not only had they married out of love (rather than arranged) but he was Hindu and she was Christian. “The love was very strong,” she said. Everything changed after two years of marriage when the husband’s father died, leaving his mother alone. She became ravenous, lonely and manipulative, making unheard-of requests of her son and blaming the wife for the misfortunes of her family. The sasu forced them to change their house to meet Hindu customs, including prayers to Hindu Gods and practices like not entering the kitchen during the period of menstruation. She began to control her son, often taking much of the money that he made and turning him into an argumentative husband. Everything changed and eventually she got so tired that she moved out of the house and in with her parents. Still madly in love with the man she met before his father died, she is confused and angry, hoping that he will soon return to his senses and ask for her back.

Another example occurred while making early-morning hospital rounds with Dr. Wout. A child was admitted the night before with abdomen discomfort, high fever, and trouble peeing. After a physical exam, we realized he had phimosis, a problem where the foreskin at the end of the penis does not retract, thus causing the inability to pass urine and accounting for much of the pain. Wout told the mother that he would simply need a circumcision to correct the problem yet the mother looked terrified and on the verge of tears. The surgery was scheduled but it hit the fan when a woman came storming into the room, yelled at the mother, made a huge racket and started screaming at her and put the mother again in tears. We asked what was happening and the woman began to scream in Marathi at Wout. We came to understand that she was the mother-in-law and didn’t want her grandson getting surgery. Wout re-explained the case to the mother-in-law and the dire need for surgery to remove the pain. With a very doubtful look in the eyes of the mother-in-law, and tears in the mother’s, they both agreed. When we returned to the ward three hours later, the child was gone and her family had packed up and left with no return.

In educated, uneducated, rural, urban, rich, and poor families, this same trend is seen again and again. A wife who has to put up with a difficult mother-in-law becomes an angry sasu herself. For the hospital and for CRHP, it means that the sasu is an essential piece to the puzzle. If we are to provide care or an operation to the child or wife, we must also recognize the influence held by the mother-in-law and include her in that decision. If the Village Health Worker wants the mother to join the women’s group, then a conversation has to be held with the sasu before she is allowed to join. Due to that influence, a major goal of these women’s groups has been to educate mothers to not be so difficult as their sasu was, and most have taken pledges to be different, and they have. They hope to set an example for all to follow.

Mumbai, Bombay… whatever you call it, it is certainly not Jamkhed

To catch a little break from Jamkhed and have a mini-vacation, Wout (Dutch doctor), Thomas (Dutch med student), and I caught a ride to Mumbai last Tuesday. The contrast between rural and urban life in India is amazing and easily visible as large farms are replaced by huge buildings, billboards change from wishing a friend happy birthday to selling a pair of jeans, and the poor who sleep in huts change to the poor who sleep on the concrete sidewalk. The cows still exist in both places, as do the dogs, but there are less of them. The rickshaws (hand-pedaled mini-taxis) and motorcycles still own the road but in Mumbai women riding on the back sit straddling the motorbike rather than both legs off to the side… a big difference in meaning. Mumbai is big, loud, very crowded, more modern but expensive, and dirty dirty dirty, but a great way to get away for a couple days. Jamkhed is a more peaceful and supportive place to live for the year and leaving for Mumbai I did expect the draw I felt taking me back to this little town.

After checking into our budget hotel in Colaba, the main tourist area and center of south Mumbai, we found ourselves with a myriad of restaurants to choose from and every restaurant we chose was fantastic. Indian food made locally is just so good that we ended up eating it for breakfast, lunch and dinner. Each restaurant has its own specialty; all filled with tons of sauces, different red, green and brown spices and tons of oil that often forms the top layer of the dish. But when mixed with chicken, spinach, cottage cheese or goat that sucks in the spice, and then mixing with garlic naan delivered steaming and very crusty, it is an amazing experience for your mouth. And your stomach does not miss out either, as it gurgles non-stop for a couple hours after a good meal, crying for relief. Every meal we stuffed ourselves until we were uncomfortably full and almost regretting it, but the next meal we’d do it all the same again.

The highlight of Mumbai was one morning when we woke up very early to catch fishermen unloading heaps of fish onto Sassoon Docks, a 90,000 square-yard dock at the end of south Mumbai. Hundreds of huge, brightly-colored wooden fishing ships that had arrived at 2am after fifteen days at sea lined the docks with their uniquely-designed flag flapping in the wind. Beginning at 5am, fisherman unload tons of fish off the boats to their fishwives on land who carry it to their little open space on the docks where they auction it off to the thousands of buyers who equally crowd the docks. The scene was chaotic and equally exhilarating as we tried to walk through this mass of people, ankle-deep in fishy water, unable to stop and stand for a second without forcefully being pushed from all sides by fisherwomen rushing to buy the freshest catch. These fisherwomen were amazing – hired by a family or restaurant to buy the freshest fish at the lowest price, they would weave through the crowd, coming within inches from the edge of the dock, while carrying a 50-pound wooden basket on her head filled with fresh and dripping fish. They would rush by, yelling at other women and making their way to the vendors auctioning off the fish. Once a new load arrived, the bidding war would begin as buyers yelled out prices for fish, ranging from tiny shrimp and mackerel to medium sized catfish and pomfret to large sharks and even octopus. After an hour and a half we found ourselves pushed out of the chaos back onto safe land, reeking of fish and wide-awake as if we’d slept 12 hours the night before.

At the end of the five days, the easiest way to get home to Jamkhed was by train to Pune and then by bus or car from there. The train ride was almost as exciting as Sassoon Docks. Since we were only able to buy confirmed tickets, we did not have seats on the five hour train ride and from the hundreds of people standing in the traincar there was no way we were going to find a seat. Fortunately, I sneaked my way to the entrance door of the car where I was able to sit with my legs hanging off the train and the wind blowing in my face. The view was amazing as Maharashtra state is hilly and green and we passed along many small little towns and over mountains and through forests and I had a front row seat for the whole thing. At times the pushing amounted to me almost falling out of the train but with a tight grip onto the handrail the five-hour journey was completed with gusto.

Election, election, election… Everyone I met in Mumbai asked me about the election and even in Jamkhed people understand its significance. And while they don’t know the policies and understand each President, they do comprehend that America’s relationship with India and other countries is at stake. And before I am ever able to state my opinion, every person I speak with, from the Africans to Nepalese to Indians, is pro-Obama. Why, I ask? “We believe what he says, and he has good things to say.” This election is reaching more places than just North America and I can only imagine the tense and exciting feeling in the states. Let’s hope it ends up as well as it can.