After an exciting journey through the Indian countryside, gripping the edge of my seat as we drove up misty mountains with poor visibility exacerbated by the glare of headlights on the road, my fear undimmed by the cautionary government signs warning of such catastrophes as falling rocks up ahead and tyres bursting due to overspeeding, I arrived in the busy traffic of Mumbai city once again, where the silent feud between myself and the driver over our choice of listening material - Saturday night Bollywood pop or Indian classical music - became entertaining as we flipped from radio station to radio station. And yes, I know that was a really long sentence.
A paragraph composed of just one sentence! What an interesting thought! (a la the flirtatious Ms Briganza of the classic Hindi film Kuch Kuch Hota Hai in response to one of her students' declarations, 'pyaar dosti hai' - love is friendship. Ms Briganza has a very interesting, upper middle class Anglo Indian accent.) Yes, an interesting thought indeed, but how else do you symbolise that you have so much to say and so little time and space? Circumstances are pressing me forward to move the frame of my narrative away from the Indian subcontinent, and yet I still have so many stories to tell about elective. There's my searing village visit with the mobile health team on my last day when I was called upon to use previously taught skills for the first time in reality -breaking bad news, multicultural communication skills, clinical data interpretation, facing ethical dilemmas - as I discussed a diagnosis of metastatic lung cancer with the social worker, who served as an intermediary for the patient's mother, while the aged patient herself sat in front of us, her true state of health kept concealed from her by everyone - even the big city doctors who charged exorbitantly for a battery of tests but didn't bother to explain them to the illiterate patient. But which dying person doesn't know deep down what is really happening? So many interesting clinical stories to tell, so much analysis and so many learning points, and yet I have to move on - condense them with commas and hyphens and overlong sentence, condense them because
I have already been in Chatrapati Shivaji intenational airport, gateway to India. I have already waited over 5 hours before my flight is open for check-in, watching the departing families, classifying the travellers into business and holiday and long term emigration. Seeing the other side of Heathrow and JFK and where else, appreciating that everyone comes from somewhere. I've already seen the builders in the Qatari Ramaddan heat and felt the movements of the earth, as people go round and ceilings go up. I've swapped my red passport for a green one now, wondering at the unfriendliness of my newfound compatriots. Compatriots? It seems like the word fellow is alien to here - nobody smiles, people only stare. There's no courtesy between strangers; are people recognised as fellow travellers, let alone fellow citizens? The flight is funny: bawling babies, women singing loudly, hand luggage that would form the entire export output of a small nation, people chatting on mobile phones even as the plane taxis, others exclaiming in aghastment...and yet, we press on. I've moved on.
Then there's the return to the motherland, the surprise at the landscape; yes, the red earth and the forests are recognised, but why does everything look so small? The tin roofs of buildings two stories high swarm the eye view, red like the earth. Is this the megacity? Still we press on, into the crush of arrivals, the escape from officials asking about Yellow Fever Certificates, the confused mess of immigration, the loving arms of family, the horrendous traffic, the cleaner city (but apparently only in some parts), the overwhelming sense of selfishness, the sapping of energy. This is not just metaphorical or personal: the constant drone of generator sets is part of the backround melody in this city's cacophonous song, if you would call it that, and I wouldn't, for by now I am cynical at the sophistry of the litterati and refuse to be a part of image moulding, white washing. So I can say categorically, frankly, and without any reservations, that I hate Lagos. Yes, I said it. But that's OK, because already it's time to move on to another city, which is to Lagos what Pune is to Mumbai. If Pune is the Oxford of the east, what is Ibadan? We'll see...
Saturday, 28 August 2010
Sunday, 15 August 2010
Bombay: a great place in which to practice your poker face
Imagine you are sitting in a bus in some very busy traffic. The heat is overwhelming and your mind is preoccupied with all the things you could be doing right now - more productive things. The congestion shows no sign of easing off any time soon. Slowly, slowly, you start to drift off. Now you are floating in a pool on a beautiful beach resort. Water from a nearby fountain sprays gently in your face. Your reflexive licking of your lips uncovers a surprise, for the fountain jets taste sweet! What tropical paradise is this? Suddenly you hear fumbling, and some shouts: 'I'm ever so sorry'. Your raft is capsizing. You get up with a start, only to discover that it was all a dream, unceremoniously cut short by a nearby accident with a Coca-Cola bottle: the fizz of the drink still sticky upon your face. A rude awakening indeed...
This, metaphorically, was my experience of Bombay. A rude awakening. A slap in the face jolting me out of my hitherto false sense of security about the world we live in. Bombay, Mumbai - the city that made me cry. That made me weep tears of frustration and sorrow and anguish at the utter depravity of the world we live in. Which was ultimately a good thing, for I cried out to God and got the salvation and comfort only he can give. But Bombay shook me up something silly. Perhaps this is a good place to start my story.
I have always been fascinated by Bombay - well, ever since I first read about it as a school child. Megacity of megacities, with perhaps unparalleled diveristy, Bombay captured my imagination. Its landmarks existed as real places in my head, thanks to its deracinated global offspring and their chronicles of early life. I dreamt of eating Kwality ice cream while walking on the pier to Nariman point. Perhaps I would encounter a family building sandcastles at Juhu beach, or watch a cricket match on the Maidan. All in the setting of a beautiful blend of colonial and contemporary architecture. You get the picture. Romanticism unbridled. I would taste some bhel puri and blend into the melting pot of this complicated city of culture. Who knew, perhaps I would even fall in love, just like in the movies....
(Never trust fantasies woven by writers, particulary expatriates or emigrés. Always take the fact of their displacement as a warning sign. Let them sort out their contradictory homesickness-bitterness on their own.)
How would I describe Bombay? Interesting. Overwhelming. Not unfriendly - in fact, the people in the city were mostly helpful. The things that disturbed me about Bombay did not have to do with the city itself per se, but what it showed me about the world we live in - after all, this is our future, is it not? Bombay is the financial capital of India, one of the world's next big economic superpowers. It teems with people. One of the things I love best about travelling is becoming anonymous for a while, getting to see how other people live and by so doing understanding more of the human condition. As we approached the city it occured to me that a person could die in a place like this and the world would keep moving. Nothing would change. Even the people for whom you were sacrificing your life would continue with the daily grind, for isn't that the harsh reality of existence? Why then are we here? I felt nearly suicidal at the thought, and remembered my loving family. Love and family are the most important things in the world, I'm realising. They are our greatest gift from God. This is probably the biggest lesson of all my cherished solitary travels in my short life.
I did not fall in love with Bombay at first sight as I did in Belfast and Paris. Nor did I beget an initially wary but eventually wholehearted admiration as I did in Geneva. I couldn't engage with the city at first contact. As a visitor you are advised to keep your head down, to ignore the calls of attention of people trying to sell you their wares or simply asking you for money or food. Refusing to acknowledge the existence of other human beings was terribly disconcerting. This, and the casual disregard for human life, the blatant discrimination between haves and have-nots in the city, were what chilled me. It is not easy to cross the road anywhere in India, as far as I can see. Everybody flouts traffic rules whenever they can get away with it. But the dog eat dog style of driving here, where big car trumps smaller car trumps three-wheeler trumps two-wheeler trumps pedestrians, was perhaps at its most dangerous here. At one point I was crossing the road with my travelling bag behind a mother and her two small children. We were standing at the crossing waiting for a break in the traffic. Suddenly, the flashy car that was parked behind us began to roll back - the driver was actually reversing into us, without so much as a by-your-leave! He was a bully, and knew that he could intimidate us off our patch of the road. Along with the driver, a wealthy looking man sat complacently in the back seat of the car, in the 'owner's corner'.
Bombay is a rich city, and bullying is routine here. It's the constant degradation of people who aren't paying customers. The lack of dignity for those who have the temerity to be in need. My friends and I were walking to the gateway of India in the pouring monsoon rain. I wondered if we could walk on the pavement adjacent to the Taj Mahal Palace Hotel, which was ringfenced by potted plants and a chain link. My knowledgeable friend said that the land belonged to the hotel and we probably would not be allowed to. I couldn't believe such a gross misappropriation of public space (how can a pavement be off limits to the public?) and convinced the group to try our luck anyway. It turned out he was right, we eventually got turfed out onto the rainy road and my Indian friend received a torrent of abuse from the security guard.
Before I arrived another Indian friend had warned me about this colonial mentality, but it was still shocking to see. What is even more shocking is the widespread cavalier response to this attitude, as if it is OK to accept prejudice. Isn't that what it is when we judge people on appearances only, presuming attributes without any evidence? Is it enough just to acknowledge these issues without challenging them when we see them? Prejudice is pernicious. It undermines our very value as human beings. I'm beginning to realise how important it is to accord people the respect that is falsely denied to so many, rather than demanding it for ourselves. Not in a simpering or exaggerated way, just in a way that recognises the worth of all people. If this means giving up special privileges which we may have received, then it's a price worth paying, because it'll make our world a safer, more joyful place to live in.
According people with respect is easier said than done. Or is it? It's easy enough to be polite and well mannered, but what about giving graciously and not assuming the worst of others? Being a newcomer in a city like Bombay really pushes you to the limits. The necessities of survival and security make you suspicious; they brought out the worst in me. How could I be so concerned by the gross disparities between the rich and the poor and yet refrain from giving money to the child begging for it on the street, finding sanctuary instead in an air conditioned cafe? The only word for that is cruelty. Now you see why I cried - for the world, for myself, for what we are becoming. I begged God for forgiveness and repented of my sin. Sin, which we are all complicit in, when we pursue our own narrow interests. I had previously been yearning for egalitarian Europe, built on a foundation of human rights - I realised that this is the true marker of development, not wealth or even happiness, which is a red herring - where there may be subtle undercurrents of class and racial prejudice and hypocritical discrimination but at least everyone has rights in the eyes of the law, and just as importantly, the opportunity to exercise them. And I cried for the piecemeal dismantling of these rights that is happening in the West - all over the world, our leaders are selling our birthright for a mess of pottage.
Today is India's independence day. The country has a solid, progressive constitution, drawn up by the nation's founders and enshrining the rights of all individuals - rich and poor, male and female, high caste and low caste - equally on paper. A lot of good work has been done. A lot of people have done well since independence. But there is still much economic deprivation and marginalisation of millions of people due to poor implementation of these laws in many places. I believe a lot of this is due to attitudes - to the way we see and treat each other. It starts with the child snatching things from other children, and ends with the rich and powerful oppressing the poor and denying them their rights - basic rights of life, liberty, shelter and good health. We need to learn to value the other. We need to truly learn to namasté - not just as a cursory greeting, but seeing our relations with others, even strangers, as an extension of our relationship with God. This is what I believe as a Christian. God himself came and died for our dark and broken world, because he cares for each person. It was only the reality of Jesus that brought me back from the brink. Jesus cares. He alone can save me from my venality, my betrayal of righteousness for comfort. He accepts me as I am, and I know he's sufficient for me - to guide me through difficult decisions, to show me how to live, to entrust with the lives of all those I meet and am concerned for. Like the half naked little boy jumping for joy in the middle of the road, gleefully showing his mother the ten rupee note somebody had given him from a passing car.
The more familiar I grew with Bombay the more I came to appreciate the city. People here are nice and will go out of their way to help you, without asking for anything in return. Twice I came across the same man who showed me to places I was looking for. Another man walked me to the train station. I missed the greenery of the countryside, and while I appreciated the city's beautiful architecture, the density and heat were uncomfortable. But those cannot be helped and are merely attributes of urban life. The place is a hustler's paradise; too fast paced for comfort. It seems I am not the city sophisticat I thought I was...
My favourite thing about Bombay was the press. India's literary tradition is reflected in an intelligent, analytical, free press that seems to value objectivity over tribal loyalties. The scope of imagination was encouraging. Surely, with such values it's only a matter of time before what appear to be idealistic dreams become reality. So I'm glad I went to Bombay. I did find the inspiration I was looking for, even if it didn't present in the way I expected.
This, metaphorically, was my experience of Bombay. A rude awakening. A slap in the face jolting me out of my hitherto false sense of security about the world we live in. Bombay, Mumbai - the city that made me cry. That made me weep tears of frustration and sorrow and anguish at the utter depravity of the world we live in. Which was ultimately a good thing, for I cried out to God and got the salvation and comfort only he can give. But Bombay shook me up something silly. Perhaps this is a good place to start my story.
I have always been fascinated by Bombay - well, ever since I first read about it as a school child. Megacity of megacities, with perhaps unparalleled diveristy, Bombay captured my imagination. Its landmarks existed as real places in my head, thanks to its deracinated global offspring and their chronicles of early life. I dreamt of eating Kwality ice cream while walking on the pier to Nariman point. Perhaps I would encounter a family building sandcastles at Juhu beach, or watch a cricket match on the Maidan. All in the setting of a beautiful blend of colonial and contemporary architecture. You get the picture. Romanticism unbridled. I would taste some bhel puri and blend into the melting pot of this complicated city of culture. Who knew, perhaps I would even fall in love, just like in the movies....
(Never trust fantasies woven by writers, particulary expatriates or emigrés. Always take the fact of their displacement as a warning sign. Let them sort out their contradictory homesickness-bitterness on their own.)
How would I describe Bombay? Interesting. Overwhelming. Not unfriendly - in fact, the people in the city were mostly helpful. The things that disturbed me about Bombay did not have to do with the city itself per se, but what it showed me about the world we live in - after all, this is our future, is it not? Bombay is the financial capital of India, one of the world's next big economic superpowers. It teems with people. One of the things I love best about travelling is becoming anonymous for a while, getting to see how other people live and by so doing understanding more of the human condition. As we approached the city it occured to me that a person could die in a place like this and the world would keep moving. Nothing would change. Even the people for whom you were sacrificing your life would continue with the daily grind, for isn't that the harsh reality of existence? Why then are we here? I felt nearly suicidal at the thought, and remembered my loving family. Love and family are the most important things in the world, I'm realising. They are our greatest gift from God. This is probably the biggest lesson of all my cherished solitary travels in my short life.
I did not fall in love with Bombay at first sight as I did in Belfast and Paris. Nor did I beget an initially wary but eventually wholehearted admiration as I did in Geneva. I couldn't engage with the city at first contact. As a visitor you are advised to keep your head down, to ignore the calls of attention of people trying to sell you their wares or simply asking you for money or food. Refusing to acknowledge the existence of other human beings was terribly disconcerting. This, and the casual disregard for human life, the blatant discrimination between haves and have-nots in the city, were what chilled me. It is not easy to cross the road anywhere in India, as far as I can see. Everybody flouts traffic rules whenever they can get away with it. But the dog eat dog style of driving here, where big car trumps smaller car trumps three-wheeler trumps two-wheeler trumps pedestrians, was perhaps at its most dangerous here. At one point I was crossing the road with my travelling bag behind a mother and her two small children. We were standing at the crossing waiting for a break in the traffic. Suddenly, the flashy car that was parked behind us began to roll back - the driver was actually reversing into us, without so much as a by-your-leave! He was a bully, and knew that he could intimidate us off our patch of the road. Along with the driver, a wealthy looking man sat complacently in the back seat of the car, in the 'owner's corner'.
Bombay is a rich city, and bullying is routine here. It's the constant degradation of people who aren't paying customers. The lack of dignity for those who have the temerity to be in need. My friends and I were walking to the gateway of India in the pouring monsoon rain. I wondered if we could walk on the pavement adjacent to the Taj Mahal Palace Hotel, which was ringfenced by potted plants and a chain link. My knowledgeable friend said that the land belonged to the hotel and we probably would not be allowed to. I couldn't believe such a gross misappropriation of public space (how can a pavement be off limits to the public?) and convinced the group to try our luck anyway. It turned out he was right, we eventually got turfed out onto the rainy road and my Indian friend received a torrent of abuse from the security guard.
Before I arrived another Indian friend had warned me about this colonial mentality, but it was still shocking to see. What is even more shocking is the widespread cavalier response to this attitude, as if it is OK to accept prejudice. Isn't that what it is when we judge people on appearances only, presuming attributes without any evidence? Is it enough just to acknowledge these issues without challenging them when we see them? Prejudice is pernicious. It undermines our very value as human beings. I'm beginning to realise how important it is to accord people the respect that is falsely denied to so many, rather than demanding it for ourselves. Not in a simpering or exaggerated way, just in a way that recognises the worth of all people. If this means giving up special privileges which we may have received, then it's a price worth paying, because it'll make our world a safer, more joyful place to live in.
According people with respect is easier said than done. Or is it? It's easy enough to be polite and well mannered, but what about giving graciously and not assuming the worst of others? Being a newcomer in a city like Bombay really pushes you to the limits. The necessities of survival and security make you suspicious; they brought out the worst in me. How could I be so concerned by the gross disparities between the rich and the poor and yet refrain from giving money to the child begging for it on the street, finding sanctuary instead in an air conditioned cafe? The only word for that is cruelty. Now you see why I cried - for the world, for myself, for what we are becoming. I begged God for forgiveness and repented of my sin. Sin, which we are all complicit in, when we pursue our own narrow interests. I had previously been yearning for egalitarian Europe, built on a foundation of human rights - I realised that this is the true marker of development, not wealth or even happiness, which is a red herring - where there may be subtle undercurrents of class and racial prejudice and hypocritical discrimination but at least everyone has rights in the eyes of the law, and just as importantly, the opportunity to exercise them. And I cried for the piecemeal dismantling of these rights that is happening in the West - all over the world, our leaders are selling our birthright for a mess of pottage.
Today is India's independence day. The country has a solid, progressive constitution, drawn up by the nation's founders and enshrining the rights of all individuals - rich and poor, male and female, high caste and low caste - equally on paper. A lot of good work has been done. A lot of people have done well since independence. But there is still much economic deprivation and marginalisation of millions of people due to poor implementation of these laws in many places. I believe a lot of this is due to attitudes - to the way we see and treat each other. It starts with the child snatching things from other children, and ends with the rich and powerful oppressing the poor and denying them their rights - basic rights of life, liberty, shelter and good health. We need to learn to value the other. We need to truly learn to namasté - not just as a cursory greeting, but seeing our relations with others, even strangers, as an extension of our relationship with God. This is what I believe as a Christian. God himself came and died for our dark and broken world, because he cares for each person. It was only the reality of Jesus that brought me back from the brink. Jesus cares. He alone can save me from my venality, my betrayal of righteousness for comfort. He accepts me as I am, and I know he's sufficient for me - to guide me through difficult decisions, to show me how to live, to entrust with the lives of all those I meet and am concerned for. Like the half naked little boy jumping for joy in the middle of the road, gleefully showing his mother the ten rupee note somebody had given him from a passing car.
The more familiar I grew with Bombay the more I came to appreciate the city. People here are nice and will go out of their way to help you, without asking for anything in return. Twice I came across the same man who showed me to places I was looking for. Another man walked me to the train station. I missed the greenery of the countryside, and while I appreciated the city's beautiful architecture, the density and heat were uncomfortable. But those cannot be helped and are merely attributes of urban life. The place is a hustler's paradise; too fast paced for comfort. It seems I am not the city sophisticat I thought I was...
My favourite thing about Bombay was the press. India's literary tradition is reflected in an intelligent, analytical, free press that seems to value objectivity over tribal loyalties. The scope of imagination was encouraging. Surely, with such values it's only a matter of time before what appear to be idealistic dreams become reality. So I'm glad I went to Bombay. I did find the inspiration I was looking for, even if it didn't present in the way I expected.
Monday, 9 August 2010
Culinary diplomacy
'I just wanted to see' - that's what they always say, isn't it, when they're caught? By way of explanation, justification, or even apology: 'I just wanted to see...' But seeing gives way to more compelling senses - touch, smell, taste, intimate exploration of the forbidden. Until time silently runs away, leaving the culprit inextricably linked with the evidence of their dirty deed and mealy mouthed excuses. 'I just wanted to see'.
I just wanted to see what was for breakfast this morning. My relationship with food has taken an interesting turn since coming to India. I like to think it has matured somewhat; the cries of my stomach no longer imperative as I've gained mastery over my tastebuds. My appreciation for good food is healthy, respectful, but not indulgent or slavering. Whatever comes later goes, and all that jazz.
It hasn't always been like this. Like many people where food is over abundant, I used to comfort eat, using food to fill any void identified at each particular moment. Bored? Have a bar of chocolate. Unhappy? Have a piece of cake to cheer you up. Happy? Have a celebratory doughnut. Angry? Have some ice cream to take your mind off things. Lonely? Go out for dessert with friends. And so on ad nauseum (not literally though, thankfully - although that phenomenon is sadly all too common). I decided that something needed to be done, starting a strict new regime of healthy food and regular excercise. 'Don't worry', reassured all my peers, 'you'll lose weight in India'.
I was bound to lose weight in India, I was told, because of Delhi belly. I'd definitely get some form of gastroenteritis at some point in my 6 week stay. I'd return gaunt, having lost essential calories. I wasn't so sure of this. Surely anyone with a basic education and access to good sanitation and potable water had enough to protect themselves from deadly tummy bugs? Remember, I was surrounded by public health posters from numerous government and non governmental organisations when growing up. Their directives were habitual: wash your hands before and after eating, wash your hands before and after toileting, before and after touching animals - in fact, before and after everything. Always cover food. Don't eat food from an unkown source. Only drink water that has been boiled and filtered. Do this and live.
No, I wasn't going to lose weight because of infection. I would lose weight because of discipline. I knew that out in rural India there would be limited opportunities for snacking on confectionery and pastries and all the other energy dense, nutrient deficient treats that have become routine indulgences. I would miss them. But it would do me good. It would be just like boarding school in Nigeria, 25 acres in the middle of the bush separated from the nearest village by a single dirt track - the only shop run by female teachers whose foremost priority was not financial gain, but the health of the children for whom they were in loco parentis. Little potential for pigging out there. Thankfully, as an adult I would have more freedom. There would be no compulsion to eat what was set before me. And why should there be? I'd have the maturity to eat it all anyway, the adventurous spirit to subsist only on the local cuisine of my new home (ignoring my mother's entreaties to at least take some cereal to snack on in case I didn't like the food) and even enjoy it. I would live as the locals live. 'Don't eat too much curry', my sister advised as I left, 'remember what happened last time you had really spicy food' (I had ended up in A&E with crampy abdominal pain). I laughed.
The first few days were difficult. I realised that as is almost always the case, my mother was right. I hadn't anticipted skipped meals as a cause of weight loss, but as I adjusted to the diet, this was precisely what happened. Rice for breakfast? Mba, no thanks. Bread? Boring. Eggs? Odikwa risky risky risky. Rice and dal fun onje osan l'ojojumo? No meat at lunchtime? The same watery lentil soup everyday, not at all what I associated with dal back home? As someone else asked, were we Oliver Twist? I was nearly glad my previous attempts at weight loss had turned out to be perfunctory. These fat reserves would need to last a long time. Or so I thought as each day I looked forward to dinner and the promise of meat. It was like a new slim-fast diet: water for breakfast, 2 chappatis at lunch and a proper dinner! Having to coordinate my meals with my antimalarial prophylaxis meant I was never in any real danger of starvation. But now I was eating out of necessity and not from desire. I picked at my food like an anorexic, struggling to maintain the impression of enjoyment.
You see, people in India are incredibly hospitable. Everywhere you go you are offered a cup of chai - incredibly sweet and milky hot tea that is thankfully served in plastic shot glasses or miniature mugs. Coming across an acquaintance who is eating merits an invitation to join in (just like in Africa). The kitchen staff here are solicitous about your well being: have you got enough? Would you like some more? While there's no one standing over my shoulder making sure I don't waste food, my conscience itself would prick me: not just because of all the starving children, but more because I don't want to waste the labour of the kindly souls who made the food if I'm being honest.
If I'm still being honest then I have to confess that this didn't stop me from surreptitiously wasting a lot of food when I first got here, before my senses adapted enough to distinguish between what I would like and what I wouldn't, making me game to try everything but loth to finish it all. I would load my plate with helpings of all the food on offer at mealtimes and inevitably by the end of the meal what I'd discovered repulsed me would be left on the plate. Trial and error - an initially wasteful, but eventually effective way to learn.
Before I knew it I was no longer discriminating between meals - food was food. I knew what to avoid and what to anticipate. Pancakes some mornings, potato pottage and fried dough reminiscent of Yorkshire puddings -puri- on others, these things I anticipated. I timed my sleep-ins to coincide with breakfast rice. Scrambled eggs and bread would depend on my mood. And I grew to love vegetarian food. What do they say, that after the initial discomfort it takes about 6 weeks to form a new habit? I discovered some new condiments to help me along the way. Halopenos and steak sauce would accompany chapattis for a simple lunch devoid of the disliked deadly dal (which I have to say I am alone in maligning). I soon began to put on weight. I remembered what my warrior ancestor, the one from whom we get our surname, was called: 'Ayogunmaru'. The one who goes to war and doesn't waste away. I used to think maybe it was some genetic quality, slow metabolism perhaps, that explained my stable weight levels. Now I'm thinking maybe he was just adaptable too. Adaptable and resilient.
I just wanted to see what was for breakfast this morning, just in case we'd been served pancakes. I didn't really plan on eating if it was anything else. But I lingered a little too long in front of the empty pot of scrambled eggs until she saw me - the friendly member of kitchen staff who always smiles graciously when I say namaste. She wouldn't take no for an answer when I assured her that toast was quite OK for my breakfast. Instead, she went to the kitchen to get some more eggs. What could I do? I had to eat. The proof of the pudding is in the eating.
Fever
'We are living in the jungle', intoned my American friend. Not quite, I thought, picturing dense rainforests impenetrable to any form of human habitation. This ordered life with its potential for familiarity and even comfort was chicken feed compared to that existence. Yet I knew what she meant - here, in the midst of the numerous ecological niches, it was easy to feel insignificant. It's impossible to forget that we are not alone as a species when there are so many other populations here vying for environmental dominion, each seemingly oblivious to the others' existence until their boundaries blur. A whole village of crows caws a strange vespers and mattins; they share the trees lining the paths with gargantuan bats that stink up the ground with their urine. Frogs hop in the puddles, relishing the freedom of long awaited rains before the baking sun once again routes them to unknown hiding places. Bushy-tailed squirrels with their confusing skunk like markings flit from bough to bough. And inside there's more - geckos on the walls, mosquitoes in the air, beetles the size of two fingers. Rats and ants stealing food: wild, untameable - and sightings and rumours of snakes. The flies, carrion even of carrion, lord it over all, feasting on a dead crow that appears to have been lynched as it hangs from a dried bark. Truly, we are not alone.
Nature above is just as awe inspiring as nature all around. As I walked back to my room I saw the stars and was once again amazed by their beauty and intrigued by a solitary red star shining more brightly than any of the rest. Was it closer? Was it dying? The stars envelope you as you walk down a dark path, making you feel secure. Until you notice the black thing lying in wait. What was it? Another dead crow? A black cat? I stood and watched, bending over to peer into the eyes of the creature. It was still. So was I. The bats began to flutter in the trees. I shuddered. There was no going back now, for I had just said goodbye to the group of men I'd left behind before embarking on this solitary walk and did not want to display my fear. I could not raise my voice to call for help. So I stood, watching, knowing that the last one standing would win. I could wait all night for the creature to move - or for a protector to come my way - if that was all it took. The bats, fully awoken by now, began to fly in various directions. I reminded myself that they were just animals flying as is their prerogative. Then they woke up the crows, who also cried out and flew. I stood watching. So did the black creature, of whose feline identity I was by now certain.
Somebody came out of a bungalow and onto the path. The cat scarpered and I strolled my merry way along to my room. My bacon was saved. Fortune may favour the brave, but the patient cowardly aren't very far behind.
Thursday, 5 August 2010
Sir Nose Devoidoffunk
Conversation between two doctors in the hospital, one my elective supervisor and the other another doctor seeing a patient with ischaemic heart disease in clinic:
Dr A: 'The ECG shows ST depression - she has ischaemic heart disease. You shouldn't just treat her medically, advise her on diet and excercise as well. And you too need to lose weight - why do you always ride the motorbike to the hospital? You should walk from time to time. You need to be fit so you can advise your patients on lifestyle.'
Dr B, protesting: 'Just because I'm big doesn't mean I'm unfit. I mean, look at Steffi Graf - you know, the tennis player? She's big too...'
Dr A: 'Don't use that excuse with me, Steffi Graf is big because she has an athletic build - are you an athlete?'
Both of them look at me, laughing. I smile nervously. My own body has gone to seed here, driven by a carbohydrate based diet of rice and chappatis and long afternoon naps that drift all the way from lunch to dinner. Who am I to pass comment? I remember the conversation with my new GP nearly 5 years ago when I first enrolled at medical school. 'Do you do sport?', he had said. 'You should - there are too many unfit doctors out there'.
While community based primary health care is the core philosophy of the work that the CRHP does, there are still many things to be seen in the hospital here. In a way, a visit to the hospital illustrates the main social problems in an area and Jamkhed is no exception. I have made a list of at-risk groups most likely to require hospital treatment here:
Dr A: 'The ECG shows ST depression - she has ischaemic heart disease. You shouldn't just treat her medically, advise her on diet and excercise as well. And you too need to lose weight - why do you always ride the motorbike to the hospital? You should walk from time to time. You need to be fit so you can advise your patients on lifestyle.'
Dr B, protesting: 'Just because I'm big doesn't mean I'm unfit. I mean, look at Steffi Graf - you know, the tennis player? She's big too...'
Dr A: 'Don't use that excuse with me, Steffi Graf is big because she has an athletic build - are you an athlete?'
Both of them look at me, laughing. I smile nervously. My own body has gone to seed here, driven by a carbohydrate based diet of rice and chappatis and long afternoon naps that drift all the way from lunch to dinner. Who am I to pass comment? I remember the conversation with my new GP nearly 5 years ago when I first enrolled at medical school. 'Do you do sport?', he had said. 'You should - there are too many unfit doctors out there'.
While community based primary health care is the core philosophy of the work that the CRHP does, there are still many things to be seen in the hospital here. In a way, a visit to the hospital illustrates the main social problems in an area and Jamkhed is no exception. I have made a list of at-risk groups most likely to require hospital treatment here:
- Children
- Young women
- The elderly (male>female)
- Migrant workers
- Members of nomadic communities
- People with chronic debilitating conditions (e.g. post stroke)
There are several reasons for the above. Children are really susceptible to infections, and in the rainy season are prone to malaria, viral upper respiratory tract infections and pneumonia and mostly present with these three conditions. They are also the single most vulnerable group to one of the main causes of acute (as opposed to planned) admission to hospital here: road traffic accidents. Another main cause of acute admissions at the moment is snake bite and this tends to affect older members of the population, with quite a few cases happening after dusk or in the bushes when people can't see to protect themselves. The hands and the legs are the most commonly bitten areas. A third cause of trauma, bull gore injuries, occurs much less frequently in the working population.
I have seen a number of the classic 'exotic' conditions you expect to see in the tropics: leprosy, tuberculosis, typhoid fever, hepatitis A....these cases are generally treated with routine anti-infective prophylaxis as appropriate and tend to make a good recovery quite quickly. Particularly at risk are migrant workers due to their precarious financial situation which serves as a barrier to accessing care since they have to move to find work, making follow up, monitoring and management of chronic conditions difficult. They are also understandably reluctant to do anything that will jeopardize their jobs such as taking time off work to have an operation done. In addition, migrant groups are more likely to be marginalised from health promoting activities, making them less informed on important issues such as vaccination. As you can surmise, control over the external environment is crucial to prevention of many of these conditions, and this requires social cohesion and economic power. I wonder if this accounts for the differences I have noticed in sanitation levels which vary so greatly from one village to the next.
Another main service provided by the hospital is antenatal care and maternity services, although the bulk of antenatal visits are carried out by the village health workers in the expectant mother's village, saving her a long trip to the hospital. Only high risk pregnancies are referred for more advanced investigations like ultrasound scans. At the moment there is an issue regarding new legislation that means only government hospitals are registered to carry out emergency Caesarean sections. As the nearest hospital where C-sections can be carried out is at least 2 hours away, this presents a major risk to women in labour in this area who may need emergency C-sections for any reason completely unpredictable pre-natally: for example, prolonged labour causing maternal exhaustion, obstructed labour and cephalo-pelvic disproportion and foetal distress. Clarification is being sought on this issue at the moment, which cannot be resolved a minute too soon.
There is an increased incidence of chronic non communicable disease - diabetes, ischaemic heart disease, chronic obstructive pulmonary disease and cerebero-vascular disease - worldwide. It has been interesting to see how these blights are presenting in rural India. Along with the routine myocardial infarction, I saw my first skinny patient with type 2 diabetes, malnourished due to insulin deficiency (we are drilled into associating type 2 diabetes with obesity). She had very poorly managed cellulitis that had spread deep beyond her skin into her subcutaneous tissue, needing surgical debridement. A lot of the patients who have poorly managed chronic conditions come from villages that are not involved with the CRHP (non-project vilages as they are called here) and so do not have village health workers to take care of the immediate health needs of the vilagers. This underscores the necessity of having someone local and available to attend to basic health needs in remote rural areas; without such people, these needs are neglected until people are in too much pain to function, by which time more extensive (and expensive) work is necessary.
Some screening work done while I've been here has shown quite a number of people to have previously undiagnosed hypertension, with some systolic blood pressures being in the high 200s (levels this high are classified in textbooks as malignant hypertension or hypertensive crises, requiring urgent medical treatment). This may account for the increased number of sudden deaths and strokes being seen here (hypertension is one of the main risk factors for cerebero-vascular disease). Although stroke patients who are brought to the hospital in time get prompt and efficient treatment, the challenge does not end there. Rehabilitation and continued care after medical discharge is crucial for the continued well being of the patient, socially and medically. I saw one such patient who had previously suffered a stroke come in with diarrhoea; what was the source of the infection? Gastroenteritis due to drinking water from the local stream instead of the well? A urinary tract infection due to stasis and immobility? It's hard to tell. Community based rehabilitation for the physically disabled is something I've been thinking about a lot recently; an estimated 70-80% of India's disabled population live in rural areas.
The best thing about this hospital is that almost everyone gets what they need in the end. There's a lot of elective surgery done here: tubal ligations for contraception, hysterectomies for menstrual problems in older women, hernia repairs, cataract repairs, mastectomies for patients with breast cancer, rehabilitation surgery for patients with leprosy who have sustained deformities, and so on and so forth. Treatment is given to all without prejudice and regardless of ability to pay, yet it is not free either. Generally the hospital and the patient work something out on a sliding scale based on what the patient can afford. I would still love to see a system where all healthcare was free at the point of delivery, but within this community this system is the most humane, feasible (enabling the continued functioning of the project since most people are casually employed in the informal sector and so can't take part in insurance schemes) and works very well. The teamwork definitely fosters trust between the medical staff and the communities they serve, an indispensable requirement for maintaining good health.
Wednesday, 4 August 2010
I thought I was going to spend this post writing about the things I've been learning in hospital - interesting clinical experiences that remind me of why I love Medicine. It was going to be a funny post. But I was wrong and that post will have to wait, because this one is more important.
A friend once told me when I confided in her about my pervasive self doubt, that my elective would be a great boost for my self confidence. I didn't understand what she meant at the time, but she was right - it's out here that I'm finally beginning to realise that I actually know stuff, that I'm good at what I do and can be even better if I just believed in myself. When you see people that really need your skills (or the skills of any physician), there is a passion borne out of your compassion for their situation that makes you overcome your own shyness or fear.
It can also lead to profound sadness. I made friends with one of the girls who attends the Adolescent Girls Programme here (a project set up to help young women interact with their peers, have fun, give them personal, social and health education and educate them on self defense and self esteem - to help them see themselves as young women full of potential and not just mere chattel or somebody's future wife). I was walking to get dinner when I bumped into a friend who is one of the interns here, chatting to the girl (henceforth referred to as N). She was impressed by how good her English is (in this area children are educated in Marathi); while not fluent the three of us managed, with much gesticulation and clarification, to have a long chat. N told us she had an English-Marathi chart and she would teach us Marathi. She is a friendly, bubbly, intelligent girl.
I bumped into N the next morning and went over to say hello. She was holding her little brother, who was very friendly and playful. I could tell just by looking at him that he has cerebral palsy. His legs were thin, somewhat atrophied and hypertonic - I was guessing he had a spastic diplegia. This was confirmed when N told me that he can't walk and put him on the floor to demonstrate - his legs went into the characteristic scissors position. He had communication difficulties - N said he only had 3 words and couldn't hear; he drooled constantly. But he was a lively child who gesticulated wildly with his hands when excited. He always returned your smile, laughed a lot, and gained a lot of pleasure from the passing vehicles (showing that his communication problem probably isn't due to a lack of hearing) - he seemed to be really stimulated by motion.
I asked N if her brother liked to play. She seemed confused (remember, we were dealing with a big language barrier, and most of our conversation was helped with body language. How do you act out the word play?) and we went on to talk about other things. We were standing outside the preschool at the time. When the children arrived with their squeals and their mirth, the conversation turned back to play, this time led by N, who asked what games I knew. I seized the opportunity to ask if her little brother played any games. No, she said, because he couldn't walk. But could he sit and play? I asked, what if you sat him on the ground and played with him? He couldn't sit either, I learned, because he couldn't maintain his balance. He had to be carried all day.
I can't get N's brother out of my head. He is a delightful little boy with a family that obviously loves him very much and shows him a lot of affection and consideration, for which he is fortunate. But I feel sad that he hasn't had all the opportunities he could have had - therapy that could preserve some independence for him: physiotherapy for balance and posture, occupational therapy to help him move around, speech and langauge therapy to assess how much verbal communication he is capable of and help him to express himself. Consequently, his intellectual potential remains untapped and I am concerned that this may be irretrievable. Most of all, I feel sad that this beautiful boy is deprived of play, such an essential component in the life and development of any child. I feel for his father, mother and sisters who unselfishly look after him, holding him all the time, but am also aware that this comes at a price of the welfare of the family since it prevents them from attending to other matters. I wish they had more support.
I think of all the support that is available at home for families of people with disabilities - financial assistance from the government, day centres where people can go and have a full, stimulating and rewarding day with physical and intellectual stimulation and social interaction. The nearest such place is 4 hours away in the city of Pune, completely unfeasible for this little boy, unless he were to stay there residentially. And how would ripping him away from the family that loves and cares for him help? They need local services and a local source of support. These are the challenges of life in the rural area. This is the challenge of the vulnerable in the developing world. It's not just theoretical. It's people's lives that are at stake.
I'm going to try and find out more about the wider issue in this area, but even if I achieve nothing else, I hope that by the time I leave N's brother will be playing. I think I have an idea...
A friend once told me when I confided in her about my pervasive self doubt, that my elective would be a great boost for my self confidence. I didn't understand what she meant at the time, but she was right - it's out here that I'm finally beginning to realise that I actually know stuff, that I'm good at what I do and can be even better if I just believed in myself. When you see people that really need your skills (or the skills of any physician), there is a passion borne out of your compassion for their situation that makes you overcome your own shyness or fear.
It can also lead to profound sadness. I made friends with one of the girls who attends the Adolescent Girls Programme here (a project set up to help young women interact with their peers, have fun, give them personal, social and health education and educate them on self defense and self esteem - to help them see themselves as young women full of potential and not just mere chattel or somebody's future wife). I was walking to get dinner when I bumped into a friend who is one of the interns here, chatting to the girl (henceforth referred to as N). She was impressed by how good her English is (in this area children are educated in Marathi); while not fluent the three of us managed, with much gesticulation and clarification, to have a long chat. N told us she had an English-Marathi chart and she would teach us Marathi. She is a friendly, bubbly, intelligent girl.
I bumped into N the next morning and went over to say hello. She was holding her little brother, who was very friendly and playful. I could tell just by looking at him that he has cerebral palsy. His legs were thin, somewhat atrophied and hypertonic - I was guessing he had a spastic diplegia. This was confirmed when N told me that he can't walk and put him on the floor to demonstrate - his legs went into the characteristic scissors position. He had communication difficulties - N said he only had 3 words and couldn't hear; he drooled constantly. But he was a lively child who gesticulated wildly with his hands when excited. He always returned your smile, laughed a lot, and gained a lot of pleasure from the passing vehicles (showing that his communication problem probably isn't due to a lack of hearing) - he seemed to be really stimulated by motion.
I asked N if her brother liked to play. She seemed confused (remember, we were dealing with a big language barrier, and most of our conversation was helped with body language. How do you act out the word play?) and we went on to talk about other things. We were standing outside the preschool at the time. When the children arrived with their squeals and their mirth, the conversation turned back to play, this time led by N, who asked what games I knew. I seized the opportunity to ask if her little brother played any games. No, she said, because he couldn't walk. But could he sit and play? I asked, what if you sat him on the ground and played with him? He couldn't sit either, I learned, because he couldn't maintain his balance. He had to be carried all day.
I can't get N's brother out of my head. He is a delightful little boy with a family that obviously loves him very much and shows him a lot of affection and consideration, for which he is fortunate. But I feel sad that he hasn't had all the opportunities he could have had - therapy that could preserve some independence for him: physiotherapy for balance and posture, occupational therapy to help him move around, speech and langauge therapy to assess how much verbal communication he is capable of and help him to express himself. Consequently, his intellectual potential remains untapped and I am concerned that this may be irretrievable. Most of all, I feel sad that this beautiful boy is deprived of play, such an essential component in the life and development of any child. I feel for his father, mother and sisters who unselfishly look after him, holding him all the time, but am also aware that this comes at a price of the welfare of the family since it prevents them from attending to other matters. I wish they had more support.
I think of all the support that is available at home for families of people with disabilities - financial assistance from the government, day centres where people can go and have a full, stimulating and rewarding day with physical and intellectual stimulation and social interaction. The nearest such place is 4 hours away in the city of Pune, completely unfeasible for this little boy, unless he were to stay there residentially. And how would ripping him away from the family that loves and cares for him help? They need local services and a local source of support. These are the challenges of life in the rural area. This is the challenge of the vulnerable in the developing world. It's not just theoretical. It's people's lives that are at stake.
I'm going to try and find out more about the wider issue in this area, but even if I achieve nothing else, I hope that by the time I leave N's brother will be playing. I think I have an idea...
Sunday, 1 August 2010
My mummy said it, so it must be true
A memory of the week before it all began, recalled from the ether. It occurs somewhere south of the Home Counties, near a railway station, in the town that is for me, 'home-home'. I am sitting in a leather chair in an Indian takeaway, watching the Ghana versus Uruguay world cup match, the important decider that will determine whether Ghana makes it to the semi-finals. So is the man at the counter. Naturally, we converse.
'Who are you supporting then?' One of us asks. We discover we're both supporting Ghana. I tell him Ghana's my chosen country since my native country's shambolic performance, besides, they've played well. He agrees. He'd like to see them go far. I learn that he's originally from Sri Lanka, a country that's not in the FIFA World Cup. It's a cricketing nation, just like India. But football is quite popular; it's only a matter of time...
We are soon joined by another family, here to get a quick takeaway meal so they can go home and beat their aunty to the TV - if they don't put the match on in time they'll miss the second half because Aunty doesn't like football. Mum, dad and teenage daughter are here. Daughter comes to sit next to me. She asks who I'm supporting. 'Ghana', I say, 'you?' 'No one really', she says, then adds as a quick afterthought, 'but Ghana now!' We watch on tenterhooks as the match heats up. I am savouring the beautiful moment - here we are from 3 corners of the globe, all supporting a small country from the beautiful but oft sidelined continent that I still call my home.
The family decide on their order. 'What do you want?' mum (or dad) asks teenage daughter, who vacillates between choices. 'I don't know, what's healthy?' she asks. 'This is Indian food, it's all healthy', replies dad. We all laugh. That's the cuisine of my future home we're talking about. It's a small world, and I'm glad to be a part of it. I realise that this place too is special: this small island, on the western outskirts of this ageing continent, is my home and I love it. I feel a twinge of nostalgia for what I am about to leave.
'You're a real global citizen', my mother often says to me, sometimes admiringly, sometimes exasperatedly, sometimes resignedly, but always heartfelt. It took going to Pune, once a British military cantonment, now grown to a full fledged member of urban India, to discover that she truly is right. Born in the 1980s, that fulcrum of globalization, in a decolonised country in urban West Africa where foreign cultural influences were equally if not more likely to come from commercial marketing than colonial influences, where the lines between 'ours' and 'theirs' -values, speech, taste- were incredibly blurred, is it any wonder that everywhere but nowhere is where I belong? Everyone is kin, in some form or another. In a bookstore in Pune I was confronted with staples from childhood - Asterix and Obelix, Tintin, Nancy Drew and Hardy Boys, The Famous Five, Archie comics....enough to make me wonder just how different my life would have been if I had grown up in India. Perhaps not as different as it may seem at first thought.
Pune was eye opening - thought provoking. I finally started to see and process the rural-urban divide up close, having lived rurally for the past 3 weeks. It is initially subtle but eventually seismic. Tell tale signs of disparities in wealth - the size of the average inhabitant. In Jamkhed I had to buy an extra-large outfit to get one that would fit; I considered myself obese by Indian standards. In Pune the reverse was the case, I had to buy a small outfit to get it to fit; most people were easily bigger than me. Food is more easy to come by in the city, particularly that of the energy dense variety - chocolate, ice cream, cake... And it is a sign of wealth - the wealthier people, shopping in the air conditioned malls, really were bigger than the average Joe walking the city's streets. Jamkhed and Pune are only about 4 hours apart by road, but the variance in infrastructure makes you understand current migratory patterns.
Pune impressed me with its combination of modernity and civility. It was by and large clean, though where Jamkhed has pigs, it has dogs. It has municipal services. No rubbish tips lying around the place. Pavements on the roads. Pedestrian crossings (often ignored, but still...) and functional traffic lights. The streets I walked on were quiet. And it was definitely a city - people who dealt with you were cordial, but strangers generally ignored each other. No routine namastes here.
Pune impressed me for another reason too - it showed me the new India. The new, vibrant, up and coming India with a booming economy and an ebullient, youthful population with enough aspiration to dampen some of its more depressing features, like the poverty that has people begging for alms on the roads - some disabled, others through circumstance, and yet others through cynicism? One minute a woman was asking for money, the next to have her photograph taken. 'What developed this learned helplessness?' I wondered. I remembered learning about how disability is relative - to the accommodation of society to an individual's impairment. What would David Blunkett, erstwhile Home Secretary of the United Kingdom, think of the idea that blind people are only able to make a living from begging and giving them alms is an act of charity and helpfulness? Or Stevie Wonder, international musical maestro -some would say genius-? Both men are blind. A wise society it is that enables all its members to fulfil their potential despite other limitations they face. 'Adjust' is a popular expression in India, meaning exactly that, but used in broader contexts. Can the new India adjust to the needs of the weak for the benefit of themselves, their communities and wider society?
The new India is fascinating, proudly and distinctly Indian, yet absorbing what the world has to offer. I got carried away with wonderful fusion jazz incorporating some of the best of contemporary classical Indian music. The majority of vehicles that ply the nation's roads are locally produced Indian brands. You can enjoy a traditional Pav bhaji on a side street or a tasty raclette in a Swiss restaurant, amongst other things. Eating Punjabi food in the down to earth juice bar in Pune's old town, I remembered the Ceylonese takeaway owner. 'What is it like to leave your business at home to start a new one in a new home?' I wondered, watching as the cooks mashed together potatoes, tomatoes, vegetables and herbs in open view of diners.
I like the new India's secure open mindedness, yet the media and other sources - security guards complete with metal detectors at major outlets, the memories of a recent bomb attack only months ago - remind me that this too is under threat. I wonder what life is like for the people of Pune. What are the living standards of the people who service the lives of the fortunately affluent? The security guards and checkout staff at malls, the waiting staff at restaurants - what do they go home to? Can they afford to avail of the services that they themselves provide: to shop in the same stores, eat in the same restaurants? They are probably more highly skilled than their Western counterparts, since fluency in the English Language (required for such service oriented positions) is a skill that is the preserve of the well educated in India. Do they have good job security, pay, respect, benefits? Do their current circumstances live up to their earlier expectations? I don't know the answers to these questions, but I aim to find out.
This journey is like a study in globalization. It's exciting. I'm seeing the process and its products: the boons and the fallout. Perhaps I can help to understand how to secure a good living for the most vulnerable in these processes and then go ahead and do so: that is my dream. What does the future hold? I don't know. But I do know this - I want a piece of this pie...
'Who are you supporting then?' One of us asks. We discover we're both supporting Ghana. I tell him Ghana's my chosen country since my native country's shambolic performance, besides, they've played well. He agrees. He'd like to see them go far. I learn that he's originally from Sri Lanka, a country that's not in the FIFA World Cup. It's a cricketing nation, just like India. But football is quite popular; it's only a matter of time...
We are soon joined by another family, here to get a quick takeaway meal so they can go home and beat their aunty to the TV - if they don't put the match on in time they'll miss the second half because Aunty doesn't like football. Mum, dad and teenage daughter are here. Daughter comes to sit next to me. She asks who I'm supporting. 'Ghana', I say, 'you?' 'No one really', she says, then adds as a quick afterthought, 'but Ghana now!' We watch on tenterhooks as the match heats up. I am savouring the beautiful moment - here we are from 3 corners of the globe, all supporting a small country from the beautiful but oft sidelined continent that I still call my home.
The family decide on their order. 'What do you want?' mum (or dad) asks teenage daughter, who vacillates between choices. 'I don't know, what's healthy?' she asks. 'This is Indian food, it's all healthy', replies dad. We all laugh. That's the cuisine of my future home we're talking about. It's a small world, and I'm glad to be a part of it. I realise that this place too is special: this small island, on the western outskirts of this ageing continent, is my home and I love it. I feel a twinge of nostalgia for what I am about to leave.
'You're a real global citizen', my mother often says to me, sometimes admiringly, sometimes exasperatedly, sometimes resignedly, but always heartfelt. It took going to Pune, once a British military cantonment, now grown to a full fledged member of urban India, to discover that she truly is right. Born in the 1980s, that fulcrum of globalization, in a decolonised country in urban West Africa where foreign cultural influences were equally if not more likely to come from commercial marketing than colonial influences, where the lines between 'ours' and 'theirs' -values, speech, taste- were incredibly blurred, is it any wonder that everywhere but nowhere is where I belong? Everyone is kin, in some form or another. In a bookstore in Pune I was confronted with staples from childhood - Asterix and Obelix, Tintin, Nancy Drew and Hardy Boys, The Famous Five, Archie comics....enough to make me wonder just how different my life would have been if I had grown up in India. Perhaps not as different as it may seem at first thought.
Pune was eye opening - thought provoking. I finally started to see and process the rural-urban divide up close, having lived rurally for the past 3 weeks. It is initially subtle but eventually seismic. Tell tale signs of disparities in wealth - the size of the average inhabitant. In Jamkhed I had to buy an extra-large outfit to get one that would fit; I considered myself obese by Indian standards. In Pune the reverse was the case, I had to buy a small outfit to get it to fit; most people were easily bigger than me. Food is more easy to come by in the city, particularly that of the energy dense variety - chocolate, ice cream, cake... And it is a sign of wealth - the wealthier people, shopping in the air conditioned malls, really were bigger than the average Joe walking the city's streets. Jamkhed and Pune are only about 4 hours apart by road, but the variance in infrastructure makes you understand current migratory patterns.
Pune impressed me with its combination of modernity and civility. It was by and large clean, though where Jamkhed has pigs, it has dogs. It has municipal services. No rubbish tips lying around the place. Pavements on the roads. Pedestrian crossings (often ignored, but still...) and functional traffic lights. The streets I walked on were quiet. And it was definitely a city - people who dealt with you were cordial, but strangers generally ignored each other. No routine namastes here.
Pune impressed me for another reason too - it showed me the new India. The new, vibrant, up and coming India with a booming economy and an ebullient, youthful population with enough aspiration to dampen some of its more depressing features, like the poverty that has people begging for alms on the roads - some disabled, others through circumstance, and yet others through cynicism? One minute a woman was asking for money, the next to have her photograph taken. 'What developed this learned helplessness?' I wondered. I remembered learning about how disability is relative - to the accommodation of society to an individual's impairment. What would David Blunkett, erstwhile Home Secretary of the United Kingdom, think of the idea that blind people are only able to make a living from begging and giving them alms is an act of charity and helpfulness? Or Stevie Wonder, international musical maestro -some would say genius-? Both men are blind. A wise society it is that enables all its members to fulfil their potential despite other limitations they face. 'Adjust' is a popular expression in India, meaning exactly that, but used in broader contexts. Can the new India adjust to the needs of the weak for the benefit of themselves, their communities and wider society?
The new India is fascinating, proudly and distinctly Indian, yet absorbing what the world has to offer. I got carried away with wonderful fusion jazz incorporating some of the best of contemporary classical Indian music. The majority of vehicles that ply the nation's roads are locally produced Indian brands. You can enjoy a traditional Pav bhaji on a side street or a tasty raclette in a Swiss restaurant, amongst other things. Eating Punjabi food in the down to earth juice bar in Pune's old town, I remembered the Ceylonese takeaway owner. 'What is it like to leave your business at home to start a new one in a new home?' I wondered, watching as the cooks mashed together potatoes, tomatoes, vegetables and herbs in open view of diners.
I like the new India's secure open mindedness, yet the media and other sources - security guards complete with metal detectors at major outlets, the memories of a recent bomb attack only months ago - remind me that this too is under threat. I wonder what life is like for the people of Pune. What are the living standards of the people who service the lives of the fortunately affluent? The security guards and checkout staff at malls, the waiting staff at restaurants - what do they go home to? Can they afford to avail of the services that they themselves provide: to shop in the same stores, eat in the same restaurants? They are probably more highly skilled than their Western counterparts, since fluency in the English Language (required for such service oriented positions) is a skill that is the preserve of the well educated in India. Do they have good job security, pay, respect, benefits? Do their current circumstances live up to their earlier expectations? I don't know the answers to these questions, but I aim to find out.
This journey is like a study in globalization. It's exciting. I'm seeing the process and its products: the boons and the fallout. Perhaps I can help to understand how to secure a good living for the most vulnerable in these processes and then go ahead and do so: that is my dream. What does the future hold? I don't know. But I do know this - I want a piece of this pie...
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