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Daulati's Tuberculosis of the Spine...

_Daulati on X-Ray Table

...I spent the entire day today at the hospital with this beautiful, angelic, and incredibly unfortunate young girl named Daulati. Even among the slum's residents, Daulati's family is one of the most destitute of all. To make matters worse, she has half a dozen siblings, is severely malnourished, and can now hardly walk due to an infection that has contorted and crippled her spine. --Daulati today on the x-ray table--

I never met or even knew about Daulati when I was here last year. However, I became aware of her painful and debilitating condition nearly one month after my departure. She and her family had heard about our work treating other children and approached Mithlesh for help. Mithlesh sent me the following photo with a short description of her severe pain and evident need for immediate treatment:

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--Daulati on June 21, 2012--

Not knowing at the time what this condition was, I asked Mithlesh to take her to the hospital as quickly as possible. Amazingly, Daulati's family had never sought treatment before. Mithlesh and Mamta both generously agreed and took Daulati with another of our patients to New Delhi on multiple occasions. The physicians there drained her abscess and referred Daulati to the All India Institute of Medical Sciences (AIIMS), India's largest government research hospital, for further care and radiology.

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At AIIMS, Daulati was diagnosed with "Tuberculosis of the Spine," also known as Pott Disease.

According to the NIH, India has one of the largest concentrations of patients with TB anywhere in the world with more than 6 million radiologically proven cases. I can only imagine there are at least twice or three times as many people who actually have it but never seek care. Worldwide, approximately 30 million people suffer from TB and nearly 3 million people die annually from the disease. Among all cases of TB, approximately 1-2% of patients develop skeletal tuberculosis, approximately half of which are reported to result in spinal tuberculosis.

_Pig in Ruins

--Conditions ripe for disease...notice the pig in the center room--

Patients with TB are often poor, illiterate, uneducated, and/or live in highly dense and unsanitary conditions. Multi-drug resistant tuberculosis (MDR-TB) is a growing problem in India, mainly due to a lack of proper patient education. Illiterate and impoverished patients start taking their antibiotics, improve, and then stop taking all medications because they feel better and don't want to waste their time or money taking pills. Strict adherence to medication protocol over as many as 9 months is vital for curing a patient's TB. However, these patients live day-to-day and lack the awareness of the harm they do to themselves and others. As a result of their failure to adhere to instructions, they occasionally develop MDR-TB that creates entirely new and severe public health concerns.

_Daulati and Sister

People here fear TB, as they should. Mithlesh expressed his concern of being infected. I could not ask people to take on a risk that I could not evaluate or take first. Instead, I attempted to have Daulati's family take care of her on their own. However, they refused/were unable to go on their own. They live in the same room as her and breathe the same air all day every day.

_Daulati on Bed

--Daulati just a few days ago--

Even though Mithlesh and Mamta had shown Daulati and her family what to do and where to go, they would not go alone. For the past six months, Daulati's condition has continued to deteriorate. My first sight of her broke my heart. She is like a pile of mangled bones shrink wrapped in dark weathered skin. She walks bent over at a 90 degree angle with her arms assisting her every move like a primate. Watching her climb in and out of chairs or vehicles is heart-wrenching. How could her parents stand by and watch her suffer so miserably?

I never cease to be amazed by the extent of suffering people will endure here. Daulati's condition has been worsening now for nearly two years. She has had severe kyphosis (hunchback) for over a year and yet her family never took her to a doctor. As shown in the photo above, Daulati spends her days laying in a mesh bed outside of her family's little shanty in the slum.

_Daulati's Father and Home

--Daulati and her father outside their makeshift home--

The longer I stay here, the more I realize that healthcare among the poor in India is a complete mess. After experiencing the deaths of Kishan, Santosh, and numerous other precious little children who died from easily-treatable illnesses, I have realized that many of the problems are fairly simple. Rapid, early treatment could have saved faces and lives in many cases.

_Manish Portrait with Dolly

-Manish's venous malformation should have been removed when it was the size of a pea--

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--Kishan should have received treatment for pneumonia before it killed him--

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--Santosh needed an IV for his diarrhea. Instead, his simple illness was fatal--

Today, however, Daulati's world took a new turn. I suited up in a mask and gloves, placed masks on Daulati and her father, and then set out with them in an auto rickshaw to one of the best private hospitals in town for appointments I had made. Within 4.5 hours, we had visited multiple senior orthopedic and plastic surgeons and obtained T-and-L-spine MRIs, chest x-rays, and blood tests. She was an ideal patient and never once complained, even when her noisy, claustrophobic MRI took nearly 90 minutes.

_Daulati in Wheelchair

--Samosas and ice cream as a treat for being such a good patient--

The physicians today were not too concerned of active pulmonary TB, which is good news for her family and me. However, I will continue to take the best precautions I can.

We will return for her results and follow up on Thursday morning, when the surgeons will drain her abscess, treat her tuberculosis of the spine, and plan an operation to repair her kyphosis that would otherwise remain chronic.

How far would Daulati's family had let her health deteriorate without seeking help? After my experience alone with her father today, I fear she would have almost certainly died.

Many thanks to the donors of Healing the Hidden who made Daulati's MRI, x-rays, blood tests, transportation, and consultations possible today. Our combined efforts may very well save her life.

(Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3075833/)

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Leading Two Lives...

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Leading Two Lives...

Sonu and Pritest in Uniforms 2

...The day after I arrived, our students suited up in their new winter uniforms and set out for their special class while regular school is still out of session for winter break. For the winter season, we purchase our students new uniforms, including sweaters, sweater vests, blazers, and long pants or skirts to stay warm. They look terrifically handsome and beautiful yet striking against the background of their foggy homes and surroundings. --Sonu and Pritesh--

Our students rarely go anywhere alone. As I expected, they have become best friends over the past few months. Hand-holding even among men is common in India and our students walk everywhere hand-in-hand.

Poornima and Anita Walking to School 2

--Poornima and Anita--

Roshan and Mother

--Roshan and his mother--

First View of All in Winter Uniforms

For those of you just joining us, these students you are looking at live in a slum and are members of the lowest castes in Indian society. No one has believed in them enough before to give them the opportunity of a world-class education, or any education for that matter. Even now, many people here are skeptical about their abilities to succeed.

We, however, do believe in them. Over the next few months, I'm going to prove to you why. These students first started school 10 months ago. At that time, they knew only the English alphabet and how to count from 1-100. They could not read, write, or speak to any greater extent. Even in Hindi, their native language, the could only recite the alphabet.

For the past 10 months, they have been studying 7.5 hours a day (2.5 hours longer than regular students) and six days per week at the Carmel Convent School, a well-renowned English-medium private school near their slum. Before I left, our students and I could hardly communicate at all beyond body language. Now, they understand much of what I am saying and can even translate for me when people approach us on the street to ask me questions.

When we walk places, they call out and spell the names of everything they see. They will point at, for instance, a picture of a elephant and yell, "Elephant...e-l-e-p-h-a-n-t!!!!" or see a rickshaw passing by and yell, "Rickshaw...r-i-c-k-s-h-a-w!!!"

Goofing Around in Winter Uniforms Cropped

They also happen to have spectacular senses of humor. They have always made me laugh with their actions but they do so now with their words as well. When passing a field where many people go to dispose of their human and material waste, the children point and yell, "Park...Dirty park!...Very dirty park!!" as they wiggle and rotate their hands back and forth to signify 'do not enter.'

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--The "very dirty park"--

In the Classroom Winter Uniforms

The vast majority of our students can now read entire pages of books out loud and without any hesitation, even material they have never seen before. I brought "The Cat in the Hat" along and we were able to read it together for the first time.

Sky View of the Classroom

They also understand that they're all in this together. They help one another when they are struggling and congratulate those who receive high marks on tests or homework. They are like a large 21-person family.

Roshan and Ahshansh in Winter Uniforms
Gudiya Ready for Prayer

Every class begins and ends with a prayer thanking God for the ability and opportunity to study. It is a precious sight to behold.

Walking Through the Slum

--Walking home from school--

Mansiha Showing Home

--Manisha returning home to begin cooking--

When school ends, the children return to their dwellings in the slums and change back into their tattered clothing. Many of them return to bare feet and quickly become indistinguishable from the other children in the slum. They begin their chores and often perform most of the work to maintain their homes. At about 8pm, most of the students begin their homework and study for 1-2 hours before going to bed.

These kids are among the most fascinating and inspiring I have ever met. They lead two completely different lifestyles now and yet fit into both of them remarkably well given their circumstances. I am proud of them and hope you are too.

JCS_2409

--Madhu cooking with her mother--

 

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Healing the Hidden: Santosh...

...April 3, 2012: This morning, a mother named Sugo Devi brought her deformed infant boy to the slum school for help. This is the first time someone needing medical attention has actively come to us for assistance and marks a radical shift in our ability to provide care to this community. Parents of deformed children here have traditionally not sought help from others partially because of the negative stigma involved with having disfigured or handicapped children. Manish’s mother, for instance, turned away from me shamefully the first time I saw her holding him. Moni, even by age 5, had never been to a doctor to have her cleft lip and palate examined. Even the young “normal” children, the least likely to judge others based on appearance, originally refused to play with handicapped or mentally challenged children. The fact that Sugo Devi showed up this morning proves that the purpose of our work is being noticed and understood far beyond our direct area of impact. The slum residents are beginning to trust us enough to overlook social barriers, which is a huge step in the right direction. I wasn’t in the slum when Sugo Devi showed up this morning, so the volunteers who were there told her to come back to the slum school at 5pm.

When class ended at the Carmel Convent School at 5pm, Heather, Natalie, Merril, Win, and I ventured into the slum. Sugo Devi was waiting for us in the shade of a slum home with her infant shielded from the judgmental eyes of others. We greeted her and introduced ourselves. Then Sugo Devi unwrapped her little boy from the excess fabric of her Sari.

The little boy, named Santosh, was shocking. No one present had ever seen such a severe cleft lip and palate.

--A clear view of Santosh's cleft palate--

As I gathered information for the surgeons, I was stunned to learn that Santosh was born on December 23, 2011 right here in the slum. I was likely within just a few hundred meters while she was in labor! For three months of age, Santosh is small. However, I told Sugo Devi that we will take her and Santosh to see the plastic surgeon in Delhi on Monday when we take Moni for her appointment. Sugo Devi looked grateful, wobbled her head, wrapped Santosh back up in her sari, and carried him back toward their home upstream.

Sugo Devi's arrival is inspiring. Within the past few weeks, I have coincidentally stumbled upon three children in desperate need of medical attention. We have taken all of them to hospitals and found surgeons who are so inspired by our efforts that they volunteer their time to help us. Now, other ailing families are starting to seek our help. It was evident this afternoon that we needed to upgrade our plan of attack. Win, Mithlesh, and I immediately set out on a search and rescue style hunt through Patel Nagar for more children we could help. We decided to follow Sugo Devi's route. With eyes peeled for deformed and handicapped children, we set out upstream.

In just over 90 minutes, we passed within 50 meters of the homes of more than 25,000 people. We stopped every 50 meters or so and asked the residents if they had seen any children who need medical attention, especially for anyone with cleft lips or palates. We found several children with uncorrectable birth defects, retardation, down syndrome, and/or polio. However, there were few children that we could drastically improve through medicine.

We searched in nooks and crannies, through the rubble of slum homes destroyed by the government, and past enough livestock to start a farm.

We were eventually led by a vigilant resident straight to Santosh and his mother. Santosh was attempting to sip milk from a bottle in his mothers arms outside of their home. Santosh cannot create suction, so his mother had unique ways to manipulate the milk into his mouth. What I saw next, however, is what made my jaw hit the floor.

With permission, I walked into Sugo Devi's home. As I did, I learned that six people live in this tiny room about the size of my bathroom at home. Six people socialize, cook, eat, clean, and sleep in this tiny dwelling.

But even more amazing is the fact that Santosh was born in this room on December 23, 2011! I was here, walking through this slum several hundred meters away while Sugo Devi gave birth to Santosh right here on this bed. Yet again, shivers shot down my spine as I stood in the dark doorway trying to picture that scene. I imagined the cringing chaos, noises, and blood that must have filled that room on December 23.

I could hardly believe anyone would give birth in a place like this, especially with doctors and dozens of hospitals within 10 km. The Indian government would have even paid Sugo Devi to deliver her child in a hospital. However, almost all of the slum residents still opt to deliver their children at home.

--Sugo Devi's biggest luxury: a kerosene stove--

We said thank you for the hospitality and carried on. Although we didn't find any more children we could help immediately, we made our presence and mission known to the entire community.

I still wonder how many more children are out there? This is just one slum with 25,000 people and we have already found multiple overlooked children with severe and treatable conditions. There are more than 65 slums in Faridabad alone! We don't know who's out there, but we will never know if we don't look.

--Mithlesh leading our search into the unknown--

It is my honor to introduce to you now our newest campaign, Healing the Hidden. Separate from the Squalor to Scholar Program, Healing the Hidden is attacking the lack of medical care and negative stigma about disfigured children head on. The purpose of Healing the Hidden is to provide medical treatment to overlooked slum children who might otherwise never receive the treatments they need and deserve. Your donations will help us seek, discover, and treat ailing children as well as educate their communities about healthcare options.

Donate to Healing the Hidden with - Donate with WePay

The new campaign is live and accessible via the blue link above. Your donations will help pay for these children's consultations, diagnostic tests, treatments, transportation to and from hospitals, and medications. As with the Squalor to Scholar Program, every single penny of your donations to Healing the Hidden (except for small transaction fees) will go directly to children like Santosh, Manish, Moni, Prianka, and Chandni. Even Mithlesh, who lives in the slum, is working voluntarily out of his own goodwill because he knows what an incredible impact we are making.

Every dollar will make a difference. Where else can you so easily, directly, and rewardingly donate cures, smiles, and life to people who truly need your help? On behalf of the children and families receiving your care and generosity, thank you!

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Goodbye India...

...When I flew to India on the night of my 24th birthday, I flew out of my comfort zone. I flew toward 1.2 billion people without knowing a single one of them and toward a culture that mystified me. As the 747 climbed away from home and the lights of Phoenix disappeared behind, I remember looking out at the austere darkness and feeling very alone. When I landed in New Delhi the next night, I had no idea where I would go, what I would do, or whom I would meet. All I was told was to meet a man outside of customs who would be holding a sign with my name on it. The uncertainty was endless and anxiety stronger than I had ever felt. Standing here tonight, five months later, I can hardly believe all that has happened since then. It just doesn't seem possible even though I lived through it all. I came here to volunteer in hospitals and gain a more global awareness of medicine. I never planned on exploring slums, deciding which slum children would go to school and which ones would stay behind, or scouring entire communities for handicapped and disfigured people neglected by society. I never expected that I would be taken under the wings of Carmelite nuns, that my host family would treat me like their only son, or that I would feel like a relative to dozens of slum families among the lowest castes of Indian society. I never dreamed that I would bathe in the Ganges, ring in the New Year at the Taj Mahal, or be taken in a speeding ambulance to drink hot milk fresh from a buffalo.

I came to India because I wanted to make a difference and learn something that I could not from the comforts of home. I came with a positive attitude and a desire to expand my horizons. But I never imagined that I would be rewarded so magnificently by people from nearly every aspect of society.

This afternoon, I went to my final class with our spectacular students. Over the last three months, I have watched them go from a destiny of illiteracy and poverty to one of renowned educations and endless opportunities. Their lives have been changed forever and so has mine.

--Neha, our first student admitted to the Carmel Convent School--

--Komal, Gudiya, and Roshan, each of whom are excelling with nearly perfect marks--

--Ajeet, who when folded is conveniently the same size as my carry-on luggage--

--Anita, the girl who will turn around her family's incredible misfortune--

--Akanksha--

--Pooja and Manisha--

--Kajal--

--Akshansh, Ajeet, and Sonu--

--Manisha and Akshansh--

--Our talented and devoted teachers, Deepa and Priya--

--Manisha, Anita, Neha, Gudiya, and Ankit--

--Madhu, Roshan, and Sonu--

We returned to the slum so that our students could change for my farewell party and I could say goodbye to the rest of the community.

--Manish and his mother, Dolly--

--Neha, Saraswati, Ankit, Sonu, Madhu, and me in Ankit's home--

--Moni with her father, Dablu--

--Madhu, which means "honey" in Hindi--

--Gudiya waiting for Ajeet while he prepares his gift for me (in Ajeet's home)--

--Ajeet in front of his old slum school--

--Rani, the widow who carries bricks to keep Anita, Sindu, Indu, and Surendar alive--

We then returned to the Carmel Convent School where the final farewell was to take place. As suggested by Crystal and Heather, I bought an entire ice cream trolley full of delicious treats for anyone who wanted one and rode around the community with the kids all yelling, "Ice cream wala!"

--The two youngest members of my host-family, Naima and Naysa--

--The ice cream cart made me especially popular--

--Sister Pushpa and the most touching family I have ever met--

--Manish's cousin, Anisha, who can often be found taking care of the little tyke--

Then the presents started to come. Nearly every family in attendance brought me a gift. I thought I was going to need another bag just to get home with all of the packages.

--Rani--

--Ajeet--

--Prianka, who will have her biopsy on Wednesday--

--Manish, who will be admitted to the hospital next week for new medications--

--The sisters and my host family with our lovely neighbors. Ironically, Mamta and Meenakshe (our neighbor) had never met before Heather, Crystal, Natalie, and I asked to meet Meenakshe. Now, Mamta and she are best friends and the kids play together nearly every day--

I then handed out my own gifts. I gave each family my favorite pictures that I had taken of them as well as photos of my family and me in America.

We then started to say goodbye. All of the kids came up to give me a hug. Madhu started to cry and I could no longer hold back my own tears. These kids have taught me lessons that have transformed my own existence. Their optimism and zest for life despite the conditions in which they live have inspired me since the day I met them. I have seen them nearly every day for the past 100 days and have watched them grow and adapt beautifully to a way of life radically different and more demanding than what they were accustomed to five months ago. They have exceeded everyone's expectations, including my own. These precious children have become my family, my friends, and my world. I cannot fathom ever working for anyone who will be as grateful or passionate about what they do as these children. I will leave them behind tomorrow, but they will never leave my mind.

This time last year, I was waiting tables in a restaurant. I had been rejected from 17 medical schools. I felt lost and unproductive. I decided to go out on a limb to a place where people needed me and where my limited resources and experience could still make a difference.

--A plaque on a cabinet door in the Carmel Convent School main office--

If I had not been rejected from my own dreams of attending medical school, these children may never have had dreams of their own. I certainly would not be here right now and would likely never have met these children, sisters, doctors, and families who have so drastically changed my life. Sometimes, even the biggest disapointments can be blessings in disguise.

I am signing off from India, but don't worry. I have the last month to catch you up on and will do so from home. In the last five months, I've taken 13,320 photographs and compiled enough experiences to keep writing about for months. In case you forgot, we also have 20 stunning students to follow for the next 10-12 years as well as a half-dozen disfigured and handicapped children to watch through their medical treatments, growth, and eventual educations.

To all in India who have shown me unsurpassed hospitality, thank you for the experience of a lifetime. To my family and friends who await me at home, I can't wait to see you and express what I could not from a distance. To those who have followed this blog and supported me throughout, I owe you a tremendous amount of posts, stories, thank yous, and photos that will be coming soon. I don't know how I will ever convey the lessons and perspectives I have gained here but I look forward to trying.

Finally, I must reiterate my utmost gratitude to those of you who have donated to the Squalor to Scholar Program. Without you, none of this would have ever happened. The swiftness and generosity of your donations have revolutionized the lives of everyone present this evening in only a few short months. I am happy to report that all 20 of our Carmel Convent School students are now fully sponsored for the next year! Some have been sponsored and committed to for even longer. However, this does not mean that we do not need new donations. I know more than 500 talented and deserving slum children who I am leaving behind tonight without being able to help at all. Every rupee of your money has been and will continue to be spent with great care to ensure that it makes the greatest impact possible in their lives. Everything you have seen and read on this blog to this date has been accomplished with $6,000. Imagine what we could do with more! If you're looking to make an immediate impact, Prianka and Moni will be having surgeries within the next four weeks. Prianka needs approximately $300 and Moni $150 to cover their medical and transportation expenses. When you make your donation, please specify if you would like your money to go to one of these special young girls. Thank you.

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Sugarcane...

...After spending several hours with Manish at the hospital for his first visit, I was exhausted. We took a tuk-tuk back to the slum, from which I began to walk home. As I passed by the Carmel Convent School, the church's driver, Ram Singh, was pulling out of the main gate with Sisters Asha and Sweta in the back seat. They stopped and summoned me to get in. I found out that we were going to look at land that other sisters had purchased in hopes of one day building a new school.

Thirty minutes later, we were in the rural villages and farms east of Faridabad. We passed two of the hospitals where I had worked in January as we continued east for another 30 minutes.

As the sun dropped low into the horizon, we finally arrived at our destination. Although I thought the location was a bit unusual for a school, it certainly made for scenic fields of wheat and potatoes.

I then discovered we were on a business trip. Multiple gentlemen came to sign contracts and discuss agriculture.

--The Carmel Convent School's driver, Ram Singh--

Since I mentioned during the drive that I had never eaten sugarcane straight from the stalk, the sisters sent one of the farmers' sons to chop us down some fresh sugarcane from a neighboring field. Much to my surprise, India is the world's second largest producer of sugarcane (after Brazil), the source of 80% of world sugar production.

Everyone gnawed with their molars to peel away the stiff bark. To everyone's amusement, I pulled out a pocketknife from pocket number 6 to accomplish the same task in half the time with a tenth of the trouble. I was shocked at how much liquid sugar there actually was in the stalk. Needless to say, it was delicious.

Here I was, in the middle of a wheat field in rural India, eating a stalk of sugarcane with two Carmelite nuns and their business partners. An hour and a half earlier, I had been in an urban slum playing with kids who all know me by name. Two hours earlier, I had been with the chief radiologist of a large private hospital conducting an MRI on 18-month-old Manish to determine whether he has a proliferating hemangioma or venous malformation covering half of his face. Now that's a full day!

--Villagers carrying crops and goods to town--

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International Women's Day...

...International Women's Day fell on March 8, the same day as Holi. Therefore, on Tuesday, the sisters hosted a celebration of their own. Three of the "best" moms from every class at the Carmel Convent School attended the event as well as the mothers of nearly all of our students. Instructed to wear red sarees and "look beautiful," the moms of our students looked particularly spectacular. --Students resting after their performance--

--Gudiya (Kashak and Versha's mother) and Ranju (Ajeet's mother)--

Everyone gathered in front of the stage where I spoke a few weeks ago. Prayers were read, songs were sung, and dances were performed. Much to my satisfaction, I have now fully realized that the sisters do not pursue anything with mediocrity. The schedule of events, temporary structures, performances, and food were all perfect, as usual.

--Lighting the ceremonial candles--

These boys were hilarious. Their confidence and energy were sky high as they danced to a popular Bollywood soundtrack called Desi Boys and pretended to be real ladies' men.

Fortunately, our musically talented volunteer Natalie Wills had recently bought a guitar. She sang a beautiful song that she herself had written.

Madhu even came with her mother, Rita, and youngest brother.

--Volunteers Natalie Wills and Heather Barnes with Madhu and staff from the Carmel Convent School--

After the celebration, everyone was welcomed to a massive buffet-style feast. I watched with huge smiles as Madhu and our moms enjoyed what was likely one of the best meals they have ever eaten.

--Sisters Pushpa and Sweta cooking me lunch on Sunday--

I would be remiss if I did not mention the sisters on International Women's Day. Since they discovered what I came for, they have treated me like family. They have said themselves that they consider me as a son. After church on Sunday, they had me stay for breakfast...and then lunch.

They weren't just any meals, either. Since they know I have not had eggs or pasta in months, they cooked both specially for me. Both were, perhaps even literally, ambrosia.

When my plane landed in India three and half months ago, one of the last things I would have expected is is to be taken in by an entire convent. I will be forever grateful for their generosity and care, but especially for the opportunities they are creating for "our children."

However, no amount of motherly affection will ever be able to top the care and love with which my own mother has raised me. I will never forget where home is Mom. It's where you are. Without the compassion and love that you have shown and taught me, I would not be here now doing what I am doing. Nothing can replace great parenting. Luckily for me, you and Dad are the best.

I often look back at these two photos. They were taken on my birthday, the day I left home. They don't just remind me that I am lucky, they remind me that I am one of the luckiest people on the planet. Thank you Mom and Dad. I love you and I'll be home in six weeks.

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