Sunday, October 19, 2014

Last Day

I have been unable to keep up with the blogging on this trip.  It is similar to the past trips in that I stopped after the third day. I did want to write one more at least to wrap up the trip and also to finally give some recognition to the team here.  Already, I am on the flight home and with only three hours left before landing.  

I've had a lot of time to reflect on this past trip and to give some sort of closure.  This trip was difficult in some ways and a much needed one in others.  I was sick and exhausted this time and when feeling like this it was difficult to be alone in a foreign country.  I was longing for the comforts of my own bed and my own kitchen to make my familiar foods.  I was very grateful for the company and love of Geeta and Ujwala.  They took care of me and kept me occupied.  

I had never gone to the seaside here before and I remember particularily, sitting on a warm bench with Geeta for hours and laughing about "gathering qi".  But really, we were gathering qi and it was not to be taken lightly.  Between those long moments of sitting, whether I was in Geeta's car watching the city go by or elsewhere in a tea shop, I did what I never do, which was just take in the moment in long silent stretches.  Even now, I have tears in my eyes just remembering, enduring the pain and yet allowing joy to come in spite of it.  


This city is hard on one's kidney qi and mine was seriously low in reserves prior to coming.  The hot sticky weather, the dusty and musty polution, and the constant bustle of the hoards of people wore on me more than usual.  I took many naps and found myself falling asleep in between.  The jet lag certainly didn't help either.  My last night there was my only night of full rest without waking.  

Regardless of the difficulties, my love for the country and the people were not hampered.  I still wished that I had more time there, that the ten days was far too inadequate for what I wanted to accomplish.  

I wish that I had had more time to work with the team to give them my support.  I hope that they will take the time to read this and know how proud I am of them.  They have become exceptional in their practice and as people.  I came to know them four years ago as their teacher and now can say that they are my colleagues.  They have taken the precept to heart that Chinese medicine is a spiritual practice and a life long study.  They have continued to hone their skills and their observations.  


The new additons of the administration team, Shashi, Rashi, Aparna, and ....  have brought the Barefoot organization to the next level.  I am realizing how far they have come from the initial days. 

This trip was much needed to connect with the people here after a long absence and to meet with Walter to firm plans between Barefoot and HAP (Humanitarian Acupuncture Project).  We have much work ahead of us and yet I am looking forward with anticipation and hope.  


On a personal note, this trip was much needed.  Over the years and especially this past one, I had become much disillusioned and tired with too much unnecesary details. How much of it really matters?  I am finding myself questioning everything in my life.  From the materialism of what I have aquired to the avoidance of a routine of a spiritual practice.  In the minutae of daily life, I have sorely lost sight of the bigger picture.  In a way, I am lost and I need to find my way back. Truly, we can't know that we are lost till we acknowledge it and that was what I did during this trip.  


There is a grander scheme to our lives and the sooner we align ourselves with it, the more we will become sustained.  Daily, I looked at the people of Mumbai and recognized that we are woven into the same fabric that connects us all.  And we must find a way to acknowledge and respect them.  To not do so, is to disregard not just basic humanity but the failings within ourselves. 
 











This post is dedicated to my Barefoot family.  I hope you know how much I have to come to love and cherish you.  

Acupuncturists: Meghna, Satish, Vrushali, Geeta, and Mitali
Clinic doctor: Shashi
Assistants: Suvarna, Nimala, Shabnam, and Anita
Administrators: Ujwala, Rashi, Pramila, and Aparna
And of course Walter











Friday, October 10, 2014

Day 3, October 10, 2014

Dharavi Clinic

Today I visited the Dharavi clinic.  This is the third clinic that Barefoot has produced and it is located in the slums of Dharavi.  To read more about this part of the city you can click on the Wikipedia link. This clinic is located in one of the most famous slums.  As a foreigner it is difficult to set up shop in this closely protected community.  Barefoot was invited and sponsored there by a few of the Jain merchants.  Without them, this project would not have been possible.  

There are some companies that give tours of the slums and indeed in one of my posts from my first visit to Mumbai, I took that tour.   It was well executed and informative.  However, there is nothing like knowing that you are a part of it somehow, now working with the people.  As a foreigner, it is not really accepted to walk around there unattended.  And even less so to take photos as it was not allowed in the tours.  However, I was very grateful for the personal guide who was one of the patients and permission to take photos.  

The energy here is really incredible.  It is alive and thriving and this is just a normal day for them.  Businesses are busy and people are visiting amongst themselves.  I've never seen this in the US, not of this magnitude.  And there is something wholesome about seeing the children mixed in with the elderly and merchants of every possible trade.  

Here, people are making shoes, selling saris and jewelry, weaving textiles, pottery, tanning hide, making soap, recycling plastic.  The enterprises here are tremendous, estimated to be worth at least 500 million dollars annually.  The next time I see an item labeled, "made in India" I will certainly be thinking of these people as it is likely that some aspect of the finished product passed through these people's hands.  I do wish that working conditions were safer and sanitation revamped.  And for all the money that is coming through, how much of it ends up with the workers?


The guy in the yellow shirt on the right side was my guide.      

Life here is extremely difficult and labor intensive.  I would never romanticize this lifestyle and yet I have tremendous respect for these people.  They have found a way to live together and a way to survive.  Also, I often think of the women who have to clean their homes daily, cook meals, wash clothes by hand, care for the children, and care for the parents.  

Children are safe here.  The community looks out for them.  It is common to see the children running about on their own or in groups.  This is the same for the elderly.  While it is a great responsibility for the adult children to care for their elderly parents, it doesn't seem to be questioned, but rather expected.



The clinic is a joy to work in.  The floors are covered in polished white marble.  The windows being on the second floor look out over the alleys.  The patients sit quietly in the waiting room and the atmosphere is cheerful and steady even with a stream of people coming in and out.  

Satish started the morning with a meditation that included the patients.  I have to start doing that in my own office.  It was a great way to set the mood for the morning.  Thank you, Satish!  

Tomorrow, I will cover Satish and Vrushali.  I interviewed them this morning and need to get my notes together before writing.  Stay tuned!  



Thursday, October 9, 2014

Day 2, October 9, 2014

Today is day two and last night was the worst with jet lag.  I should've known I would be up half the night from past consistent experience.

There have been many changes since the last time I was here. I was pleased to see that the initial clinic staff were still there, but now with the addition of a full administrative personnel and a separate office to house them. There is actually something quite cheerful about the new office.  While it is a cozy space, it doesn't feel so entrapped with the glass wall facing the street.

Rashi and Ujwala
Today was gentlemen's day.  Upon arriving, there were already ten men waiting to be treated.  I was talking with Satish, one of our long time acupuncturists about the most common conditions that the clinic sees.  There are many people with strokes and arthritis.  I was reminded of a patient I had seen the last time I was here.  He had arthritis and had been on steroids for many years.  He didn't have any followup care and nobody was monitoring his medications.  Therefore, he continued to take the steroids resulting in edema in his legs, face, and arms.  I was alarmed at the duration and the toll it had taken on his body.  Steroids should never be taken long term and if they are deemed necessary they are usually closely monitored.  I found that this was a common occurrence.  The glaring lack of followup care and overuse of medications is incomprehensible.

Many of the medications here are termed old school.  There are much more sophisticated, modern medications out now.  My impression was that the older medicines are more easily accessible and cheaper.

View from inside the office. 
I was going over some numbers today.  I thought it would be good to give an outline of what the economic landscape is like for those who live in the slums.  For every  dollar there are sixty rupees.

It is common for a worker who lives in the slums to make between 200 to 300 rupees per day, multiplied by twenty-eight makes between 5,600 to 8,400 rupees.  Converted to dollars per month makes between $93.33 to $140.  Now in comparison, what they make in one month, I often make in a hour.  Furthermore, a meal on the street which may consist of rice, legumes, and a chapati can cost thirty rupees, which is fifty cents here in the US.  Where in the US can I get a full meal for fifty cents? It is because of the low cost of necessities that people in the slums are able to survive.  Should that skyrocket, then millions of people will become effected.




Now to paint another economic picture, it is common for many households in Mumbai to have a housekeeper who comes daily to clean.  The usual salary is between 1,500 to 2,000 rupees per month.    This converts to $25 to $33.33.  That is how it is affordable to have a housekeeper, driver, and perhaps a cook.  And yet somehow the housekeeper, driver and the cook can feed their family and keep a roof over their head.  Hard, hard work.

The cost of a treatment at the clinic is twenty rupees or thirty-three cents.  Of course, if they don't have the money to pay, they will still be accepted.  This amount is not much but helps offset the cost of needles and other supplies.

In the upcoming days, I'll be interviewing the staff and including them here.  Keep posted for more!


Wednesday, October 8, 2014

Day 1, October 8th, 2014

It is my first day back in Mumbai and it is like I never left.

Life here goes on.  The smells are the same.  The noise is the same.  The hot stifling humidity is the same.  And yet like returning home, I welcome it like I would a dear, dear friend.  I overlook the garbage and the molding walls and see instead, the beautiful saris, the innocent children and the flowering vegetation.  It has been raining here and the leaves are bright rather than dusty as I had remembered them to be.

I spent the morning at the clinic and was happy to meet the new additions to the Barefoot team.  I'll write more about them soon as I am still learning their names and their roles.


The morning clinic, as I call it, is located in the East Bandra slums.  It is a community style setting with up to six tables in two to three open rooms.  There is a large movement in the acupuncture field in the United States that calls the clinics, "community" style with multiple chairs or tables in a large room.  I like to think of this clinic here representative of how acupuncture is practiced in much of the rest of the world.  Most of the world does not have the luxury of single patients with the privacy of their own rooms.  This is what I feel is the true "community" style long before it became popular.

We were busy with patients and on Monday, Wednesday and Friday only women come to the clinic.  Tuesdays and Thursdays are for men. It is customary not to mix the genders in certain public offices especially in a clinic where the spaces are open and not as much privacy.


I was struck by this patient.  She had shoulder surgery one and a half years ago.  I found the scar to be quite extraordinary as shoulder surgery in the US is often marked with only one inch incisions.  Her story is quite unusual as well.  After the operation, as she was being wheeled out of the room, the door apparently had been slammed on her shoulder ripping apart the incision.  This required an emergency repair.  I can only imagine the damage that had occurred and wonder what might've been worse, the actual initial complaint or the massive amount of scar tissue.  We'll never know.

If this were to happen in the US.  There would have been multiple lawsuits against the hospital, the attending staff and the surgeon.

As it is, the care that can be provided through the team here is wonderful.  There are not many other options for followup care.  And truthfully, there couldn't be a better option.  How many other people are out there in the midst of the millions of slum dwellers who have stories like this?

According to this link, 54 percent of the population of Mumbai lives in the slums.  They are estimating that by the year 2025, there will be 22.5 million slum dwellers.  It is overwhelming to me the amount of work that needs to be done.

I'll be closing up now as it is getting late and I have yet to eat dinner.  I have more time during this trip for writing and there is lot to cover.







Wednesday, October 1, 2014

Heading for Mumbai - 10/6/2014

For the Gofundme campaign that this post is listed on, click on this link here

On October 6th, I'll be heading to Mumbai to volunteer for two weeks. People are always asking me why I do this and this is what I tell them: I’ll never forget the first time I came to India. A young man came to the clinic asking if Walter and I could come to his home to see his mother. We went that afternoon. This was the first time I had visited the inside of a home in the slums and I came to understand the living conditions that the people are faced with. One small room that served the purpose of a bedroom, dining room and living room for four or more people. The elderly mother was lying on the cement floor, and upon seeing her we knew immediately that she had had a stroke. She was resting on a blanket and nothing else. Upon further inquiry we understood that she had been like this for a couple of months and because it was not within thirty days of the onset, the doctor refused to treat her. We told the young man that his mother had a stroke, and suggested a thicker mattress to protect her from the cold floor. We encouraged him to include her in family activities to get her moving around as much as possible. And to bring her to the clinic when they could get her to walk. I’ll never forget this story. 



Photo by Lydie Nesvadba

A number of things struck me then, and have stayed with me to this day. The low level of care for the millions of people in Mumbai alone is overwhelming. The amount of education required to help people with basic self care is overwhelming. The daily survival mechanisms of these people, which go back multiple generations, is also overwhelming. I immediately understood the importance of what we offer. Where I come from in the United States, Chinese medicine is usually seen as secondary care or primary care in conjunction with allopathic medicine. However, here we can help people as primary care and, more importantly, community support. This is the difference between compassionate medical care and none at all.



Photo by Lydie Nesvadba

Since 2008, Barefoot Acupuncturists has treated 4,500 patients in four clinics that are set up in rural villages and urban slums. After chronic or acute pain, the range of treatment includes paralysis and stroke recovery, digestive disorders, gynecological issues, stress and anxiety, and hypertension.

If you believe health is a human right, DONATE to our cause: 
$ 30 will allow a grandmother to reach and use slum latrines on her own, giving back to her some independence and dignity. 
$ 50 will enable a family breadwinner to go back to work and to prevent the family from falling into poverty. 
$ 150 will help a paralysed stroke patient to walk and talk again. 

Even a small donation will make a world of difference. Please help us reach our goal.  All money collected will go directly to the clinics in Mumbai.  Anne is covering all of her own expenses related to airfare, travel, accommodations.  



Video produced by Kathryn Nemirovsky. 
Humanitarian Acupuncture Project is the USA branch/ partner with Barefoot Acupuncturists.  To learn more about either one of them go to:

http://humanitarianacupunctureproject.org/
http://onindiangrounds.blogspot.com/
http://www.barefootacupuncturists.com/