Home Sweet Home

Praise God! Laurel and I arrived safely back in Little Rock on Wednesday.  I drove to Ft Smith the next morning to my parents' house to start a new rotation that day. Yes. I know. What was I thinking? I had to leave early from clinic because I was falling asleep in midsentence. We had been up for 36 hrs because our midnight flight was delayed till 2 am and then we flew 15 hrs to Newark, then to Houston, and finally to Arkansas. 

It's good to have the comforts of home but I certainly miss Kothara and the people there. I didn't expect the reverse culture shock since I'd only been in India for seven weeks but there it is. It seems more acute since I've been working in the hospital since the way things are done at Kothara are different from the way things are done in Fort Smith, obviously. And I miss the warm sunny weather! I'm so glad Laurel and I shared the experience together, because we can talk through the adjustment back to life here. 

There are so many more stories I'd wanted to share on the blog but alas, I couldn't spend too much time blogging (esp with the frequent power cuts) so I'll just have to share those with you in person. Thank you for keeping up with my blog and for praying for us. I learned and experienced so much more than I could imagine and received so much more than I could give. God is good. 

My heart tells me that this won't be the only trip to India for me and I feel more strongly than before that I'd like to pursue medical missions somewhere. For the next three years though, I'll work on finishing an internal medicine residency...only God knows where at this time. I and everyone else will find out where on Match Day. It's coming up on March 19! Whereever I am matched, I know God has prepared the way for me and will continue to guide me in the way I should go. Despite my overwhelming anxieties before starting another phase of my life, he has shown himself faithful time and again to lavishly provide all that I need--places to live, friends, church, ability to handle the responsibilities I'm given, and even difficulties to strengthen my faith. I will trust Him again and all the days of my life!

Last week in India

Last Tues through Thursday, Laurel and I joined other Kothara staff in running "camps" in various tribal villages surrounding Paratwada. It's absolutely been the most fun we've had the entire time in India.

On Tuesday, we set off with Deepali, the medical intern, Pramoth, the community outreach coordinator, and a couple of other World Vision staff or volunteers to hold medical screenings for World Vision-sponsored children in about five or six hill villages. We were excited to be off campus on an adventure and to visit some of the villages from where our tribal patients come. We saw incredible scenery, beautiful people, and extreme poverty. Laurel and I contributed to tooth decay in the villages by giving out tons of candy; we were selfish actually because we just wanted to see the kids smile. :)

On Thursday we held a medical camp in Bhandaraj, right next to a Hindu temple. The camp is a twice annual one that sisters from a convent nearby run on their own. They provide the medicine, arrange for the doctors to come, and publicize the camp in the nearby villages. There was a cave nearby where a priest lived in bare conditions. There were about 360 patients who came in with various ailments, from minor colds to serious conditions, like probable hepatitis and cerebral palsy. So many children had conditions that had gone on far longer than it might have. Dr Steve saw the peds cases, Dr Asha the adult gen med patients, and there were also a gynecologist and an orthopedist. The ortho techs from Kothara also screened many patients to take back on the van with us to receive free eye surgeries from Dr Shyam. In all, there were 44 patients who came back with us. Most of them were older patients who had extremely mature cataracts. The doctors said many of them had never been outside of their village so coming to Paratwada was like us going to Mumbai!

It was an amazing experience for us. We are now in Mumbai, a bit overwhelmed at first but we're loving the new sights, sounds, and tastes. It's a bit chilling to walk in the same areas where the shootings occurred, like the train station, the Taj hotel, Leopold's cafe. But we know God is our protector and we are in his hands. Pray for us anyway! Yesterday we visited the dhobi ghat, where an entire neighborhood is in the business of washing clothes. It was an incredible sight. If you've seen Slumdog Millionaire, the scenes in that movie are all around us--the begging children, the slums, the trash...as well as the high rises and wealthy neighborhoods. Laurel and I were glad we watched it on Sat night because we recognize many of the places in the movie now that we're in Mumbai!

We are going sari shopping today (Monday) and buying more luggage to fit all the stuff we've bought. The doctors at Kothara told us to haggle like Indians, so we'll try our hand at it. We have so many more stories to write about but our time in the internet cafe is limited so I'll end here.

One more thing. If you remember Atish from my last post, he passed away a few days after he left the hospital. Dr Rashmi said that his dad called her up and asked her if those girls who took pictures of Atish could give him one photo of him to remember him by because he didn't have any pictures of his son. My heart breaks for him. God be glorified even in this situation! Pray that his family would come to know and experience Christ's love for them even through this circumstance. Maybe God has a glorious plan for them.

The boy who captured my heart!

This afternoon, Atish, the four-year old boy I'd mentioned a few posts back with the liver tumor and massive ascites (fluid in the belly), came in again with his dad and his grandma. Just breaks my heart. It's hard not to cry when you see him!

Today, he looked so much more emaciated than two ago when he came in initially, while his belly was fuller and more tense. Whatever tumor is growing is making more fluid in his belly than his body can rid. He was breathing fast and using his accessory muscles because of the huge pressure on his diaphragm and lungs. Apart from the hugely swollen belly, it's just his shoulders and ribs with tiny arms and legs around which I can wrap my thumb and index finger. His whole body was burning up so he must also have an infection somewhere.

His dad took him to get a CT scan in Amravati a couple days ago and it does not look good. The radiologist said that there was no hope of a cure and that he needed to prepare himself for the end. It frustrates me so much that we have no idea what kind of malignancy it is and that he's probably not getting a definitive biopsy to figure out whether the prognosis is truly hopeless or not. The family seems to love the boy so much and the dad just looked so heartbroken and hopeless. I think they want to do anything they can do, but Dr Rashmi said they'd used up most of their money already just bringing the boy in and getting a CT done. 

Dr. Steve did another paracentesis (removing fluid from the abdomen) this afternoon to relieve the tension on his belly, which helped him breathe a little better. We took out about 500 mL of fluid slowly over three hours. Atish was an angel. For three whole hours, he laid there with hardly any protests, except for the initial insertion of the needles (without sedation or anesthesia!) and later moving them to get more fluid out. His family was required to stay out of the procedure room (and yet he was so stoic!) We stayed with him, held his hand, and sang any songs we could think of to him to keep him occupied. Despite his tiny size and squeaky voice, he seemed more like an old man than a four year old--very serious and attentive to everything going on. When the procedure was done, he took care to button the one broken button on his shirt and fold over the collar just right. I couldn't help but think that if we could only bring him back to the States, maybe he'd have a fighting chance. At one point, I considered pediatrics after a rotation on heme/onc at the children's hospital, but I know, after seeing Atish, that I could not maintain emotional distance enough to be professional and do my job!

As the family walked out of the hospital, holding Atish, we wanted them to know that we would pray for him in the name of our God. We asked Abigail, one of the nurses, to translate and she'd understood (and thus translated) that we wanted to pray for him right then. They nodded and looked at us expectantly. When I found out why they were waiting, I asked if the family would be okay with us praying, which they said they were, so I prayed for them in the name of Christ. If you do pray, please pray for Atish and his family. I thought of the occasions on which Jesus healed the child of a desperate parent, seeking some hope for his child. Pray for healing and lessening of suffering for Atish, for wisdom for doctors to know how to treat him, for resources to be able to treat him properly, for the family to come to know Christ's love for them, and for God to be glorified through this situation.

Some of my pictures are up on picasaweb. Here's the secret link:

http://picasaweb.google.com/hannah.epark/HannahToIndia?authkey=CExecYYl-LU&feat=directlink

Thank you for keeping up with my blog and for your prayers! 

Pics from Aurangabad

The last cave we visited...there is a waterfall on one side of the cave during the rainy season.
One of the Buddhist temple caves...I love the arches!
The road in front of our hotel...one of the main roads in town...can't you tell? BTW, soon after I took this shot, five other piglets came squealing across the road.
Yummy! Clockwise from the top: Naan, Rice with raita (yogurt), chicken jalfrezi, and chicken...something I don't remember but it was good...
My new Korean friends

Jesus is my protector!

We finally got the opportunity to venture off the Kothara campus on our own and do some traveling this weekend. Kothara being such a small community, everyone knew we were leaving and several people offered to help us plan for the trip, including Mr. Ravi Gaikwad, w

ho is one of the administrators of the hospital. He and his wife have been so kind and helpful in so many ways, especially planning for travel to Aurangabad and Mumbai. Now although no one said it outright, we got the sense that they were apprehensive on our behalf since we constantly got advice and comments about EVERYTHING: what to wear (the traditional salwar), where to stay, what kind of city transportation to take ("never take the taxis!"), where to visit and what to see. Always stay together. Never go off on your own. Take this list of home and mobile phone numbers of several people from Kothara in case you get into trouble. Some were surprised that it was just the two of us girls going on this long journey. I honestly thought that they underestimated our travel savvy and saw us as inexperienced foreigners. Little did I anticipate how overwhelmed we would be!

On Thursday evening, Pastor Silas and his wife drove us to the private bus company stop, where we got on a "luxury" overnight bus, a one-way ticket for two in hand (all for about $5 a piece for an 8 hr trip). But, no return ticket! We had to buy them when we got there, but...we were cool. We were grown women with travel experience, and we could handle it....or so we thought. Well, the bus had twin-sized bunk-style beds down each side of the bus, with a narrow aisle down the middle. (We thought one bunk for each of us, right?) Pastor Silas said that we were fortunate that the two of us were going together because if we'd been alone, we'd

 have to share the bed with a stranger! (What?!) Ours stated 4A on one end, 4B on the other. Pastor S talked to the driver to make sure we'd make it to Aurangabad and then came back with his wife and asked us if we would be OK. (We hope so!) We then shut the curtain and tried to get our stuff situated on the bed. Laurel didn't want to risk losing our expensive shoes below our bunk, so she brought them up and set them in the corner of the bed. Needless to say, we were a bit cramped, but Laurel much more than I. Guess this was one of the very rare instances when I was grateful to be short! Now, our American sensibilities of privacy had to be abandoned because when other passengers began boarding the bus, several of them swiped the curtains open to...I don't know...check to see if anyone was inside? These passengers (mostly male) just stared at the two non-Indian girls, even peering through the spaces between the curtain and the wall from time to time. We waited till the bus departed Paratwada to change into our PJs and climb into our sleep sacks.

The luxury bus made several stops during the night, as I vaguely remember Laurel getting off the bus for a bathroom break. After her description of the toilet, I happily held off and waited for a bathroom in Aurangabad. In the morning, the bus stopped and I woke up to see men and boys at a roadside stand, serving tea to passengers outside and through the window to those inside. L & I munched on our Marie Gold sweet biscuits and drank our bottled water. We finally arrived in the city of Aurangabad around 7am and gazed at the mixture of wealth and poverty, of modernity and traditions through the window. Apartment buildings. Tattered tents. Open fires. Car dealerships. Goats in the streets. Colleges. Hindu temples. Mosques. Supermarkets! (Praise the Lord!)

The driver pulled over on the street and abruptly yelled "Aurangabad! Off here!" There was no bus station or sign to be seen, signifying our stop. Should we get off? Were they too cheap to drive us to the station? Well, we couldn't exactly argue in Marathi, so we frantically grabbed our stuff and hopped off. A group of five autorickshaw drivers swarmed us and tried to get us to go with them. "Where you are going?!" "You want hotel?" "You go Ellora? Ajanta?" Lord, please protect us, is all I could think! Though Laurel was wary of these guys, we had no idea where in the city we were, nor how to go look for hotels. So, we ended up taking an ARS (autorickshaw) after insisting on the "metered rate" and asking for the Classic Hotel, one we'd read about in Laurel's Lonely Planet. Of course, our driver drove past several hotels, asking us if we wanted to stay there instead (he'd get commission if we did), but in the end, he took us to our promised destination. We had no change to pay the 20 rupees, only a 100 rupee bill. He said he couldn't make change, but it was a lie since he gave back 80 rupees when I gave him the 100 rupees. We walked inside and he followed us, badgering us about taking his ARS for a

 tour around the city and to Ellora. (Uh, no. We weren't stupid.) As we were discussing rooms and prices with the hotel desk clerk, he suddenly pulled out a 100 rupee bill ripped in half! He said something about giving him a ripped bill and that I needed to give him 100 rupees. (Ha! Nope, not falling for this one!) Laurel suspected he was lying as well, so she told him sternly, "No! No!" But he kept insisting to us and the hotel clerk that he had been given a torn bill. We decided the best thing to do would be to just go up to our room, so we left the guy and started walking up the stairs. On the way up, I suddenly thought, what if he's right and I have a torn bill in my wallet? I'd better check. To my utter dismay, the other half of the bill was sitting in my wallet. It'd probably ripped against the zipper. I ran downstairs and took the torn one from him as I handed him a whole 100 rupee bill. He was finally satisfied and smiled at me. I felt extremely guilty as I walked upstairs. I'd learned my lesson: don't distrust what someone says before verifying the truth, even if there is good reason to be suspicious!

After dropping off our things in our room, we had breakfast at a nearby restaurant and then took off to the Nirala Bazaar area, near the Muslim part of the city, in order to find some of the recommended shops and restaurants. We were trying to find Cafe Coffee Day, one of the major coffee chains in India, which we'd gone to in Nagpur a month ago and knew was somewhere in Nirala Bazaar. We just didn't know where, since the book listed no address and the streets were unlabeled anyway. We walked down one of the streets, asking person after person where it was, but no one knew. One young Muslim woman pointed in the opposite direction and said it was behind that bend. So we turned around and walked back the way we came, but still no CCD. We were excited to see a Cafe Coffee Break but couldn't believe the guy who told us they weren't open (at 11am!) Anyhoo, we gave up our search and took an ARS to the state bus terminal to board a bus to the Ellora caves. At the station, we saw a Caucasian girl carrying the exact same Lonely Planet India book Laurel had. We saw several more travellers during the trip carrying the same book. I could just imagine what the Indians thought of us backpackers: "welp, there comes another one with a big pack on her back, a lost expression on face, and that strange purple book in hand." Anyway, the girl was Polish, didn't speak much English, and wasn't going to Ellora but we were still glad to see another foreigner. On the hour-long bus ride to Ellora, we were the only non-Indians on board, and of course, we were stared at the whole time, as we were everywhere else in Aurangabad. :)

The Ellora caves were breathtaking! (http://en.wikipedia.org/wiki/Ellora) So much beauty yet the burden of serving all these gods hung over the place. It was interesting to see the Hindu, Buddhist and Jain caves/temples existing in one area, many of them built around the same time period. The awe-inspiring Kailasa temple is the centerpiece of Ellora, and it's twice the size of the Parthenon and carved from one piece of rock. Wow. In one of the Hindu temples, I met one of the keepers, and he told me he worked there for over twenty years. He worked shifts in the temple caves, rotating through them every month and working nights every 3 months. There was no electricity in the caves, so he'd have to walk through with a flashlight! They were creepy even during the day; I couldn't imagine guarding them at night! The temples were functioning temples, so there were people going inside the Hindu and Buddhist temples to worship. There were altars and pits in the ground so I couldn't help thinking of all the sacrifices that were offered in the past millenia and a half in those very places.

We saw some Asians in one temple, and they dutifully eyed me, the other Asian in the near vicinity, as I returned the favor. (for those unfamiliar with this protocol, please see http://www.asian-central.com/stuffasianpeoplelike/2008/03/05/25-staring-at-people/). We kept on seeing them in the other areas and I finally heard them speaking a familiar language, so eventually (after several more mutual eyeing rituals) I approached and asked if they were Korean, in Korean. The three travelers, one guy, two girls, were surprised when they heard me speak, and asked if I was backpacking around India. I told them that I was working at a hospital for a couple months and they told me they were travelling around the country for a month. After the pleasantries, L & I walked to other caves, where we saw them later, and then saw them again in a restaurant near the caves. We were absolutely worn out with walking up and down the temple steps and the roads leading up to them that we set out on one last Hindu temple that was one of the most impressive. It was beautiful. On our way down, we ran into the Koreans again, and I joked about them following us. Thought that was the last we'd see of them. We went back into town, showered off the three inches of dirt + sweat that'd accumulated and changed into a fresh salwar. We were absolutely faminished but we were just ecstatic about trying out a tandoori restaurant near the hotel that the LP book said was the best in town. We arrived at 5:30pm but the door was locked. The men sitting and staring nearby said that it would open at 6pm. A security guard said, no, it opens at 6:30pm. 

We spent the next hour exploring the Vishal supermarket nearby and finally came back to a still closed restaurant. Boo. While 

waiting for the place to open, I mentioned that it'd be crazy if the Koreans showed up at this very restaurant for dinner. Well, just before 7pm, who shows up but that very same trio? They were as flabbergasted as we were. I thought they'd want to sit with us for dinner but for some reason L & I couldn't figure out, they preferred not to. Well, at least I got a snapshot with them before they got away. Dinner was AMAZING, the waiters was hilarious, and our bellies were happy. Thank you Lord for an amazing day.

The next day, we explored Nirala Bazaar and the Muslim quarter of the city. We had lunch at a place called Smile, where I had "dosa", which looked like a version of pizza, and Laurel had a veggie cheeseburger and fries (with a Coke). Yay! While eating, a guy on a motorcycle with "Jesus is my Protector!" on it pulled up and sat there long enough for us to take a pic. :) Earlier in the day Laurel also saw an ARS with a "Jesus Loves You" window sticker on it. This sounds cheesy, but we could see how God was assuring us of his presence in our lives, even at that moment, and showing us that his children are everywhere, even in that city. More of the story and pics to come later...

Kothara and a litle girl named Kima

Laurel, the other med student here with me in case you don't already know that, wrote a nice post on a God-moment we had last week in clinic. I can't describe it any better than she can so I highly suggest reading about the cool story about a Hindu pundit who recently found Jesus. I might've wrote this already but sharing about Jesus openly is strictly against the law so any evidence of our faith that patients see comes from our "Christ-like actions and attitude" (as the staff frequently pray for) or from tracts that may be lying around. But, God is alive and drawing people to himself all the time, even when we don't realize it.

In the past few weeks, we've heard pieces of different stories about Kothara staff and how they or their families have come to know Christ. The Kothara Leprosy Hospital has been around for over 100 yrs and initially begun as a home for leprosy patients on land given by the government to The Leprosy Mission. Families brought people affected by leprosy and left them because they could no longer care for them or did not want the stigma of leprosy in their families. The patients then provided nursing care for each other since there were few people not affected by leprosy who'd live and serve in such a stigmatized community. Thus a whole community linked by leprosy was birthed, and many in the community came to know Christ because of Christian missionaries who served there. By the time effective treatment for leprosy was found, patients no longer needed to live in Kothara. They were treated, found jobs in the community and had families. Well, many of the staff today are either past patients or are children or grandchildren of past patients. Many patients had life-changing encounters with the living God and their children and grandchildren have also followed in their footsteps. It's marvelous to hear about the legacy of Kothara over the years and how God used a horrible disease to bring about good not only in the patients but also the generations that followed them.

Christians are still very much a minority in this area and the vast majority of the patients we see are Muslim or Hindu. We can usually tell which religion they follow by their clothes, especially the women, since the Muslim women wear the black hijab and the Hindu women wear brightly colored saris. It's interesting to see how the hospital is respected in the community for the medical care it has provided over the years, free of cost to leprosy patients and low cost otherwise.

Just yesterday, a little girl was brought in by her grandmother and uncle with an extruded left eyeball. It was an opaque white globe that was just hanging out of the eye socket (sorry to be so graphic). From what we could understand, her mom had died early on and the father abandoned her several years ago because of the deformity. The maternal grandmother found her not too long ago and decided to bring her to the hospital despite lacking money. Laurel and I had no idea what had caused the deformity or what it was. Dr. Shyam examined the beautiful, frightened little girl (named Kima) and diagnosed it as a staphyloma. We'd never heard of it. In fact, she'd never seen a case in ten years. Just in case it turned out to be a tumor, like retinoblastoma, she decided to surgically remove it since she had no possibility of vision from that eye anyway. Turns out that a staphyloma is just a protrusion of the eye when a malformed eyeball gets too big for the socket, here usually due to vitamin A deficiency...sadly something preventable but thankfully not very common anymore. Her family is from a tribal area and they'd heard of Kothara because of the free medical camps often held in the tribal areas. Dr. Shyam said they'd provide free care for Kima since the family had done a lot just bringing the girl in to the hospital and they might never see the girl or family again if they mentioned anything about money considering their extreme poverty. This afternoon, Laurel and I watched the enucleation (or surgery to take out the eye) and then stayed with her until she woke up. There were no one at her side to watch her! (at Children's Hospital, there would definitely be a nurse with her monitoring her vitals, keeping a close watch on her!) The sedation took a while to wear off and we were worried about her so we tried to wake her up every few minutes...so frequently that the optho tech sitting with other eye patients in the room chuckled at us calling out her name and me adding in various Marathi words I'd picked up. "Soondal Kima! " (Pretty Kima) She is so precious, so in need of love. I wonder if she was teased because of the deformity. I wonder if she was ever held by her mama. Her grandma and uncle must love her since they came all this way to get her treatment. We hope she is taken care of and loved, and shown Christ's love for her.

More food and fun to be had...

It's almost the start of another work week for us. Saturday turned out to be a busier day at the hospital than all last week, and for that, and that only, we're thankful that we didn't go to Nagpur. A man in status asthmaticus came in on Friday, got better with treatment, and then all the sudden stopped breathing Sat morning. Dr. Rashmi intubated him and ventilated him manually with an ambu bag. In the States, there would be a machine doing the breathing for him but here, a person has to stand there and squeeze the plastic bag continuously...for hours! The pt then started having seizures, which we treated with Dilantin, and then he started breathing short gasps on his own. He was transferred by ambulance to a bigger hospital in Amaravati. Another seriously ill patient came in on Friday; she was a patient with pancreatic cancer. She was deteriorating and the doctors didn't know if she'd make it so had to be with her the whole time. Then a ten year old tribal boy came in with severe grease burns on his face and body that he'd incurred the night before! I don't know the exact situation but I couldn't believe that the parents brought him in so late. Much to our relief, his corneas had been spared. Wow. What a weekend.

We're heading over to Dr. Asha and Dr. Steve's house for his 50th birthday party celebration. Laurel and I are taking over chocolate cheesecake (sort of). She did a good job of substituting things that we had for things we didn't have--like cream cheese and whipped cream, sort of..umm...essential. Laurel's quite the cook! And so is Manisha, the Anands' daughter. We're going over to their house multiple times a day in hopes of getting some treat or another that she's making at any time. It's amazing to me to see the stuff she makes, like choc cake, considering that any kind of "Western" ingredients, they have to obtain in Nagpur, which is four hrs away.

Yesterday we had a good time hanging out with Mitalee, the sweet and godly counselor for Kothara. We visited her room and she showed us the awesome rooftop that her building has. You can see around for miles, including the mountain that we were hoping to climb! It was a gorgeous view. We hope to still get a chance to go. She came over for dinner and we made quesadillas with chapatis (the flatbread we get everyday, every meal), processed cheese, chopped okra, tomatoes and onions. It wasn't authentic, but it was purty good for what we had on hand. I also fried up some okra, which was sooooo good. I had said to Dr. Shyam that fried okra is my favorite food in the whole wide world, so she obtained some for me (okra is called ladyfingers here, who knew?) Everyone here has tried so hard to make us feel at home.

Today, Laurel and I taught a new song in church after practicing it with the Dr. Sunil, Dr. Shyam and their son Nihal. We sang Dennis Jernigan's Wider than the Ocean. It's been quite a long time for me since I've played instruments during a worship service, and I have to say that I'm loving it. I've gotten quite rusty at the keyboard and it's hard to keep up with the talents of Nihal (who can play anything by ear!) but the practice is good for me. I imagine Laurel's tired of me practicing at all hours, though she says that she likes it! She's a sweetie. It's interesting that some of the well-known hymns they sing have different music to them; for example, the doxology hymn is to a tune of a different song. Totally throws me off when I'm singing and playing at the same time, yet I love experiencing different ways of praising God in different cultures. I was kinda hoping they incorporated dance into worship here since dance is so prominent in Indian culture. Maybe it'll catch on soon. Maybe I can get them started. Laurel's been treated to the sight of me dancing around her room to my ipod music. Without TV or internet (until yesterday), we have to find new ways for entertainment :) I'm entertained by Laurel's yoga moves, which I think are physically impossible for me! I guess we're immersing ourselves in Indian culture in our own ways--dancing for me, yoga for Laurel!