Tuesday, May 5, 2015

Going to Bed Hungry

This weekend, four friends and I, took an 11 hour train ride to Dibrugarh district in the north eastern most corner of Assam. The mission? Nutrition outreach camp. Loaded down with formula, multi-vitamins and essential medications we climbed aboard a 3 tier sleeper car for our weekend adventure.
Our Team! Showing off bottles of coconut oil we gave away as fat supplements

We headed to Chabua Tea Estate, said to be the first tea estate in all of India. We arrived to a little col-du-sac of European style bungalows nestled within dense tea gardens. The hospital, a well maintained structure left over from the British rule, was about a 6 min walk through the tea plantation.
Tea Laborers headed to work



Tea gardens are mostly employed by seasonal workers, often transplants from other parts of Assam looking for a way to earn wages. Laborers spend long hours bent over in the intense Indian sun, hand cutting the leaves of acres and acres of tea plants. Hazards of the job include dehydration, poisonous snakes and at times even leopards.
Tea Laborers


Laborers and their families generally live in tiny mud thatched houses provided by the estate. Wages for working 7 days a week 10 hrs a day are approximately 1,000 RPS a month or $16 US dollars. Pregnant mothers are exposed to pesticides and are often malnourished themselves. These conditions predispose them to having babies with birth defects among which are cleft lips and cleft palates.
Cleft Lip baby, moderately malnourished with chicken pox
Child of the Tea Gardens fresh from a bath

Children of the laborers are at extremely high risk for malnutrition. For starters, their parent’s meager income is often insufficient to provide them with the adequate food. Tea workers on average have about a fourth grade education and are often unaware of basic childhood nutrition needs. In addition, children with clefts have a much harder time breast feeding and drinking from a bottle. Many require spoon-fed formula, which as you can imagine takes time and patience. Unfortunately with both parents working, this tedious feeding process is left up to an elderly grandparent or an older sibling who might only be 6 or 7 years old himself. All these factors make it extremely challenging for children on tea plantations to get the calories they need to thrive.


Screening patients in the hospital lobby


This little one has finally gained enough weight for surgery! She'll be getting her lip operated on soon. She had a horrible case of scabies. 


We had a total of 15 families from the area show up for our nutrition camp. Some traveled hours by bus to reach us. Despite our fatigue after the long journey we quickly got to work weighing and measuring the children. The World Health Organization (WHO) has created a method of identifying children at the greatest risk of dying from malnutrition by plotting them on a curve based on their measurements. According to WHO, children whose height plots at a -3 are severely "stunted", meaning they have been malnourished for such a long time their body is no longer growing.  Children whose weight plots a -3 for are considered medically “wasted” which means they have a very high risk of dying from starvation.
Alice at work getting the essential measurements. 


Of the 15 patients we saw this weekend 50% were plotted as -3! This means half of the patients we saw were either so chronically malnourished their bodies refused to  grow or they were so thin they had a 60% risk of dying from starvation.  Several of the families told me their children go to bed hungry at night because they don’t have enough food in the house. Desperate mothers admitted to diluting formula with 3 to 4 times as much water as they should be just so they have something to offer their crying babies.
Onima giving medication and nutrition teaching to a family


One mother brought us her 4-month-old baby who weighed 1.7 kg, that’s about 3.7 lbs! The poor baby was literally a skeleton. The baby had a cleft lip and a cleft palate making it impossible for her to breastfeed. The family was too poor to buy formula so they were spoon feeding her a diluted rice paste donated to them by a government health center. The baby looked as if she was in agony. Every rib was visible and her skin was literally hanging off her like a baggy pair of pants. After talking with the family they told us two previous children in the family had died, one at 3 months of age and another at birth. I knew that if we didn’t intervene quickly this baby would also die. We pleaded with the family to take the baby straight to the hospital for admission and emergency care. When children are this malnourished they require very careful re-feeding so the body does not go into shock from the sudden calories. This process needs intensive monitoring by a physician.
Severely malnourished 4 month old baby weighing only 1.7 kg

The following afternoon we visited tea labor family’s home. Their baby Sudhir is an 8 month old boy with both a cleft lip and a cleft palate, who is severely malnourished. Sudhir’s parents, both day laborers, collectively earn less than $2 a day. This income has to feed and clothe, Sudhir, his two brothers and his grandparents.
Sudhir and his mother welcoming us into their home

Sudhir’s mother was hesitant to show us her humble house. She told us she was embarrassed by the conditions in which she and her family lived. After some convincing she led us to a modest mud hut composed of two sleeping rooms, a larger room for cooking and a small side room holding a few modest possessions and family puja. The house was tidy and neat and the mud floor was surprisingly clean. They’d recently burned it to prevent dust from coming up. The entire family sleeps on two beds. They cook from a small hole in the ground and the smoke fills the tiny house as they do. You can imagine how this might lead to respiratory infections among other illnesses as the children, play, sleep, eat and gather in such a small space without a chimney.
Main sleeping room (2 beds for 6 people)

Kitchen with cooking fire

I spent the train ride home reflecting on the past 2 days. We saw so much suffering in such a short time. I thought about lives of those precious children and what kind of future they’d have. It’s hard to keep from feeling overwhelmed by it all. The problem of food insecurity is so vast here it seems insurmountable. India has the most severely malnourished children in the world accounting for 34% of the global total. It doesn’t matter how well you teach families and how many vitamins you offer, without food the children are still going to starve. It’s heartbreaking that we live in a world where despite both parents laboring 10 hours a day for 7 days a week under the hot sun they can’t even afford to feed their starving families.
Sudhir and his family posing for us in front of their home

Tea Garden Child after a bath in the garden

Curious neighbors wondering what all the fuss is about

Bath time!

Nutrition patient with a cleft palate and suspected Downs Syndrome


Mother of a 5 year old girl who is severely malnourished 

Example of Tea Laborer's House

Beautiful neighbor poses for a photo

But quickly laughs and covers her face

Child helping his dad cut bamboo with a machete

Grandma wants to see what's going on

Curious neighbors


We are going back to Chabua Tea Estate Hospital next month to check on our little group of patients. I can only hope our meager drop in the bucket is enough to make a small difference in the lives of these precious little ones.
5 year old girl who is severely malnourished. She needs to gain weight before she can have her cleft palate surgery
If you have a heart to donate to this cause I'll use whatever money you send to buy medications and nutrient dense foods for these little children. All donations are tax deductible. To donate click this link

Sunday, February 15, 2015

I am only one...

Today was a particularly hard day. On Sundays we feed homeless children living in a slum next to the railroad tracks. These children typically dig through the trash to for their meals. It’s a tragic picture. Beautiful, bright-eyed little boys and girls ages 3 months to 13 years old, covered in dirt, playing amongst the ruins. They are uninhibited by the broken glass, dead rats and barbed wire as they chase each other around the tracks.


Street kids have a distinct look. The difference is in their eyes. They possess an untamed beauty, as if they hold a raw truth the rest of us can’t see. The reality is their lives ARE untamed and raw. They live a reality I can't even pretend to know.

The children start to swarm as we pull pots of rice and dhal from the backseat of our car. They fight to help carry the makeshift water jug made from a plastic garbage pail. We remove our shoes and climb the ledge to the small little Hindu temple where we set-up an assembly line of rice, dhal, salt, chillies and bananas. The children are told they wash their hands with soap and water (from our little bucket)before they can eat. You have to regulate the water station because they try to drink the water, which although might be cleaner than the water they typically drink is not potable.

With clean hands they crowd around the feeding line. Children of 4 years old carry babies of 12 months. They look at you with their dirty little faces and runny noses smiling as you dish them a warm home-made meal.

Some of the older boys show up high. The depravity and hopelessness of their existence drives many kids in the slums to huff white-out in a desperate attempt to escape their reality. You see them walking around with rags up to their faces, inhaling chemical hope. Some look as young as 9 or 10.

Today, a woman frantically told our translator her husband had been burned and wanted to know if we could come see him. I followed her around a broken barbed fence over sharp stones and human feces near the train tracks. Pigs and naked barefoot children walked around me until we reached a pile of stone pylons covered with a ripped tarp and about 10 people gathered around a man in his mid 20’s. His face, arms and torso were covered in 3rd degree burns. His skin was sloughed off leaving him to shiver under the hot sun. He was emaciated and dehydrated, his eyes sealed shut by melted eyelids.

My stomach made the all too familiar ascent into my chest as I took it all in. His clothes caught fire after from a cooking fire about 11 days ago. Apparently he was treated at a hospital for 2 days after which time they sent the family “home” because they could not afford to pay for a longer stay.

His wife poured the contents of a plastic bag at my feet. It included a liter bag of IV saline, IV antibiotics and IV pain medicine. He had a few oral antibiotics and vitamin C. This is what he was given for his recovery. Whom the doctors expected to give him IV medications was unclear. He lay there shaking and moaning, surrounded by flies with nothing but a dirty sari covering his body.

His wife asked me if I could help.  Could I get him admitted to a hospital? Could I give them more medicine or creams? I instantly knew his outlook was grim to say the least. I felt so incredibly small, so helpless, so powerless in an area I’m supposed to be good at. He was beyond hope, even if I could get this man to a hospital, he would most likely lay on a dirty mattress on the ward floor waiting to die from infection and dehydration. His fluid loss was extensive, he looked cachectic and likely septic.

In my head I churned over the logistics of getting him to a hospital. Could I get him off the tracks and into a car without causing more suffering? How does the system work here? Will they even admit him? Surely he must have been worse when they sent him out in the first place.

At a loss, I told them to keep him hydrated, give him fluids every hour, and keep him covered. Make sure he continues his oral antibiotics and try to get him to eat.  I admitted I wasn’t sure I could do much, but that I’d try.

I left feeling defeated, totally inadequate and sick over the gravity of suffering in this world. They say one person can make a difference; you change the world one small action at a time. But sometimes your small actions don’t feel big enough.

How do you know you when you are doing everything you can do? You could spend 24 hours a day trying to alleviate suffering and still find yourself surrounded by it. Yet if you stop, can’t you argue you could’ve continued longer? How do you know when you need to keep pushing and when you just need to light a candle and say a prayer?

I don’t have the answers. I feel small and my soul feels heavy. Helen Keller said, “I am only one, but still I am one. I cannot do everything, but still I can do something; and because I cannot do everything, I will not refuse to do something that I can do.” 

I called my good friend Kristin. She's been living here for 4 years, she serves these families in the slum. She helped formulate a plan for tomorrow. For tonight, I lit a candle and said a prayer. For now...it's all I can do. 

These beauties give me so much joy

Thankful mom brings her baby for needed food
This little 3 year old toddles in with her 6 year old sister


One of our regular little girls, she likes to help carry the water
6 month old baby born in the slums to a 13 year old mom


The slum where these kids live


Saturday, January 31, 2015

Two weeks in India


           I had a moment on the plane. One of those moments where you stop for a minute, just one minute to bask in the beauty of life.  I can’t accurately put into words what overcame me. I looked out the plane window somewhere over the Middle East and thought, “Wow…so this is where it all leads”. 

The past year has been a whirlwind to say the least. It’s been chalk full of failure, uncertainty, love, loss, grief and frustration.  But for some reason, all I feel is overwhelming gratitude. The things my former self might have considered failures have turned out to be the most incredible gifts I’ve ever received. That moment on the plane, I felt the gravity of that gratitude. For however brief my soul was overcome with thankfulness, I felt unadulterated joy, happiness; in it’s purest sense, and I cried.

I wish I could tell you every day since my arrival in India has been laced with the same sentiment.  My first week was overwhelming to say the least. My first “oh shit” moment came when the hot water in my shower (which by the way is a generous term for the spicket that comes out of my bathroom wall) didn’t work. It took a good 10 minutes of talking myself into the ice cold water. You’d be surprised how many excuses you can come up with for NOT showering.

India IS overwhelming. It’s overwhelming and confusing on every level. It’s brimming with life, and life is both overwhelming and confusing.  It’s real, it’s dirty, it’s smelly, it’s heartbreaking, it’s loud and yet at the same time it’s vivid, it’s vulnerable, it’s vibrant, and it’s incredibly beautiful.

Walking to work I literally run the gamut of human emotions. I pass a woman colorfully covered in a pink sari bending over a campfire to cook breakfast for her family, and I smile.  Almost simultaneously I turn the corner and step over the saddest dog I’ve ever seen. The balding patches on his fur reveal a bony skeleton and his eye is sealed shut by a thick layer of blood and grime. He doesn’t move out of the way because he doesn’t have the energy to. My hand instinctively covers my heart and my belly, anything to appease the sinking feeling I can’t escape. I feel helpless.

On the same road full grown men stop me to ask “Excuse me mam, from where are you from?” Their curiosity amuses me. I stop to buy oranges, 24 for $1.50 from the man with a limp and a lazy eye. Lately he’s been lighting incense in the middle of the piles, I guess it’s good for advertising?  His excitement to sell me a bundle of oranges dismays me.

A few meters further I pass a family of 4 living on the sidewalk under a heap of newspapers, cardboard boxes and dirty tarps.  This time I can’t keep walking. I give them my lunch of PB&J and a handful of oranges. Their gratitude for my meager offering humbles me.

Boys on bikes with bushels of dead chickens hanging off the sides and men with long poles carrying massive baskets of eggs pass me by.  Smells of roti and dhal start to fill the air as the street vendors begin their cooking for the day.  Everyone stares at me. I guess I stand out. They have no qualms about staring at the strange white girl as they sip their morning chai.

So this is India. This is my new home. It’s a crazy place. I’m sure I’ll have a few breakdowns. I’m sure I’ll laugh until my stomach hurts as I take in all the strange sights and inconsistencies. I know I’ll cry, but most of all I’ll be truly ALIVE.  I’ll experience life in its confusing, overwhelming and raw beauty.  As they say here “Let’s wait and see”. 





















Wednesday, January 7, 2015

Surrender

Surrender

Waiting. Patience, a virtue I have yet to master. Why in life do we find it most difficult when we have ZERO control?

Today my mom came home crying. Today my visa was postponed. Today, I feel helpless. Today, I wait. I wait for some higher power, surrendering to divine intervention, a sign to justify my waiting. Hair twirling, feet tapping,  clothes folded, unfolded…I wait.

I have such an ingrained need to FIX. Some things just need time to heal. A wound, no matter how well you dress it, how great the salve you slather, still needs time. I need to learn the art of waiting, surrendering to time. The art of letting life, BE life, too fast, too slow, never just right, always just a little uncomfortable, always a bit out of the expected.  Life.

My mom came home crying. She is exhausted by her passion, by her love, and her desire to be her best. We always fail. Does this need for perfection ever end? Are we always living with the assumption that we are great con artists?  "Someday they will realize I have NO idea what I’m doing”.  When do we stop believing we are fraudulently impersonating OUR OWN lives? When do we believe someone else will love us as fully as we love our beloved? 

As a child, whenever I had a hard day my mom would tell me my grandmother, Genevieve Riesterer always told HER, “this too will pass”.  She’s right, all things pass, this waiting, this feeling of helplessness. All will pass.

For now, I choose beauty, I choose truth, I choose vulnerability…I choose LOVE. I held my mom tonight, the woman who so bravely brought me into this world, the woman who spent countless sleepless nights rocking me to sleep, watching over me until my eyes closed. Tonight, for a few minutes, I was able to hold HER while she cried. I tucked HER into bed. I finally had the chance to tell HER, “This too will pass”.

Life…you tricky bastard.  Thank you for uncertainty, thank you for vulnerability, and thank you for teaching me the beauty of waiting. Thank you for postponed visas, thank you for uncertainty. Thank you for making me wait. 

I see now. I SURRENDER. 


Very little grows on jagged rock.
Be ground.  Be crumbled.
So wild flowers will come up
Where you are.

You have been stony for too many years.
Try something different.  Surrender.
-Rumi