First week of the Fellowship

So...I have now been in Delhi a week. After a pretty unexciting weekend (very light sightseeing, figuring out the Metro, doing laundry, grocery shopping, and otherwise getting settled in the apartment), I started in the CARE India office here in Delhi on Monday.

First Impression: Very professional, very smart people doing really meaningful work.

The office itself, as one might hope for a non-profit organization, is in an industrial part of town - mostly factories and a few small shops that have sprung up to support the people working in the neighborhood. CARE has two floors in a factory building - very nice, clean, airconditioned offices (a very good thing given the scorching heat outside!) that could be in New York or pretty much anywhere. It's a mostly-cubicle set-up with a few offices for the President and his direct reports, a couple of pantries, a lunch room, and a few conference rooms.

Outside the CARE India offices

I was given a cubicle, a laptop, and (eventually) a sim for my phone. My first day I met with M. Srinivasan (known as MS - many Indians go by their initials) from HR and went over the history of CARE (quite fascinating as it originated as a purely food-aid related organization in the US, providing "CARE packages" to Europe after WWII) as well as the mission, vision, operating principles and major programs of the India office.

My work station!

I had the opportunity to meet quite a few people in the office, and shared lunch with them - when people get together to eat in the office, they tend to open up all their containers of homemade food and share them with everyone - a great practice! I had bought a tiffin of food from a service that provides them to the office for a minimal cost (40 rupees, less than 80 cents!), and shared what little I had - a daal, or lentil curry, a blackeyed pea curry, some rice and some roti (flat wheat bread).

I finished up the day doing some additional research on kala azar (the parasitic disease that will be the focus of my primary project), went home. A very good, very productive first day!


Tuesday was similar - my "manager" at CARE, Dr. Raj, was still out of the office, but I did get the chance to meet more of my new colleagues, find out more information about CARE's programs, and share another lunch - this time, with food I'd cooked the previous night - a potato and okra curry with roti and a mango.

One of my early attempts at Indian-style cooking:  
Potato and okra curry with roti.

Dr. Raj returned on Wednesday, so I had the chance to meet him, and he gave me an overview of my primary project as well as a great overview of the Indian public health system.

The program I will be focusing upon is called the "Strengthening Kala Azar Elimination Program," or SKAEP. SKAEP is funded by the Bill and Melinda Gates Foundation, and CARE will work over the next two years to implement it.

As mentioned in one of my earlier posts, Kala Azar (KA) is a disease spread by a sand fly, which transmits the protozoan Leishmania donovani from person to person. The "epicenter" of the disease is in the State of Bihar, which will be the site of my field visits over the course of my fellowship. Bihar is the poorest state in India - people living in villages there survive on an average of about one US dollar per day. About 30 million people in this part of India are at risk of contracting KA, along with other conditions like malaria and tuberculosis.

An illness like KA, thanks to time missed from work, mis-diagnoses and ineffective treatments, can cost a patient a significant proportion of their annual wages - some have estimated up to 60-70% on average!

My role with the program will be first to set up a study to truly evaluate the journey of a KA patient in the poorer villages, determining how long they are sick before being properly diagnosed, how they go about getting diagnosed, how the health care system (starting with local community health care workers called ASHAs and going all the way up to District Health Centres) enables them to get diagnosed and treated, and what kind of impact all of this has on the individual. Importantly, we want to focus on the best way to diagnose and treat the patients, and what hurdles there might be in the process. Later, I will help set up the treatment and monitoring program to help evaluate progress against the goal of elimination.

Part of the program will entail indoor spraying with insecticide (DDT) for affected areas, incentives for the local health workers to find potential KA patients, free diagnostic testing, and free treatment for the patients - as well as free transportation, meals and compensation for time missed at work - this will help encourage patients to actually show up to the health center and get treated.

Because KA only persists in the human population, the goal is to find as many patients as possible and cure them, while also reducing the sand fly population enough to eliminate the disease. A huge task, but hopefully one we can accomplish!

CARE produced a series of posters
 geared at dispelling key Myths about
women in India for International Women's
Day

 I finished out the week with several more meetings about the KA program, doing more research on my own, and also learning about another key CARE program, called EMPHASIS, which helps migrant workers from Nepal and Bangladesh to have a more safe and secure life, with a particular focus on HIV/AIDS prevention and treatment. There is another American in the office, Samantha, a grad student at Emory University, who is an intern here at CARE and will be working with the EMPHASIS team. She arrived on Monday, and is only here briefly in New Delhi before heading to a CARE field office on the border of Nepal...but it was good to know I am not the only person learning the ropes this week.

CARE India is doing some great work in other areas besides health, such as food security, education and gender quality. I feel honored to be able to be a small part of it for a few months!

Last full day in Dhaka and return to Delhi

Dhaka DAY 4

Today, Zubayr decided to show me a little of Old Town Dhaka and also to take me outside of town to see some of the Bangladesh countryside (and some historical sights).

We started in Old Town, with its narrower, more winding streets, even heavier crowds, ancient ruins, streetside butchers and other foodsellers. We were fighting the rain, which was alternating between "light sprinkle" and "horizontal firehose"...but it was nice in that it cooled things down a bit.

Rainy Old Town Dhaka, outside the Lalbagh Fort 

Zubayr buying tickets

After making it through the traffic on the tight roads, we pulled up to a long wall with a gate and an adjacent ticket window. This was the Lalbagh Kella (or Lalbagh Fort), a remnant of the Mughal Empire dating to the 1670's, with lovely gardens, fountains, a beautiful mausoleum, a small mosque, and a hammam, or bath house. It was founded by Azam Shah, a Mughal Prince, who constructed the mausoleum (Tomb of Bibi Pari) to his betrothed who passed away before they could marry. See the pictures below - apologies for the odd angles at times - I was struggling with an umbrella and some strong wind!

           

Tomb of Bibi Pari

Gardens at Lalbagh Kella

Zubayr and I were not able to enter the mausoleum, but we walked over to the hammam, which has been converted to a museum. The guard was in the process of sending out all the other visitors, but as we walked up to the door, he welcomed us in for a private tour! He gave us an entertaining and animated walkthrough of the artifacts and the structure of the building itself.

Inside were relics from the Mughal period and beyond, through the 19th century, including some British weapons and some beautiful old books, mostly editions of the Qur'an.

Armor and weapons, including arrows tipped with
poison "like from a cobra that would kill you right away"

Me with a Mughal Warrior. You can see the
effects of the horizontal rain.

Chain armor

Beautiful hand-made Qur'an from the mid-1800's

Inside the hammam - there were hot and cold water bath rooms

Outside the Mausoleum

Zubayr and I returned to the car, and Zubayr decided to take a risk and head out of the city to Narayanganj, about 25km southeast of Dhaka, to see the castle of the last Bengali Muslim ruler to fight the British. This place, Bara Sardar Bari, is now a museum.

I learned a lot about Dhaka traffic that day. Specifically, you can easily sit in one place for up to two hours, waiting for...who knows? Then eventually some "dam" breaks and everyone goes. I managed to take a lot of pictured from the car that day! Really, it just took us about 90 minutes to get to Narayanganj.

Zubayr in the car, in traffic, in the rain

I liked the crows lined up in the background

We were stuck under this underpass for about an hour...
but it made for some colorful people-watching

Once out of the city, things got steadily greener.

We arrived at Narayanganj, a town right off the highway, southeast of Dhaka. It was just as colorful here, and though there were still people everywhere, it felt a little less hurried than Dhaka..

A busy intersection off the Dhaka-Narayanganj Highway

Autorickshaws here are red, not green

Even the smaller town was busy on this rainy day!

Along the scenic little road to Bara Sardar Bari

We turned off the main road to head toward Bara Sardar Bari. I really enjoyed this small stretch through town and then a bit into the countryside. Very beautiful land here, with a lot of water (the highway traveled along a river, and there seem to be many streams, lakes, and ponds everywhere.

When we arrived at Bara Sardar Bari, I was really taken with the beauty of this place. Once a palace, it is now a museum. We got out, and went up to the gate - but found that the museum was closed today. Luckily, we could still appreciate its beauty from the outside!

Bara Sardar Bari

Brickwork along the gate

The ubiquitous stray dogs padding along the road from the museum

Mango sellers outside the museum gate

Zubayr and our driver, Mamun, negotiating with the locals

This little boy was begging for change, and was very
 persistent, following us around for  about five minutes

The road back went quickly until we got back to the outskirts of Dhaka. There, we had to wait in traffic for another couple of hours to make the last mile or two back to Zubayr's in-law's place.
.

All the trucks seem to be painted with scenic art, words, numbers...

I noticed a lot of unfinished buildings along the way - I guess a
 hallmark of a developing country with waxing and waning investment

Ornate rickshaw in the rain

Back in Dhaka, we got ready to go out to a family dinner with Professor and Mrs. Huq and Anouchka and her husband, Muntakim. We went to a steakhouse called Steak House. It was very good - and here I thought I'd not be having a steak until I returned to NYC! It was the perfect ending to a great week of fun, friends, culture, and great conversation.

Flower seller along the road to the restaurant

Anouchka, Muntakim, Zubayr, me, Mrs. Huq, Professor Huq

We got up early the next morning for one last delicious breakfast at the Huq's place, and then Zubayr brought me to the airport.

Goodbye to the apartment in Eskaton Plaza!

Veg seller we passed on the way to the airport - an appropriate last look at busy Dhaka city

It was very hard leaving Dhaka - you don't often get the chance to visit a new country and experience such amazing hospitality as Zubayr and the Huqs showed me! A wonderful trip with lots of great conversation. I hope to be back sometime soon! Zubayr finishes his research up and returns home to Scotland in a couple of months, but - who knows? - maybe we'll have the chance to meet up again before long...

RETURN TO DELHI

Another ho-hum flight (food was even worse this time!), but landed on time.

Steven from CARE was waiting for me at the airport, and drove me over the the new apartment, where I'll be living for the next five months.

A very friendly security guard met us at the gate, and took me upstairs to me place. I'm on a 3rd-floor walk-up in a building with four stories, one apartment per level. The place is more than large enough for me! Two bedrooms, two baths, kitchen, living room/dining room, and some outdoor space. It's in a quiet neighborhood called Greater Kailash I in South Delhi. There are a couple of markets in walking distance (even with the heat) and it's a short rickshaw ride to the nearest Metro station that would take me anywhere in the city.

First day in the new place - on the terrace

My new home until November

Dining room/living room/office space!

The kitchen is small, but will do!

My bedroom

The terrace - will be nice when it cools off a bit!

The new neighborhood - Greater Kailash I

I did some shopping to stock the fridge and got the lay of the neighborhood. Fruits and vegetables are available from vendors who walk through the neighborhood, sometimes singing out to let people know they are around. Other foods and supplies are available within a 1km walk. I've already tried a few new foods, and am eager to experience many more!

The wi-fi works well here, as does the air conditioning, so I think I am going to be pretty comfortable. The landlady, Mrs. Prakash, is very nice and has made sure everything was prepared for me.

Fruit from a cart vendor - he walks his cart through the neighborhood

I'm looking forward to starting work on Monday. Until then, I will explore the city a little and try to get ready for a new work setting.