The Taj Bengal

I leave Hastings gratefully only to be assaulted by the literally opposite yet equally disturbing world of affluence at the Taj Bengal, the most fancy and expensive hotel in Kolkata. It is certainly not a relieving change of scenery, but one that serve to exaggerate the mindblowingly tragic juxtaposition of wealth and poverty that exists in this city. Sitting below crystal chandeliers, surrounded by balconies with gorgeous flower gardens, dining on the most exquisite and plentiful variety of Indian food, glorying in the luxury of flush toilets with toilet paper, sinks, mirrors, lotion, and body mist, not to mention paper towels, and walking on marble floors that are distinctly clean to an extent I had thought impossible here, I feel a deep guilt for both the existence of this level of excess and personally guilty for my opportunity to take part in it if only for a few hours. As the most well-renowned medical experts of Kolkata give lectures on the cutting-edge advancements in clinical treatment of various thyroid diseases like Grave's, hypothyroidism, and thyroiditis, to a full audience of fancily-dress physicians, I wonder how it is possible to have so many doctors and such advanced health care, but care which is entirely inaccessible to the vast majority of citizens who are too poor to afford it or too alien to the health care system altogether. Whether it is a hormone imbalance requiring RAI or ATD, or a nodule needing an FNAC or USG, toxicosis vs. thyroiditis, subclinical hyperthyroidism or Grave's orbitopathy, I can't help but feel that this information is nearly irrelevant to our street patients when the most pressing issue is likely as simple (or complex) as iodine deficiency and the treatment option merely nutritional supplementation. Nevertheless, as I try to absorb the medical jargon, decode the 3-letter acronyms, and understand the lines of thought of clinical diagnosis, I am reminded of the fascinating breadth of knowledge and intellectual stimulation that is medicine, a field I am totally excited to have the opportunity to learn in a few months when I enter medical school. Then, dining on decadent fish, fried snacks, chutneys, and curries, I wonder why this food will be digested by my body and not by those of the malnourished children who just swarmed me to take their photos, and realize with helpless disgust that the mountains of extra food will probably be discarded as waste rather than rightfully distributed to those who really need it. The contrast of the absolutes of my day are an eye-opening taste of the true injustice that sits innocently unresolved like the bowl of sickeningly sweet syrup that drenches those white spiced balls of sugar that we all devour so enjoyably. The soaked starch is so tempting and fulfilling that it succeeds in distracting us from the bitter and utterly disgusting reality of poverty, of places like Hastings where I have been only hours before. It breeds a feeling of happy indifference, a blissful complacency that becomes a nauseating intoxication, erasing the troubles of the poor with comforting excess and hedonous gluttony, rendering them entirely unimportant and horrifyingly invisible.

Hastings

A place where malnutrition turns a child's hair pale, brittle, and thin.

A place where the overpass is the roof for hundreds of dwellers who hold steadfast to their territory against police raids out of both stubbornness and the pure lack of alternative.

A place where children cut open your bags to steal your cameras and wallet while their sisters distract you by doing the 2-finger twisty handshake.

A place where drunkards complain of cracked skin demanding to be seen by the doctor as if it is an emergency meanwhile breathing stinky alcohol fumes in annoyingly pestering closeness into your face.

A place where no child has had a vaccine, and worms extend babies' bellies to a point that is no longer cute.

A place where school is a luxury, perhaps even such a foreign apparatus as not to be used at all.

A place where new babies are born every day due to lack of family planning, entering a world of injustice, destitution, starvation, and utter chaos.

Bess Crawford Orphanage

A small pot of curry potatoes, some chapati
Was breakfast and lunch for 69 + orphans
Brother Christopher says
Every day he goes door to door
Begging for vegetables and money
To feed the orphan children
The teachers and he eat the food first
While the children have Vitamin A deficiency
Give them papaya
One time he did
How much food do you give them?
Only as much as I can get, all I get, I give to them
I have no money
7 teachers
double as cooks
1 gatekeeper
A doctor volunteering
Shameful record of immunizations
Obvious evidence of malnutrition
Children sleep in a warehouse on the floor
A disaster
A black hole of need
So small amount of food you give?
At least we give them
He says

Raw

My new single word to describe Kolkata is "raw." First are the obvious sensory qualities like the smells seeping uninvited into my nostrils from all directions, those of human urine and shit, food of sweet or spicy deliciousness, sugary milky chai frothing, the stink of vomit on the metro, nauseating fumes of exhaust, pollution, and smoke from charcoal fires and trash burning, and the many unidentifiable odors that are inexplicably stronger here than anywhere I have ever lived. Then there are the sounds; my ears witness babies being spanked, children chasing one another, chickens being murdered, goats being herded, bicycles fighting for space with bells while cars fight back with incessan beeping, meals sizzling, beggars' cups clanking, blind men crying "Allah," the song of the call to prayer, vendors calling "Yes Madam?", "EEEEgggggsss!" or "Pallllaaaaakkk!", and the neighbors' private conversations from the uncomfortably close windows along with the noises of their dishwashing and bathing. The auditory stimuli are overwhelming not only in quantity and intensity, but in their often private and unexpected nature. More obvious is the rawness of the images that confront me daily. Whether it is the open wounds of the beggar on my sidewalk downstairs, the butchers bleeding their livestock on the street corner, a mother oiling her baby, the beauty of the women's saris and pashminas, a child pooping on the sidewalk, the men bathing at the water pump, the shantytowns that cover any available space to create real estate from wasteland, or the folks who resort to sleeping at my doorstep on blankets, every day is a disturbing myriad of visual interest.

 

Kolkata is raw in the dangerous variety of infectious diseases that rampantly prey upon these victims who cannot afford to treat them, or who seek medical assistance but receive such a poor quality of care, the doctors' competence is so lacking, and their bodies are so weak, that they expire anyway.  It is raw in the visibility of all trades working diligently and desperately on street sides as they creatively make a living by identifying demand and serving the public. It is raw in its waste that results from the millions who take part in this literally open-air market society, a place where refuse is discarded thoughtlessly to accumulate for the street-sweepers whose duty it is to rectify the littering problem singlehandedly and for the ragpickers who recycle every scrap possible not necessarily out of conscience for the environment but rather in an acheing need to survive. It is raw in the terrifying exploitiveness of beggarmasters who create a system of paradoxically dishonest and real need that plagues the peope with a disturbed guilt that borders on insanity from the pure helplessness of resolving the problem with their spare change. It is raw in its abject poverty that threatens to desensitize the soul of all compassion for its debilitatingly urgent and ubiquitous confrontations.

 

And Kolkata's people are raw. Encapsulating the extremes of human nature, they are unjustly deceitful and crooked, unprecedentedly generous and hospitable, in a passionate fight for social justice, or desperately struggling to escape this place; thus, composing what I see as a more complete expression of humanity. These people are REAL. Whether it is the amused boys who entertainedly run along side me or shamelessly charge me like bulls, the metro-riders who stare at me and take secretive photographs, the shopkeepers who cheat me, the woman who tried to pickpocket me, the businessmen who call out or invite me into their homes to try to get me to pay them for home-cooked meals, the many friends and strangers trying to find a way to come with me to America, the kids who trick foreigners into treating them to cricket bats, amusement parks and zoos, or the milk seller who lies about the price of milk to foreigners and locals alike, they have a sheerly human quality that is unadorned and strikingly naked. The sins of human greed and malice, and the reality of human suffering are so apparent here, the evil as rampant as the consequential pain.

 

On the opposite extreme is the pure generosity, kindness, and friendship that I experience just as frequently. I can recall the chai stall men who picked me up and washed my wounds after my fall, the stranger who paid for our taxi ride, the shop owners who gave me a free shawl when I said I was cold and insisted I don't pay them for it, the vegetable man who returned my change when I overpaid him accidentally, the art teacher who showed me his studio and work gratuitously and invited me to exhibit with him, and of course my host mom who gives me everything and more. It is these people who teach me what it means to live for one another, and force me to humbly accept my reliance on community and fellowship for my own survival.

 

There is a transparency, an honesty to this place that reveals the true colors of human sin just as it offers an inexplicably inexhaustible fountain of love. It is this absolute contrast between wealth and poverty, delight and hatred, greed and generosity, frustration and reward, good and evil, that I see even in the stark, moody ink-paintings of Rabindranath Tagore, where the juxtaposition of black paint with the white paper create the exaggerated emotional effect that makes the image great, that makes life real, that makes the rawness of Kolkata both devastating and beautiful.

The Sikh

Maybe it was my comment about hating geting ripped off all he time in India that the Sikh man spontaneously paid for all of our taxi cab on our way to Howrah train station. At such an early hour we didn't have the option of a bus, so were unpleasantly forced to splurge on a cab. But instead of having to pay the 50 Rs (as opposed to 6) this complete stranger who happened to be sharing the cab, also shared and in fact completely paid for our fare. It was an act of kindness that was no only unexpected but almost absurdly generous since he paid double what he would have had to pay for himself. Though we insisted against his offer, he insisted in return, feeling bad that we as foreigners had always been cheated here in India. He didn't want us to have that impression of his country. He proceeded to show us how to buy our tickets, get reserved seats, and find our plaform entirely out of good-heartedness, and in the end even handed us his card and requested we get in touch to go visit him in Jashedpur. Though I still canno tell he difference between rue Indian altruism and the type of niceness that expects eiher money, business, or sex in return, I had an instinct that this man was honestly of the former category. It is a bit insane how everyone I meet appears to be either entirely evil or absolutely good. I suppose it is appropriate as I come to understand India's identity as a country of extremes.

Street medicine in the Abode of Peace

"Risko?"
"Mela?"
"Rickshaw madam?"
These were three of the shoutouts that were inevitably heard in intervals of about 5 feet as we arrived in Shantiniketan, and ironically unfitting for the town that means "Abode of Peace". It became quickly annoying to be constantly confronted with bicycle rickshaw drivers who had a competitively aggressive technique for getting passengers; that is, by shouting at them repeatedly in an attempt to convince them that they needed to be transported. Telling them we could use our own two feet was futile, as they generally would remark how far away the town was and that we could not possibly walk the 2 km to get there. On the other hand, despite the hassle of these public transporters, I was attracted by the reality that all transportation was either by foot or by bicycle. It seemed that everyone owned a bicycle--the street was overcrowded with them. This environmentally friendly quality and the much appreciated reduction in noise and air pollution forgave the irritating rickshaw drivers who were only trying to make a living and provide a service. The people here were surprisingly open and friendly compared with the city, as a shopkeeper brought us to his friend's home when we inquired about using a toilet. And the "Abode of Peace," eventually lived up to its name once we left the train station. After a breakfast of puri and sabzi, we continued walking past goats, cows, and handicrafts. Even more than the relative silence of the countryside, I enjoyed that the town is a cultural and artistic epicenter, as it is the home of the Visva Bharati University, founded by the Renaissance man, the Leonardo Da Vinci of India, Rabindranath Tagore. He was a heroic painter, poet, singer, and playwright, his talent and passion leading him to open schools all over West Bengal, create masterpieces of writing and painting which I have been appreciating, win the Nobel Prize for literature, and basically become West Bengal's cultural hero as well as my own. His paintings are atmospheric and expressive, and he valued the traditional Bengali painting styles when the British empire threatened to eclipse it with its own European styles and techniques. His poetry speaks to the truths of daily life, spirituality, and human nature. It enthralls me to read more and inspires me also to write. His art school, the Khala Bhavana, was a museum in itself, which made up for the fact that the actual museum was closed. I was impressed by the very artistic nature of the architecture--buildings covered with drawings, mosaics, murals, and relief sculptures. Meanwhile, art students worked in teh quiet afternoon on their wood sculptures and oil paintings. The other schools included the Institute of Humanities, Science, Dance, Drama and Music, Rural Reconstruction, the Indira Gandhi Centre for National Integration, Centre for Rural Craft, and the Centre for Social Studies and Rural Development. I would enroll there if I had the chance. In the evening we enjoyed the local handicraft and music fair that occurs every Saturday night to exhibit local crafts, food, and Baul (gypsy style rhythmic traditional Indian) music and dance. The place brimmed with creativity and an appreciation for art. In the morning I enjoyed a fantastic run through the countryside where I passed peasants, those whose agricultural lifestyle had the beauty of simplicity, but which certainly require extremely hard labor to make their livings. The rice paddies and potato fields, the children playing, the cows being brought into town, the bicycles commuting from the countryside, all made me want to both find out more about these poor villagers' lives, and even live there myself.

And if the culture, the art, and the peacefulness of rural life in Shantiniketan weren't enough to win me over, I also got a delightful taste of the medical programs for the rural villages and tribespeople. We were greeted there by a Canadian man named Brian who runs an NGO called the Peace Clinic, one of the towns social development organizations working on education, health care, and health education for the poor people there. We did not even know this man prior to our arrival, but he took us into his home for the night, and showed us all around the town. More fascinating even than the art school of Tagore was our conversation about public health and medicine and its role in social justice movements. His organization runs a clinic for a nominal fee for small basic needs, since the nearest health center is over 6 km away. They have conducted a survey of teh state of health in teh tribal areas nearby to evaluate the population's health risks and problems (diabetes is big there) and access to health care. These people lack access to basic health care due to their geographical distance and destitution. They are working to teach villages about simple first aid and early child health and hygiene so that they can pass down knowledge to fellow villagers through the sustainable method of health education. But what excites me the most is their beginnings of a street medicine program with an outreach component, a mobile clinic proposal that they were working on when we called. It would improve access to care for those most marginalized rural folks who speak only indigenous languages. Though there don't seem to be "homeless" people here in the countryside, it is a different kind of "street-dwelling" where everyone lives at a level of poverty that compromises health in similar ways. Their mud and hay thatched huts provide adequate shelter, but often collapse to suffocate the inhabitants during the rainy season, and their dirt floors prevent the maintenance of good hygiene. I suppose it would be comparable to the city's slums, as they barely have enough to maintain such a roof over their heads and to provide food for themselves. Most people were farmers, it appeared, and the land was thankfully plentiful. Their problems were less about nutrition and more related to social and infrastructural needs like access to education and health care. Now that I write this I am filled with questions about the people I could only view briefly from the roadside, but people who smiled as I passed on my run. I desperately want to return to work with this group as they begin a street medicine project in this rural setting, a place I feel more suitable for me than the city. Even after such a brief visit, I feel sincerely that I have finally found my niche of future work--rural street medicine.

The weaving project

In a dimly lit warehouse live a variety of looms that work in a soothingly efficient rhythm as they fabricate 

pieces of cloth. Some men spin thread onto bobbins, while others prepare the thread for the looms. The majestic contraptions magically produce cloth with a mechanism I have yet to understand.

Among the rice paddies of Canning lie the two weaving projects of Calcutta Rescue, the main Tamuldah site and the smaller Canning site. Training students who fail to make it to school as well as impoverished local youth, the program offers them both skills and employment in the fine trade of weaving.  All of the cloth produced goes to clothe the patients of CR clinics, to make uniforms for the students who often cannot afford clothing, is used by the people at the handicrafts project, and even supplies the entire stock of bandages used at the clinics, particularly the leprosy clinic. Materials produced are poplin, cotton shawls, and even fine silk. Rather than exporting its goods as a business, the program is an internal way of sustaining CR through supplying necessary fabrics, as well as sustaining the 4 staff and 12 weavers it employs. Trainees were recruited by the local government in 1997 when the project began, giving them basic 6-month weaving training, after which most students continue to work for the project while some move on to production at other sites. Workers are paid a salary and a nutrition stipend, which helps to support their family in this area of high unemployment and poverty.

Asif has been the supervisor of the entire weaving project for the past 11 years, having received a degree in export management as well as government weaving society training to prepare him for this demanding job. He is proud of the work that goes on at these training centers, glowing as he shows visitors around Canning and Tamuldah with delight. However, he has not always been in such a fortunate position; it has taken many years of work to get to this position. "I grew up very poor," he says. He used to do hotel work in Delhi before he found this opportunity at Calcutta Rescue. "I am continuously fighting. I am still now fighting. My life is fighting. But my mind is honest. I am honest. I have inspiration from my past history. This is my challenge."

I had the honor of sketching one of the men that create the excellent, colorful threads and fabrics. Kanai Sardar is an expert weaver at the Tamuldah site, who has worked there since he completed the training 11 years ago. From South Iswaripur, he was a "native local poor boy" when he was recruited for the weaving project and took advantage of the education and job opportunity. His favorite thing about his job is producing the very finest weight cloth. He says his biggest difficulty in life has been not being able to find a job and support his family, an anxiety that he is thankful to put to rest now that he can rely on employment through the weaving project. Through his work, he earns enough to support a wife and two daughters.

Chitpur leprosy clinic

Arriving at the Chitpur leprosy clinic this morning, I witnessed the staff assembling its structure for the day, tying tarps to bamboo poles drilled in the ground, lugging metal cabinets full of medications, dressings, and patient files, and assembling chairs and tables to create the waiting, examination, physiotherapy, pharmacy, and wound care stations. Due to absurd regulations about the land ownership and certainly also the stigma against leprosy, CR is not allowed to maintain a permanent structure here despite fighting for the past 18 years. This makeshift street-side health care center is therefore rebuilt daily and deconstructed nightly, an inconvenience that is nevertheless worth the nuisance for the incredible services CR is able to offer.

All of the patients here are infected with Hansen's Disease (leprosy), a chronic yet curable disease caused by Microbacterium leprae whose incidence in West Bengal is one of the highest in the world. Chitpur clinic offers wound care six days a week, along with comprehensive medical care three days a week (M, W, and F) when a doctor is also present in addition to the wound care nurse. A health educator begins by teaching the patients about the disease's signs and symptoms, as well as wound care so that they may maintain, clean, and bandage their wounds at home. Staff commented that over time, they have returned to the clinic cleaner and cleaner due to this invaluable hygiene education, despite the reality that most of them are living on the streets and cleanliness is an uphill battle. After their lesson, the patients are instructed through physiotherapy exercises that slowly strengthen their numb and debilitated limbs. Though they have difficulty following a regular regimen given their living situations, they at least can complete the movements in supportive company. Next, the patients soak their feet as they wait in line to have their wounds dressed, a process that is quite efficient and satisfying to watch. Scales are removed, nails trimmed, skin shaved, and bandages applied as the healing process progresses for each one. Finally, if necessary, the patients see the doctor for any medical issues. Patients receive free anti-leprosy medications from the government hospitals, and any other medications, extra dressings, as well as crutches and reconstructive therapies from CR. The clinic sees about 35 patients on a busy day, people who come from far and wide to be seen anywhere from every fortnight to once per month. They recieve a meal when they arrive, since coming to the clinic is a big deal for many, the travel and time forcing them to lose an entire day of work if they have a job at all. Altogether 270 patients are seen at this clinic.

The magical and tragic thing about leprosy is that it is entirely treatable, and after months of visiting the clinic for medications, physiotherapy, wound care, and health education, they often return to a relatively healthy lifestyle. However, it is certainly true that the stigma associated with their clubbed feet and hands, loss of digits, and handicapped limbs will stick with them forever. Indeed, they have often been alienated by family and friends, unable to get jobs, and forced to beg on the streets.

Nonetheless, "Someday, leprosy could be cured!" Asis, the clinic manager, told me hopefully. After spending the day sketching the leprosy patients, seeing their optimism, gratitude, and camaraderie, and observing the efficient quality of care they received, I have no doubt that this ideal will one day come true.

Kids

Perhaps it is my fondness for youth, the joyfulness of the teachers, the creativity required and desired, and the eagerness of learners that I am falling in love with the schools here. There is a sense of responsibility for bringing up young minds, a positivity that is contagious, an undeniable satisfaction at the smiles on children's faces and a heartwarming hopefulness at their immediate love for every other human being. Their innocence, their optimism, their gladness for life, their malleable minds, their undamaged spirits, I just can't get enough.

Art

Due to the impersonal nature of the clinic setting, my inability to understand what is going on in Bengali, and my reluctance to bother the busy physicians with questions, I end up just sketching children and other patients to pass the time, when I am not busy making health education posters. In fact, art has become the ONLY way I can either contribute or communicate in this place. Whether it is the design of these posters about arsenic or HIV, or the portraits of these kids, or the organizing of art classes and an exhibition of child art, my drawing and painting background has proven beneficial both practically to allow a way to be constructive and personally as a way to express what I am experiencing when it is the only thing I CAN do besides watch passively. As soon as I bring out my sketch pad, I get a curious crowd that peeks and often thumbs roughly through the book, nosily trying to see every image I have created. They babble in Bengali about what each picture is, and soon request that I draw them once they realize my ability for doing portraits. I cannot even explain how amazing it is to have this talent; it breaks the barriers instantly, allowing connections I could never otherwise make, perhaps not even as a physician. Art even has sparked communication with the clinic staff who normally do not even make eye contact. I have befriended a health worker named Shila whom I plan to give drawing lessons. She does henna, but has always wanted to learn drawing. Our common interests led into a conversation about her unhappiness after 18 years with CR (she is one of the ones looking for another job) and then about homelessness in general. I found out that a common perception is that there are no homeless or street dwellers in the US. How could it be? We are so rich! Doesn't the government help them? I explained the nature of homelessness in Pittsburgh and America and dashed her perconceptions by telling of the inadequate shelter system, horrible unemployment, drug addiction, alcoholism, and mental illnesss that contribute to the problems forcing street-dwelling. She had believed that only in India did people have to live on the streets, and could not understand that I had had a job in the US helping the same type of people. It is these enlightening exchanges of culture and knowledge that truly drive my being here.

Street occupations

street sweeper
garbage collector
shoe-shiner
barber
fast food vendor
laundry detergent seller
pen seller
beggar
scale weighing man
rag-picker
milk man
chicken carrier on bicycle man
rickshaw driver
water pumper
chai wallah
bread wallah
electrician
cell phone repair man
mechanic
knife-sharpener
hair accessory sellor
tailor
fabric/scarf seller
fruit vendor
vegetable vendor
tool vendor
shoe vendor
handmade sandal vendor
fruit salad vendor
used book vendor
coconut juice man
sugar cane drink man
underwear seller
plastic kitchen ware seller
metal kitchen ware seller
lime juice maker
bhel puri man
metal scrap sorter
welder
cigarette roller
lassi maker
fried snack man
solderer and welder
candy man
watch seller
plastic sorter
goat-herder
lock-seller
ice cream seller
typewriter/scribe
xerox maker
mattress seller
huge bags of rice and other huge things carrier
metal beam transporter
bicycle rickshaw man
cooking assistant
laundry washer
magazine seller
photo album seller
map seller
calendar seller
henna drawer
shop advertiser
tablet single use sellers
cardboard box binder/recycler
newspaper seller

This list represents my ongoing compilation of street occupations, in order to demonstrate a glimpse of the uncanny specialization of this paradoxically advanced and primitive society.

The game

I am fed up with being ripped off and being made a fool every time I shop as I consistently return home to find that the local price is about half the price I paid for the item. Whether it is food, clothing, taxis, or books, I seem to pay a foreigner's tax, a tourist premium; I am held to a different scale that charges me as an unwelcome guest. On the contrary, the shopkeepers gladly welcome me, aware of the naivete that I exude through my hair, eyes, skin, speech, and clothes, knowing full well that they can easily take advantage of my ignorance of the cost of their goods. Indeed, they are not ashamed of their dishonesty; in fact, they describe what I call cheating, a mere "sport" where "sometimes you win, sometimes you lose." Well, I always lose. And this weekend, I had enough. I went shopping for a sari, having gotten sick of the starers as I walk down the street. I simply needed to fit in, at least in my dress. I'll admit the colors and intricate patterns have been tempting me even with my detest for materialism—it is like walking through an art museum every day seeing the beautiful patterns of their saris and pashminas. I didn't intend to buy anything yet, but just wandered through the shops on Saturday eyeing the possibilities and disappointing shopkeepers who were irritated at my indecision and refusal to buy. I am extremely picky besides. Thus, I kept shopping, of course not finding the perfect sari. At the final shop, I found one I was mildly fond of, a colorful yellow and red one with Bengali animal print. I wasn't crazy about it, but the man gave me chai and was so insistent I take it that I basically couldn't leave without buying it. I even bargained down 375 Rs to 200 Rs. Nevertheless, once I got home, I learned from my host mom that I had bought quite the shitty sari; it was worth only 50 Rs, and the kind street sweepers wear (actually, I like their saris best and wanted that kind). Normally, I would just try to get over the loss, but my host mom and Padma were so livid that I had been so cheated and were unable to accept my error. "You have to watch your money! They are theives out there! Never buy anything on your own. You must return it. We will find out what to do. 200 Rs is hard to earn! What a waste!" It didn't help me feel any better. The worst was when I tried to wear it, I could understand their judgment of its poor quality. It was impossible to wrap around the starchy and stiff piece of cloth. I still have no idea how this thing is worn, even with the help from these Indian women. They kept going on and on about the price and how I had been cheated. I resolved to rid myself of the reminder of my own foolishness, whether it be returning it, selling it to another volunteer, or just giving it away. I went on Sunday armed with Padma to return the piece, only to find the shop was closed. On Monday I went alone, walking the entire way to Kalighat, psyching myself up the whole way. I had literally lost sleep over the guilt of this purchase, the anger of my stupidity and their deception, and the anticipation of this confrontation. I went to the shop and faced the man politely at first, kindly asking for my money back. "Excuse me, no return." He solidly refused to give me money back, and noted the sari wasn't folded properly. I spent about 20 minutes trying to fold the thing painstakingly in front of him, to the entertainment of the crowd that had gathered amused by my request. I could not get the folds correct, and he eventually shoved the cotton back in the bag. "Take it please." I wasn't leaving so easily. "Why can't I return this? In my country, you can always return. People are honest. I need the money back. I don't want this sari." He was as stubborn as I was, and insisted it was not possible. He offered me to exchange it for a different sari, showing me ones that were in fact worse quality. I revealed the reason for my coming. "You charged me 200 Rs and my friend said it is only worth 50 Rs." Accusing him of cheating me made him even more defensive. "Quality difference." Istarted talking about how much of a liar he was to the surrounding shopkeepers and customers. Why do you cheat foreingers? How can you lie to people like this? What would you charge a local person? You ripped me off. This is a low quality sari." But it wasn't so much the price or quality that I was fighting about, but the concept of being repeatedly cheated by these people day after day. He told me to go, he was going to the market. I was strategically in the way of his door, making it impossible for him to shut it. I was making a scene and attracting a curious crowd, to which I revealed the shopkeeper's dishonesty. Soon, it became a bit awkward, I had no more to say, so just stood in his was silently, sulking in obstinance. I would only go if I could either get my money back or exchange for a better sari. He began showing me other saris, conceding at last to allow the return. I found one I finally liked, a silk red one with a pretty gold border. It was the type my host mom had showed me that is easy to wear and appropriate for me. That was the one I would take. He asked for 150 more Rs, this one cost 350. I knew it wasn't true, so I said no, 200 Rs for this. I stood without speaking, continuing to protest and prevent him from leaving, while spectators sympathized with either me or the shopkeeper. After about 10 more minutes of this, he said I could take it for 50 more Rs. No. 200 only—I had already paid him. "How much did you pay for this? This isn't fair. How much would you charge an Indian woman for this" I eventually realized I could get my way  by only offering slightly more, I said 20 more Rs and I would leave. He agreed out of desperation to be rid of me, though I knew he was still making a fair profit from the sale (I saw the same saris for 230 Rs when I paid a total of 220). I left delightfully with a much better sari and more importantly my dignity, as I at least attempted to teach the Indian thieves a lesson through the night of needless embarassment. Not that I expect them to change their crooked habits, but it is the principle of being honest with your fellow human beings that I stand by, even more than my diehard thriftiness. Indeed, I was arguing over the equivalent of only $4.00. I look back at this feeling silly, but when I recall the bystander's comment about bargaining as sometimes "winning and sometimes losing," and I am proud to have won my first game.

Street Medicine

On Saturday I had the honor of going out with the CR ambulance to Kalighat, where the doctor and health workers managed to see over 20 street clients within only a couple of hours. I was impressed by their very high (80-90%) turnout rate of patients. Their outreach teams have identified street-dwelling areas (about 13-14 sites in Kolkata) and they walk around the streets to find which people require medical treatment, providing the patients with tokens and information about the location and time of the upcoming mobile clinic. Patients arrive at the ambulance, parked merely on the sidewalk nearby where the street dwellers reside, and are evaluated for disease and risk factors by the doctor, and children are given de-worming medications, vitamins, and often over-the-counter medications such as for fever and lice. All of the meds are kept in bottles in a large chest, out of which a pharmacist dispenses the pills, about 1-2 weeks worth. The pills are enclosed in a paper printed envelope that delineates the instructions about dosage and indications. While patients wait, the health educator gives a brief course with information about de-worming, diarrhea, ORS (oral rehydration solution), hygiene, and malaria. The population is generally mothers with children, who arrive there together. It is a highly efficient system. Patients are surprisingly compliant, even when their care requires them to visit a clinic or hospital, since CR does absolutely everything to ensure continuity of care—transportation, medications, and social services. It is such a well-run operation, and I even felt in the way as each member of the team played their precise roles. The team is led by Debu, the OSN equivalent of Mike Sallows, who carries the same dignity and pride about his work. I have the utmost respect for this man, who is basically running the street medicine program single-handedly. Nothing more or less needed to be done, and I have a hard time trying to think of improvements, especially those within my talents. I got up the nerve to do some portraits of the children as they waited, though they were funny subjects—always staring down at the drawing as I made it, which is apparent from their pictures. They were fascinated by my drawings and others wanted their own portraits done. I was disappointed not to have enough room to sit by the doctor; besides, all was in Bengali, and I could not really help or witness much medicine. Nevertheless, once I started sketching, I was able to break a barrier, evoke smiles, and communicate with these people in some small way. It was a fantastic feeling to get to speak to them in pencil, at least. I would like to do more of these portraits, but without interfering with the elaborate operations. I have to be honest, I felt more in the way than constructive, and it was a bit off-putting how cold the workers were at times. I am not sure if it is just a pride thing, or an Indian thing, or a personal thing, or a fear thing, but it has been a bit disturbing how often I have felt completely unnoticed or worse, unwanted in many clinical situations. I don't know why this is, or if it is my imagination. Either way, I wish it weren't true, I wish I had more to give, I wish I could be more a part of the absolutely incredible things going on before my eyes, which are run entirely by completely competent Indians in perhaps the most impressive organization I have ever seen.