Parathas Problems

I knew this would happen. I knew I would start a blog with grand intentions only to fail miserably. I have never been great at cataloging, especially personal experiences. Every diary I have ever kept is half finished; all of which, may I add, are as emotionally stirring as a collection of re-purposed Coldplay lyrics can be. If I knew what tumblr was I think I would be onto something...

Hopefully, this blog is not spiraling down the same path.

The last four weeks have been full of ups and downs. Our project had grown in size and we were happy to feel like we were actually contributing. And then we hit a hiccup that felt like a closing door. This discovery was simultaneous with a bad paratha, from an expensive food court of all places; I was sick for days and so we holed up in our apartment. 

On day three of the re-evaluation process we came up with something. It is a combination of patient held medical records for pregnant women, support accessing local resources from established women's groups in the community and follow-ups conducted by the community mobilizers. We will be distributing the card for a field test next Monday. To support the "pregnancy diary," as we have dubbed it, we created a new patient history form used by the community mobilizers (CMs) and GRC during health clinics. For this form we prioritized current best practices and potential best practices. Time is also a serious factor; the GRC staff spends at least 75% of their day filing out paper work. The form is meant to (1) support the pregnancy diary but can also be used alone and (2) be easily incorporated into an electronic system.      

Additionally, we have been creating a manual that outlines data collection practices and information flows to prepare for the pilot project next summer. We updated the existing database of clinics to reflect current services and costs, with the aim to plot EmOC providers. Finally, we mapped all current self help groups that the GRC supports. This will serve two functions: (1) as per the new project proposal, SHGs will now function as community support for pregnant women and (2) visualize the SHGs within the catchment area to prioritize locations for subsequent groups. 

Tomorrow we present our first draft manual, the pregnancy diary and the new patient history form. Wish us luck!

NEVER AGAIN:

 

 

The Commute

Every morning I take a cold shower and rinse off; even though the A/C and a fan are left on in the bedroom throughout the night, I still wake up sweaty from the stale, recycled air. But its better than outside. Opening the front door and walking out into the street requires silent coaxing and a strong will. It feels like that scene in Backdraft:

Not that one...

This one:

                                                          

And so the commute begins.

First, we walk from our apartment to the closest major road where we flag down an auto (tuk-tuk). Once a price is agreed upon by all parties we hop in and brace for our lives. We weave around pedestrians, potholes, buses and bicycles by swerving into oncoming traffic.

Next we take the Metro from Govind Puri to Jasola Apollo. The train is air-conditioned and clean, a nice reprieve from the auto and the following rickshaw. Once we descend the steps from the metro we approach a swarm of rickshaws calling out for business from a blonde and her Chinese friend. We are partial to a young boy who takes us the quick way and doesn't overcharge. He usually waves to us with a genuine smile.

The ride starts on the edge of Jasola where big business has set-up shop. This part of town has a liquor store, a handful of highrises and paved roads. Within 10 minutes we are riding through thick clouds of flies, sewage and children walking around barefoot. We have arrived at our destination.

At the end of the day we get into a rickshaw and head towards the Metro. By now I am starving for my next cold shower - but now I feel covered in sweat, dust, and the grim that only comes from getting stuck behind a diesel bus in a tuk-tuk.  

                                                         

Participant "Observations"

My morning ritual is minimal. Today as I got out of the shower, I looked at myself in the mirror and literally could not care less. Its too hot to care, and I am working in a slum. Aside from dressing culturally appropriate, I do not care what I look like. To be honest, I am more concerned with how I smell.

So this morning I put on some deodorant and mosquito repellant (its actually borerline too hot for mosquito repellant) and walked out the door.

When we arrived to the GRC there was 12 inches of water covering the dirt road that had turned everything into think mud. Kids were walking in it barefoot. Motorbikes were trudging through. Everything was going on as normal. The community was constructing a water pump up the road.

We had some tea upon arrival and discussed our respective days. The plan for Yizhe and I was to sit in on the various vocational training programs the GRC  hosts through out the day. The first program was "beauticulture." This is a 6 months program that provides women with a certificate upon completion.

The group wanted to paint our nails. So we obliged. Then, I lost all control over the situation. They asked to do my makeup and I said "ok." I have never had my makeup done for me. Ever.

As several women looked on, I was all dolled up. Complete with bindi and dark lipliner.

For twenty minutes, I felt like how she must have felt:

By the way, Googling "Barbie heads" was a creepy search.  

Once my transformation was complete, I was was placed into some dynamic poses and voilà.

Yes, I am blushing under that hot pink rouge. And yes, this is the third funniest photo I have ever seen of myself. No, you cannot see the other two.

First Day

Today, I experienced my first Delhi traffic jam on the way to the JMC office. Its not so much stopped traffic as it is this:

                                      
...+ this... 

I thought about taking a video of the clamor, but I was too consumed with anxiety to stop clasping my hands together. 

Our first team meeting was very productive. We discussed various projects for the GRC, both active and new ideas, as well as each team members' individual goals. We plotted resources and activities on a white board. It was all very exciting. I was taking handwritten notes. Given my usual dependence on Times New Roman, I cannot currently read my notes from the meeting. I will have to get around to that before our field notes are due this weekend. 

I was impressed with the work completed by New Concepts and the JMC, which produce high-quality reports, research and ICT solutions for organizations like UNICEF, UNDP, CARE and various governmental bodies throughout India. 

After a delicious lunch prepared by our supervisor, we headed out into Jasola to visit the GRC. The office is smaller than I imagined. Given the number of programs run out of the GRC and the number of people impacted by the center, I thought it would be it's own building. Instead, it is a simple 2-room office on the second floor of a light blue building. Women and children filtered in and out (mostly in) for four different programs held simultaneously in 1 room with partial partitions: women's adult education, two different vocational training workshops and children's informal education. As the GRC staff wrapped up with our introductions, the women and children situated themselves in their respective learning-areas (each roughly 6'x6'). 

After which we were escorted home by a fellow intern at the JMC via: bicycle rickshaw, metro, and subsequently an auto (tuk-tuk). We will meet her at the same metro stop at 10:15am tomorrow morning. Here is hoping my partner and I can communicate and negotiate with the tuk-tuk driver and navigate the rush hour traffic for the first time. It took us 15 minutes to get from the Metro to our flat today with help. We are giving ourselves an hour tomorrow. 
 

Arrival

I had heard that arriving in India was overwhelming but when I landed at 1:00am last Sunday morning, I was too tired to notice anything except how apt my driver was at navigating the traffic on a major highway with no lanes and seemly no traffic laws. I didn't even find the heat and humidity to be overpowering; until I woke up at 8:00am on Sunday, damp with sweat and parched from 23 hours of travel and 7 hours of sleeping in a sauna. 

Then it hit me. 

My first walk around the block almost gave me a stroke and I immediately returned home to take a nap. I don't think I have stopped sweating once, even during my twice daily cold showers. 

Admittedly, I had Pizza Hut for my first dinner: a personal size "veggie lover" with a 7-up. I ate it alone in the flat whilst perusing Facebook. It was not my proudest moment. I think here is a good time to mention that India is the first country I have been too not dominated by Coke-a-Cola but, instead Pepsi co. Majorly bummed. Have I mentioned I have yet to see the sun as a result of the pollution?

I promise this blog will not regress into a pre-teen's diary of all that is wrong with the world (like the lack of Coke products at the local dukāna). I'm a grown woman, I can drink Pepsi.

I traveled to India to participate in a ongoing, collaborative research project through the Global Health Affairs (GHA) program at Korbel (JKSIS) and 3 in-country organizations: New Concept Information Systems, Jaishankar Memorial Center and the Gender Resource Center (GRCs) in Jasola, a slum community in south east New Delhi.

India is responsible for 20% of all maternal deaths worldwide, a majority of these deaths are preventable. Pregnant women living in slums are at high risk for pregnancy-related complications and death. A recent census reported that 64 million people in India currently reside in slums and this number will continue to grow over the immediate future. In New Delhi, 15% of the population live in shanty-towns. 

The universal healthcare system in India can be difficult to navigate. The New Delhi government recognized this barrier to access and implemented the Mission Convergence program to facilitate better coordination and accessibility across agencies and sectors. Previously existing GRCs are now incorporated in this model and each GRC acts as a primary channel for utilization of services and schemes. There are 127 GRCs throughout Delhi. GRCs in Delhi are essentially community centers that serve to empower women through programs like literacy and vocation training; they also serve as Suvidha Kendras (health facilities). 

The GRC in Jasola serves approximately 20,000 households. 
 

As a result of previous research, a pilot project has been developed: community-based management and technology for intrapartum health. Under this intervention, among other inititaives, community mobilizers (CMs) from the GRC will be outfitted with palmtop devices to (1) use GIS for health referrals during home visits and mobile clinics and for (2) real-time data collection, potentially linked to patient records and (3) M&E. 
 

My research partner and I have been tasked with "Filling in the gaps" before pilot roll-out next summer (expected 2014). Ultimatly we will be creating a manual that documents current practices (particularly related to data collection and dissemination) and opportunities to improve.  This applied research will include qualitative and quantitative analyses. A qualitative assessment of challenges and opportunities will be conducted to improve system monitoring and responsiveness for CMs and ways to further incorporate community members into system design. 
 

savāla?