Monthly Archives: May 2015

India, India! (I return)

After over two years, I’m back in India. For whatever reason, this country has grabbed me more than most, and I have returned to the same place again in my travels, with plans to return for many many more visits… 

  

SNP Widows

 In the middle of an unrelenting heat-wave, I am back at the BIRDS campus in the village of Muthylapadu, in the Kurnool District of Andhra (no longer Andhra-Pradesh), India. The school children are on summer break and without them, the campus feels empty but at peace. Taking their place, are the widowed employees of Shelter International’s Sanitary Napkin Project. Visiting them in their workshop and my interactions with them have been a highlight of the last few years. Words do not begin to express my sentiments and I hope that I am able to process and share these feelings in the future.

While I am here for the widows, I am also here to research the beliefs and practices of feminine hygiene in this portion of village India. Two friends have joined me and together we are trying to create a concrete and evidence-based picture of the area’s current feminine hygiene practices. As tools, we are using focus groups and individual interviews with women and Community Health Workers (CHWs).

 

Transportation

 So far, only two days into the individual interviews, our results are quite interesting. It seems that the majority of women here already use sanitary napkins, most having adopted them recently because they wanted the “freedom” and “comfort” to move about. Previously, they used bits of cloths that restricted their movements, caused mortifying menstrual mishaps, unpleasant smells, rashes, and were embarrassing to wash, dry, and reuse. When I ask these impoverished women the maximum price that they would pay for napkins, they almost unanimously reply, “Napkins are now a necessity. Even if the cost was 100 rupees (current prices in the villages range from 26-45 rupees), we will pay it, because we will never go back to the old ways.” 

Despite this unexpected progress, many of the women still face restrictions on their behaviors and movements during menstruation. So far, none of them worship during their menses, as they feel “impure.” Several do not travel or leave the house, many restrict the foods that they eat, and some are forced to stay outside or in a corner for the duration of their period. Thus, while some women do have the freedom and comfort to go about their days normally, because of custom, many women are still restricted and stay home from work or school during menstruation.

Education is also lacking and, perhaps surprisingly, mothers do not tell their daughters about menstruation until after menarche (their first period). And, as one might expect, sex education is lacking in the Indian school system. Thus, when girls see their first drops of blood, they fear disease or death and run crying to their mothers, who then tell them that this is a normal process for girls– their entrance into womanhood. Several of the women revealed that they never had the opportunity to learn from their mothers, because they were married within a month of menarche and their mothers did not have time to explain how to manage menses. Furthermore, women have no knowledge of the physiological process of menstruation and very few women are able to identify the origin of menstrual blood.

Still early in this process, my mind rolls over future projects and mostly educational interventions. I am also dreaming up ways to expand Shelter to employ more widows, as widows frequently travel great distances hearing that we employ widows and treat them well (unfortunately, the stigma of widows is still strong). While I do have a slight bias, I have already seen the impact that Shelter has had on the lives of our employees and even on women in the villages. I feel so lucky and thankful to be able to do this work. It is what drives me and gives me the energy to succeed in my studies.

More to come as time, internet, and power allow…

 

I interviewed this widow over 2.5 years ago. She is still alive, wearing the same blouse, and is now in her 90s.

  

Raw Material and almost finsihed product

    

The BIRDS farm

 

In Closing: No End In Site

It’s been almost a year since my first day of medical school, and this first year, “MS1”, is finally coming to a close. Writing as a form of procrastination, I’m staring in the face of my last final and will fly to India the following day, where I will spend three weeks working with the widows and women of rural Andhra Pradesh on feminine hygiene. I promise, dear readers, that you will hear more about this project later, as time allows.

It’s been a wild year, so wild in fact that I can hardly differentiate or recall many of its details, as days tend to blend together while staring at my computer screen… That said, this year has had many highlights, many memorable moments, and more than a few “learning opportunities”…

All in a day's (24 hrs) work

All in a day’s (24 hrs) work

Going into medical school, I was convinced that I would take care of myself, maintain friendships both in and out of medical school, continue to write, and somehow get enough sleep. However, with an all too often empty refrigerator, free pizza several times a week, and an ever crushing workload, it’s been difficult to take the time to luxuriate in past enjoyments or even finish conversations (much less the copious amounts of “me time” to which I had grown accustomed). Instead, I languish away in medical school, watching others live their twenties through the lens of facebook, while I torture my brain and preserve my skin, enjoying the great indoors of lecture halls, libraries, and my cluttered office. This past year and for the foreseeable future, time off is not really time off (it is a time to sleep, or, better yet, watch the several weeks of classes that I have yet to stream…).

Almost one year in. How do I feel? Tired. I don’t have the same energy or enthusiasm for my studies that I had during my first semester. However, for the most part, I still enjoy what I am doing and am happy with my decision to go to medical school. As my reader can tell from my tone, I’ve had my fair share of frustrations, but mostly I’m just tired. (And a little bit stressed.) I also wish that I had more time to devote to intellectual and personal pursuits outside of medicine, as demonstrated by the forty or so tabs currently open on my browser (to “read later” of course…). But for now, I am learning. More than ever, I know what I am working towards and I know that the sacrifices I am making will be justified.

One thing that this past year has reminded me of is that the active pursuit of knowledge must be part of my life (these past few weeks, distracted from my course work, I’ve missed the stimulating environment and intellectual freedom of Reed College). Whichever specialty I choose, I feel that I will fit best into an academic setting, one where I can have side pursuits (public health, global health) and where others share similar ideals and desires to expand knowledge.

Until then, I will work.

More on India soon.

A&D