grub and toilets - part 2

I find that being abroad makes me much more typically English than I would be at home. Every time someone sees me they say "hello, how are you?" to which I reply "very well thank you" .... which of course is complete and utter bollocks, but I've yet to master the Tamil for "I've just spent the last 2 hours watching what can only be described as the lining of my gut fly out of my bum at the speed of light"! Conversation amongst volunteers, once the introductions are done with, descends to endless talk of bowel habits (the likes of which can only be equaled by the elderly). Solid poos are a cause for genuine celebration. I've done 2 so far..... in 3 months (in case you were wondering - I'm sure you weren't!). After the ultimate in loo roll conservation - one roll in 2 months (I became extremely adept at the ancient art of paper folding!) - I am now in heaven as I have a stack courtesy of my sister (when I mentioned loo roll I was thinking one, maybe two, but no...I'm now the proud owner of a family of nine quilted rolls!). When bowels are exhausted, both conversationally and otherwise, talk turns to food. Ahhh - the hours I've spent talking about what I'd like to eat, how I'd cook it, what it would smell like - I've mastered food meditation. Don't get me wrong it's not that the food's bad, it's just that it's so different. My first 2 months were quite challenging as vegetables were minimal, fruit non-existent, protein zero, just good old carbs and chilli. Rice bloats you instantly and then a few hours later leaves you really hungry. Chilli....well you know the effect that has and I won't digress back onto bowels....needless to say, spicy on the way in and out! The food provided by my new family is a big improvement. Lakshmi is a fantastic cook but I don't know how she manages it. Her house is minute, much smaller than the bedroom I stay in. There are 2 tiny rooms, no bathroom or toilet and no water (there's a tap outside that works twice a day). She lives with her husband, Durai and her two boys, Sadhiz and Vinit. It feels quite ridiculous to think that I have a house all to myself back home - I wish I could do a swap. Lakshmi's house is right next door to one of the largest houses I've seen in India. It seems strange that they live side by side. There doesn't seem to be any resentment - people just accept their lot and get on with it.

To monsoon or not to monsoon

A few weeks ago it looked as though the monsoon had finally arrived, with the onset of daily storms and downpours (although this has now stopped and it appears the monsoon has, in my part of Tamil Nadu, failed). The Indians class this time as the "cool season", I call it the "fractionally cooler season"! The temperature still soars into the high 30s during the day, but it is slightly cooler at night and I no longer lie in a pool of sweat. The heat is probably the biggest challenge for me here. I have classified hand-washing as an extreme sport - the sweat streams from my nose like a tap. I used to do my washing in public, but it's a little daunting having an audience of six women discussing my technique, so I now indulge in naked hand-washing whilst in the shower. Most of the families where I live use a "dhobi" - a person who washes for a living. I'm sure they think I'm nuts doing my own washing but I feel that there are already too many barriers between me and the locals and I don't want people thinking I'm above doing my own dirty work. Anyhow it gives me something in common with the dhobi who gives me an enormous toothless grin when she sees me lugging my washing around.
With the rain came the dragon flies in their hundreds, all hatched out overnight and busy making their maiden voyages the next day. Also thriving are the mosquitoes, who have taken a particular liking to my feet, even the soles. Last count 20 bites. How they manage to bite there without being squashed is beyond me. Perhaps they are a new kamikaze breed! They certainly don't have a sense of smell that's for sure!
We have enormous thunder storms each day, which I absolutely love. They are the kind which make the hairs on the back of your neck stand up, you can feel the electricity in the air. I stand on the roof terrace and watch the lightning crackle overhead, it reminds me that we are very small in the grand scheme of things, little dots on a planet which is still raw and volatile. The rain falls in torrents, so heavy I can't see the other side of the street. The road transforms into a river half a foot deep in a matter of minutes - it's quite a sight. Life here goes on regardless, people wading about, bikes wobbling through potholes, whole families perched precariously on the backs of motorbikes, turds floating by.

Redundant!!

As far as nursing goes this hasn't turned out to be what I expected. I am able to do very little hands-on so spend most of my time observing which can be very frustrating. This is partly because of my inability to speak Tamil but predominantly because my role as a nurse in England simply does not exist here. A dressing here consists of covering or packing a wound with gauze which inevitably sticks and causes further trauma when removed. Dressings, catheterisations, removal of sutures etc are all done by the Drs. Injections are one thing I can do but for me there is an ethical dilemma attached to them. Literally every person, regardless of what is wrong with them gets at least two injections. Tablets are pretty much redundant. I tried to raise the subject with the Dr but he quickly gets defensive. His argument is that people are not educated enough to realise that they need to complete a course of oral treatment and therefore it is best to give a one off injection. He also says that people want a quick fix and that if he refuses to give them an injection they will just go elsewhere. My point of view is that as an educated Dr he has a responsibility to try and change atitudes and re-educate the many people he sees on a daily basis. If the patients then go elsewhere so be it. Injections should not be given on demand. Needless to say that he gets paid for every injection given. Even antibiotics and paracetamol are given by intra-muscular injection - it's unheard of back home. Needles are thankfully changed between patients but are used several times on the same person. Syringes are re-used for giving a specific drug and sit uncovered, in the heat with flies walking all over them. The gloves, which are used for internal examinations, are dropped in an orange bucket of bleach, given a stir and then pegged out to be used again. So as you can see I have a big dilemma over whether I should participate in potentially harmful practices. The language barrier means that I cannot begin to explain why I have a problem with what they are doing and even if I could communicate I don't think it would really sink in.

The two Drs I am assigned to are old school in the sense that they see the nurses as little slaves. The female Dr in particular seems to be incapable of doing anything for herself. As soon as she coughs (not covering her mouth, and normally in my face!) a nurse scurries to pass her a glass of water which is easily within her reach. The nurse checks the patients' BP before they see the Dr but she immediately checks it again because obviously nurses are too thick to do it accurately. It drives me demented and there are days when I would happily strangle her with her stethoscope!

Still it's not all bad. On Tuesday I went to a medical camp and actually did something productive! I was taking blood tests to check for HIV. One woman was terribly unwell. Her skin was taut over her skeleton and she could barely keep herself upright. She collapsed so I scooped her up off the floor and carried her like a baby over to a bed. She was as light as a feather. Thirty-three years old and probably only a few days left of her life. Her test came back negative but her family hadn't taken her to the hospital before now and medical attention had clearly arrived too late.

My "family"

There are nine people in my family. They are Mr Gomathanyagam and his wife, his two sons Jeeva and Nallithambi, their wives Maheswari and Uma, and last but not least the grandchildren - Bharathi (15), Nithya (9) and little Yudesh (2). They are a very traditional Indian family as they all live together in the same house. When Indian men marry, their wives have to go and live with the in-laws (quite a hellish prospect for most English people I'm sure!). Each family has one room where they sleep together on the floor, on a "mattress" made of old sarees. Within the house there is also a small living room and a larger kitchen. The sons work on their father's farm and they start the day early at 4.30am to attend to the cows. Mr G is an avid supporter of organic farming and natural practices, and is in many ways ahead of his time. He works hard to change the views of locals and to clean up the town. He also plants thousands of saplings to one day provide shade on the parched streets. He's quite a gem and it's easy to forget that he's in his 70s until he starts getting a little repetitive, like all good grandads! He speaks excellent English (as he used to teach it) so we've enjoyed many long debates about how to put the world to rights. Occasionally we've had the odd misunderstanding, normally related to pronunciation. My favourite being a discussion about criminals and their "terrible rapping". It was a good ten minutes before I realised that it wasn't their musical abilities that he was criticising, he was talking about raping! Mr G's wife cannot speak a word of English but will happily feed me until I pop. She gives me a huge grin when I agree to 2nds, 3rds, 10ths! My First Tamil words were "poordum, nandri" which means "enough, ta". Soon to follow were "small", "rat" and "toilet"! Bharathi has been like a little sister to me. She also speaks English and has on many an occasion acted as translator. She really enjoys having people to stay as it adds a little light relief to her hard schedule of tuition, school and then more tuition. Girls here definitely seem to get a worse deal than the menfolk. Yudesh, as the only male grandchild, gets spoilt rotten. I regularly have to bite my tongue as he never gets disciplined for throwing the most ear-splitting tantrums and often gets a treat instead to distract him. Whilst he's very sweet now I hate to think what he'll turn out like. I find it very difficult to adjust to men taking priority over women. It's simple things like I'll be in full flow talking to someone but if a man wants to speak to me he won't wait, he'll just barge on in there. Same as if I'm talking to a man and another man appears on the scene, I'll cease to exist.

spot the odd one out

The hardest thing to adjust to here is being the minority. It's something which, with the exception of a few holidays, I've never properly experienced. The part of Tamil Nadu I am living in is untouched by tourism. Apart from myself and the other volunteer I live with there are no white people in our town and for miles around. We get some very funny looks and people will even go to the length of crossing the road to touch our skin. I am up to a whole head taller than the local women and most of the men. There are days when I feel like a giant white freak show! This was literally the case when we visited a circus. It took ten minutes to get the children to watch the act instead of gawping at us! It is not rude to stare here and women in particular will gaze intently at me despite smiling and greeting them. It can be a little unnerving (I find myself checking for toothpaste moustaches, bogeys etc!). The staring has even led to a couple of biking accidents - people who were so busy looking backwards they didn't see the potholes approaching! All the guidebooks comment about trying not to see yourself as separate from the community in order to help integration. This can be easier said than done. For instance there are usually two entrance fees for attractions in India - one for Indians, one for foreigners. I was taken aback to find the entry fee for a wildlife park was 20R for Indians and 300R for foreigners!! I can appreciate that attractions need to be affordable for the local population but can't help but feel that if the same happened in England there would be a huge outcry and it would be seen as racist. Things are slowly improving though in my town as people no longer notice me when I walk to work. I never thought I'd appreciate something so insignificant so much.

You know you're getting older when....

Just back from a weekend spent in Kanyakumari, the very southern tip of India where three seas meet. It was my first time on my own tackling the public transport and I'm pleased to say I survived! It was my shortest journey yet, a mere 5.5hrs and 3 changes. I met up with another volunteer who lives in Nagercoil. She's 18 and spent most of the weekend having to explain the meaning of various words that I'd never come across - felt like a right old fart! She also spend a substantial amount of time doing make-up, has visited most of the world already and never missed a ski-season since she was three.....as you can imagine we had soooo much in common! My favourite comment was "I love the way they (Indian street sellers) assume we're made of money" .... I tried to point out that in comparison to the majority of people over here we may as well be made of solid gold. All said and done she was a nice person and we muddled along just fine.
My bus trip down was beautiful. The mountains provided a stunning backdrop to the bright green paddy fields and every now and then there would be a track carpeted with red chillies, laid out in the scorching midday heat to dry. Signs flew past advertising Poomer Panties (Indian knicker company) - brilliant name - definitely "been there, done that and got the T-shirt", the spices play havoc with your guts! I got chatting to the girl sat next to me. She was 22 and due to be married next year. I asked if she was excited. She said it would be the end of her freedom and she would no longer make decisions for herself as her husband would take full responsibility for what she did. She's currently working, but again whether she continues to do this is up to her husband. It must be so strange marrying someone you have only seen in a photo - if that. You also have to go and live with your husband's family which may be far from your own. It made me feel so lucky for all the freedom we have in our country, it's so important to appreciate it, I can't imagine being in her position. I have had long debates with the Grandad in my "family" and there are clearly positives and negatives to both kinds of marriages - arranged and otherwise. One's not necessarily better than the other but it's certainly nice to have to have a choice. It's hard to explain "love marriages" to the Grandad - he said to me that when I get home I must make sure I arrange my "love marriage" as soon as possible!! If only it were that easy!
Kanyakumari is famous for it's sunsets and we saw a really stunning one. The sun slid behind the clouds but they weren't thick enough to hide it. We could still see a big deep pink disc sinking into the sea. Sadly on route to the beach I got a double handed arse grope - when wearing an outfit suitable for the most modest of nuns! I saw red and punched him...I don't think he'll think western women are slags anymore just a touch violent...hope he'll think twice next time.

fawlty towers

The hospital I am based in really does remind me of fawlty towers...especially the operating theatre. There's even a little man who runs around like Manuel! The other day was a classic. We were watching a caesarian when there was a power cut. The generator kicked in but it's a little dodgy so there was a few minutes of disco lighting. Then the surgeon wacked his head on the operating table light. This was quickly followed by a ten minute "domestic" - never have a huband/wife team operating at the same time - disasterous...she gave him a right good bollocking! Just behind where we stand are the light switches so when you're feeling bit tired and you lean against the wall, off go the lights (thankfully not me but the other volunteer). The lady Dr is not too careful where she drops the blood soaked gauze and more often than not doesn't hit the bin. She got a good aim with the placenta, but it made a bit of a splash. There's a cuckcoo clock on the wall and mobile phones always provide regular musical accompanyment. When the operation was over and we'd finally got past a fit of the giggles we were offered a cup of tea. Very civilised you might think, but unfortunately the thermos was right next to a pot of entrails ... I gave it a miss!

tough cookies

There are so many contrasts between nursing in England and nursing over here. The nurses are excellent and are masters of a little bit of everything but are still very much servants to the Dr's. One thing I find staggering is that it appears to be unacceptable for patients to be upset, show they're in pain or scared. I always feel a large part of my job back home is to provide reassurance, explanations of things which might seem frightening or just give someone a hug...but that's not the case in this hospital. Yesterday I watched a lady give birth on a wooden table.....silently! It was as though she wasn't there - the Dr made more noise than she did. When the baby finally slithered out there was no reassuring smiles, handholding, welldones - I gave the exhausted girl a smile and thumbs up which meant bugger all as I think it's the sign for having a drink here - she probably thought I was suggesting heading down the pub for a drink (if only!). Before operations people are blindfolded before being anaesthetised - it must be terrifying as needles are jabbed in without any warning. Indian people certainly are tough and maybe this approach is the way to get people to cope with conditions that we wouldn't be able to handle. No mollycoddling and definitely no feeling sorry for yourself. I spent one day with sickness and diarrhoea...I really don't envy those who are seriously ill. Still, I did have some companionship - a giant cockroach - 3inches long was keeping a close eye on me as I attempted to empty both ends down the toilet whilst simultaneously shooing him away!

trains, buses and autorickshaws!

Weekends...a time to relax...well maybe at home but certainly not here! On friday I set off for Kerala with some of the other volunteers. We were heading to Varkala, a small beach on the West coast. On the map it looks so close and perhaps the distances aren't that staggering, but my god it was a journey of epic proportions! The 11.30 bus didn't appear so we got on the one an hour later. There were perhaps 5 women on it including us. It looked quite empty when it pulled up but the men made a dash for all the seats..the little buggers didn't even sit together so there were empty seats that we couldn't sit in as it's totally taboo for men and women to sit together. Our second bus took us over the Western Ghats Mountains...eventually! We kept getting stuck in potholes the size of our bus. There were so many people standing that the bus was unbalanced and swayed alarmingly on every hairpin bend. We passed two trucks in the ditches....I thought it could very well have been us. Then there was a crash and a rock flew through the door window. We all got off and had to wait for the police as the hours ticked by. Once back on the bus we thought that was the last of it but no....at the next village we stopped again..all ordered off the bus to wait for another hour. The Indian women were starting to get a touch pissed off by then and beckoned us to come with them to the police station. After a lot of shouting a sheepish bus driver emerged after enjoying a spot of tea - nice for him! We arrived in the city of Kollam by 7.30pm. We were lost but thankfully came across a very kind soul who rang to check our train was running and sent us flying across town on a rickshaw. We caught our train with one minute to spare - accidently got on the first class compartment and got shooed out! The doors are left open on the trains to let some air in but it's scarey if it lurches to one side someone could easily fall out. We arrived at our final stop after 10hours on the road!! Completely knackered but it was worth it. My first beer in 2 weeks was heaven!

grub and toilets

Meals here are so different from what you imagine. There are no plates in most houses so food is dished out on banana leaves. What a fantastic idea - no more washing up! After a week I am slowly adjusting to eating with my right hand (no knives/forks). To start with I got more down my front and smeared around my face than in my mouth, much to the family's amusement. Most of the meals are rice (plain or in the form or pancakes or little steamed cakes) with spicy sauces, ghee, or coconut chutney. We also have hibiscus juice and sweet tea (which tastes nothing like tea!). Although it's lovely it takes a lot of adjusting to and I am getting very familiar with the Indian style (hole!) toilet! There's even entertainment in the loo - small lizards regularly run past and at night there are minature armies of ant busy carting things too and fro. On my way to work I pass what used to be a river but now is sadly a rubbish dump. In Puliangudi the sewers are open and they drain into it. I always see people going to the toilet there (it would be a very appropriate place to play poosticks!). Some men/children also squat on the road side so you really have to watch where you step! Very noisy spitting is also the norm as it coughing your lungs up whilst not covering your face - the Dr's are the worst - I can hardly believe my eyes!

Arrived at last

Well it's a few days into my 11 month "break" and I'm sat listening to the happy chaos on the road outside, horns blaring, cows wandering and crazy rickshaws weaving around. My fights here went smoothly - small panic attack at Doha (Qatar) - delay meant only 20mins to change flights but made it by the skin of my teeth - it was midnight and 33 degrees - not great for a 500m sprint. On my next leg, a few miles up the date suddenly occurred to me...Sept 11th, not the best date for flying and especially not when the man sat next to you is merrily tapping the emergency exit handle in time to the music. The air stewardess thought I'd lost the plot when she came around giving everyone white cards before the early 1am curry breakfast. When she got to me I told here that "I wouldn't be needing one, thankyou, as I am a vegetarian". She seemed puzzled that this would make me exempt from needing to fill out my immigration details...it wasn't a menu...I am officially a thick foreigner!



The heat hit me when I got off the plane...no more cold English summer, talk about one extreme to the other. Kerala (where I landed) is beautiful, green and exotic. It was a 7 hour drive to get to Tamil Nadu - it only appears to be a small hop away on the map! Here it is more dry and barren, but the mountain range which runs between the two states is suprisingly big and provides a beatiful back drop to Puliangudi, the small town where I'll live for the next 2 months.

My "family" are just lovely and go out of their way to be helpful. There are 8 people living in the house and I live off a nearby courtyard in a basic room which suits me down to the ground. The day I arrived in town I was introduced to the Dr at the hospital. It is tiny and chaotic. I was shown through to his wife who was stitching up a lady (in stirrups) who had just given birth. I am quickly learning that there is no such thing as privacy in hospitals! The same night I went to observe a lady having half her stomach removed (10pm-2am) and then slept at the hospital (at 2am the temple music started nextdoor - MUCH louder than a nightclub!). The operating theatre had a bug walking down the wall and fan kept on blowing things around. The most surreal moment was the 10min break mid-op when the surgeon was trying to get his digital camera to work to take a picture of his handy-work!