Wednesday, February 9, 2011

Day 5: Christmas Eve Part 2

The kids are little dumbstruck when they hear my dad's and aunts' story. They can't understand that a little toff from the states could spring up from a situation similar to theirs. I let them sit with the idea, but their teacher Prem Latha is smiling. It doesn't matter if the story is true or not, although the fact that it's the former is simply genius. The chance that I've gotten their gears turning is enough.

The air's a little too heavy, so I bat it away with a large bag of friendship bracelets. Immediately the kids are preoccupied with which color they want, but more than that, each of them wants to put one on me--a tradition that follows from Rakhi, an event where girls tie strings around boys unrelated and related to them as a promise to protect each other from harm. So, by the time I get to the last kid, my whole forearm is covered with these ridiculous bands.

We gather up to practice "We Wish You A Merry Christmas," and then shortly thereafter, file out to sit in rows in the courtyard for the Christmas assembly. Every class performs their song, and a few classes below ours sings "We Wish You A Merry Christmas." Immediately, my kids are up in arms, but I calm them down with the challenge of out-singing the others when it's their turn. By the time we've finished, my ears are ringing. Sangeeta ma'am asks if we want to do the tobacco avoidance performance again, so I wave them up to the front again. The damage of losing their opportunity to monopolize "We Wish You A Merry Christmas" ebbs away and they jump into their roles. Prem Ma'am requests that I retell the story of my father, but this time, I have Shahnewaz, Aakash, and Devashish retell it. They do a great job, except they mess up the punchline--that I'm the daughter--which is just hilarious.

After a few more messages and lectures, we finally make it back to the room. Everyone's a little drained, but I get Barsegh to come over and say hi in his Santa costume. The kids roll around with laughter--in fact, Om Prakash literally falls off his chair, although I'm not sure if that's on purpose as some sort of melodramatic stunt.

We spend the next hour doing a mini talent show, and I record the kids singing, dancing, and making speeches. Laughing with each other, but mostly at each other, we finally hear the last bell, and my kids rush out for my last time at Nai Disha. Everyone high-fives and says bye, but most of them are too eager to get home to stay and chat. I'm a little disappointed that it's over so soon, but I shrug it off. They're a bunch of prepubescent kids. I'd be the first to get the heck out too. Besides, there's a game of KoKo starting outside. Now, who in their right mind would want to miss that?

Day 5: Christmas Eve Part 1

I walk in on the last day feeling peculiarly hollow. It could be the lung I hacked up the night before, but it's probably more likely the piece of my heart that preparing itself to settle down at Nai Disha.

In the morning, I spend a good deal of time writing out honor roll certificates for each of my kids. I didn't buy them chocolates or Christmas stockings, and now I'm thinking that might have been the better option for fifth graders. It's too late though, and I can't back down, so, I fill in the last certificate and make my way to the cars. On my way, Mohammed Sain rushes over and hands me a box of sweets -- it's from his family. I'm not sure how much the sweets must have cost his family--when my parents were little, sugar was rationed to everybody and I'm not sure if that's still true-- but I'm grateful and give him a big hug.

At the school, the kids already know that I'm leaving. A few of them clamber up to me to give me personal cards they'd made for me at home--there's Muskan's flower and Aakash's dried roses and glitter. They're incredible.

They tell me they'll miss me, but what they can't express is worse--you're leaving us, just like everyone else has.

Even though there isn't much I can promise them, I know I can't leave them without some sort hope. So, I start with a story.

There was a little boy. He lived with his five brothers and four sisters and mom and dad in a small one or two room house, somewhere in the bustling center of Jamshedpur. Day in and day out, his dad worked in the blast furnaces of steel factory. There wasn't a lot, but the children were sharp. With whatever they had, the little boy made it to school for a few years, until it became too much for the family and he was forced to drop out. But he liked school so much, he beseeched his friends to lend him their books at night, and under the nearby street lamp he buried himself into the lessons. Two of his sisters noticed and begged to be included, and after some convincing, the brother gave in and began to teach his younger sisters. They worked as a unit, teaching each other and themselves, until they sneaked their way into sitting for the national medical and engineering school entrance exams. All three received high ranks and distinction--the brother joined the Indian Institute of Technology (the MIT of India) and later medical school and both sisters joined medical school. After completing their training with honors, they made their way to the states with the help of their siblings, married and had their own sons and daughters. But the three siblings were proud to share their stories, and one day, the brother's daughter, inspired, journeyed to India, to Nai Disha, to present herself as proof that just like her father did, any of her students could achieve their dreams with a little patience, focus, and hard work.

Monday, February 7, 2011

Day 4: Evening with PHFI

On our way back up the stairs and to our classroom, Bhupender and Aakash try to tell me something. They're obviously distressed, and I curse myself again for not knowing the language. Finally, I gather that neither of their parents were able to come, and that they didn't feel their effort was worth it. I realize that the presentation was more than about tobacco avoidance, but a chance to show off their skills to their parents, who probably rarely have time for them.
Resting my arms around their shoulders, I let them know that they'd made a huge mark by being leaders and presenting to all of the adults. It's one of those consolations you can toss around and begrudgingly accept as an adult, but as a child, it simply doesn't make up for a great sense of disappointment.

Humiliation and disappointment, I found, are two sentiments to avoid evoking in a child at all costs. Events that procure these feelings tend to stay in the minds of kids for the rest of their lives, marking their actions like scars. Although children have an incredibly ability to heal and soak up attention and happiness, they tend to have a low specific heat, as a nerd like me may analogize. They're quick to become happy, but just as quick to become sad.

So, I pat them on the back and reiterate how important they were for the team and nudge them to lead the class into another round of "We Wish You a Merry Christmas."


School ends shortly, and after I've seen my kids off with a few hugs and high-fives, I make my way to the courtyard to meet up the SARSA team. The group gets involved with a discussion on the evening's activities, but my mind is elsewhere. I find Sangeeta ma'am and let her know I'm ready. We'll be seeing the Public Health Foundation of India in an hour or so, and I'm worried we'll be late.

After a bit of a verbal tussle, I get a few of the group members to come along with me, so that we can take one of the jeeps to PHFI and, therefore, make it in time.
The office turns out to be on the other side of Delhi, but we make it in a good amount of time. Looking at the long hardwood table and glass doors leading into the conference room, I know right away that PHFI is part of this modern tip of India.

Dr. Arora and her team file in, and I jump right in to describing our project and purpose in India. About five minutes, I'm worried I'm taking up all of the time, that I'm repeating myself, and that I haven't said anything of interest or substance, but continue until Hardik, Amanda, Sangeeta ma'am, and Joseph feel comfortable and the need to ask questions or describe their projects. Dr. Arora's team and work is impressive. They're running a massive longitudinal study evaluating the effectiveness of a peer leader based tobacco intervention program. With 16 schools, 8 public and 8 private, 8 in Chennai and 8 in Delhi, Dr. Arora summarized that they were seeing a great deal of success with their program. Their program avoids lecture based teaching and is completely collaborative and based in games and art.

In the next hour it becomes apparent that Dr. Arora is a boss.
The amount of work she's accomplished in understanding obesity trends across socio-economic class, age, and gender is enviable.
At first, the rich were getting fatter and the poor were getting weaker, and then as commercialization and access to processed foods have risen, the poor have begun to catch up in terms of CVD, LDL, etc. With the rise of gym culture, the rich have begun to shed a few kilos. Her projects and conclusions are incredibly nuanced, but I leave the details for Hardik to absorb, since his project is on obesity.

Next up is Sangeeta ma'am. Dr. Arora and her share some ideas about implementing the program and the everyday problems they've faced with attendance, motivation in class, etc. In the end, we take a group picture and trail out. Overall, the meeting is great--I'm not sure if PHFI has gained anything from us, but we've certainly had a lot to take away with us. At the elevator, Sangeeta ma'am and I talk about meeting--the point wasn't really to come to some grand conclusions, but to forge a new connection and network. In this line of work, Sangeeta ma'am tells me, you get bombarded by a million ideas, challenges, and helping hands, and since the venture is intrinsically flexible and open to development, she grabs anything and everything she can and puts it into her back pocket. Sometime or another, she may need to pull something out, but for the sake of the kids, she can't afford to miss out on even the potential for an opportunity.

Friday, February 4, 2011

Day 4: Performance

I wake up with a soar throat.
It's the type that makes you feel like you're swallowing broken glass in peanut butter. I do my best to ready myself and spirit for school today, but I know today is going to be much tougher with my cold. The kids are intelligent and fun, but they can also be very rowdy, and I'm not sure how my voice will hold up to them today.

We arrive at the school, and I start by telling my students that I'm not feeling well and that my throat hurts--we have a few rounds of learning body parts in English and phrases related to wellness, such as, "I feel sick; my throat hurts." I put up the day's schedule, but even with my back to them, I can tell that my dip in energy compared to the day before has thrown them off a little. We go through the motions - practice our Christmas song, recap on Salman Khan's muscles, and run through the tobacco avoidance presentation. All of us are a little bit uneasy. For mysterious reasons, we were moved to the second floor today, and from the balcony, we're able to peak down at the parents assembling for the monthly PTA meeting.

I'm nervous. This will be the first time the kids will have to present. Judging by their first impression of the assignment, I can guess that the parents are going to have the same response. We while away time by repeating "We Wish You a Merry Christmas" about twenty two times, until we're called over to present. Just as the kids assemble, I realize that I can't find my camera. After running up and down the stairs three or four times, I give up and rush over to the parents and Sangeeta ma'am. Moms and dads are sitting on a raised concrete platform, with a few of the dads standing around the edges. I can imagine that considering their work schedules, it's taken a good bit of sacrifice to come over for the meeting.

Sangeeta ma'am introduces me, and all at once I feel incorrigibly foreign--I can't even speak the darn language. Somehow I muster the courage to introduce myself in whatever little Hindi I know. I finish lamely, and scan the crowd for understanding--they're probably bored.
My eyes fall on Aakash--my go-to translator - and I pull him over (and pat his arm, because I've realized I might have pulled too violently). I ask the moms and dads whether they're familiar with tobacco and whether they use it--there's a few whispers and tons of giggling. Anyone my gaze settles on shakes their head in negation--No one uses tobacco. Apparently.

I don't push it--clearly, the parents know the hazards of tobacco usage and clearly some of them use it regardless and clearly, they don't want to admit it in front of their children and their teachers, who're admonishing usage. It's the response I expected, but I'm happy that at least their habits haven't formed out of ignorance and that they're not standing in the way of preventing these habits from forming in their children.

Aakash gets the ball rolling and the presentation starts. I have Muskan and Jyoti come to the center as the two narrators.
One-by-one the other's are introduced as their roles -- bidi, cigarette, lung cancer, stomach cancer, etc. My heart swells with pride--my kids are doing great. And I know how terrifying it can be to perform in front of parents.

When they finish, we all take a bow and I catch a few high-fives from the kids. I'm so overwhelmed that we've finished that I begin herding the kids back to the classroom without addressing the parents again. Sangeeta ma'am calls me back and asks if me if I'm sure I don't have anything to ask the parents. I tell them that I'm very happy to be working with their children, that they're children have taught me a lot, that it's very admirable how much devotion they have for their children, and finally, that it's time for the kids to get back to their lessons. I ask if anyone wants to say something or if anyone has questions, but their silence is more than enough affirmation of their appreciation.


Thursday, February 3, 2011

Reflections from a distance

Being back in Los Angeles for almost one month now, with the new school semester heading into full force, I realized that I have yet to upload the photos from my trip. Better late then never!

Today I finally got down to transferring the photos from my camera into my computer. Looking at photos I had given throughout my trip made me a little nostalgic of my exploration of a entirely different world, the hospitality of Larisa and her family throughout my stay, relying on google translate to learn and understand Russian especially in an environment where English was not needed for daily activies, and being able to conduct my own research and following it through. On the right is a photo of Larisa and I before I departed Ufa for my 20hour train journey. You may probably notice how inappropriately dressed I was for the Russian winter, in comparison to Larisa! Throughout my stay in Ufa, Larisa kindly allowed me to borrow another coat of her to use.
The photo on the left shows a "health warning" label printed on cigarettes that were sold in bulk at one of the bigger supermarkets in Ufa, which translates to say "Smoking is highly addictive. Do not start smoking." Compared to scary images and threatening warnings on cigarette packages in other parts of the world, I am uncertain if that in itself is an effective warning, especially for current smokers since they have already begun smoking and will probably buy cigarettes because they are already addicted! Usually I have only seen cigarettes sold wholesale at airport departure lounges. Seeing cigarettes being sold in bulk at a local supermarket was really an indicative sign that there is a high prevalence of smoking in Ufa and probably many other parts of Russia. The photo on the right shows two Russian men taking a cigarette break while waiting for their bus to arrive.

At the same supermarket in Ufa, Ialso noticed that almost one-third of the store was stocked with alcohol beverages, like the photo on the right showing row after row of smirnov and other brands of vodka. Being invited to join Larisa's friends to celebrate birthday parties as well as joining them in outdoor activities such as ice-skating and ice-tubing, beer and vodka was always available and it seemed like an essential ingredient for having a great time!

I was so exicted to hear from Dr. Akhmadeeva earlier this week that they will be presenting some preliminary results of the study at the annual BSMU Neurology Conference in April! This is definitely a great start that hopefully will lead to more changes in attitudes towards smoking and alcohol consumption in Russia.
Last but not least, here is a photo taken of me in my borrowed fur coat standing in front of the hospital where the a large proportion of the CEA operations in Ufa take place. It was definitely an enjoyable (but chilly) trip and once again, I am really grateful to the USC Global Health Instiute for affording me this educational experience!