By Vaidehi Mujumdar
At Dartmouth, so many of us take off-terms that take us all around the world. Many experiences and stories get lost, forgotten or kept within a small group of people. It’s often the little things–the anecdotes, the frustrations, the process of writing itself, and the important aspect of being able to communicate with others—that lead to personal growth within the various societal, community, and even global atmospheres we all take part in.
For the past month, I have been working with the NGO “One!International” in the mainly urban outskirts of Mumbai to gauge changing cultural perspectives towards food and nutrition. The research constitutes a link between traditional small-scale ethnographical studies and macro-oriented studies of development.Throughout my study, I hope to share my experiences and stories in the field.
Mumbai, located in western India, is home to some of the richest people in the world as well the poorest. This fall, I am conducting ethnographic research on perceptions of nutrition and food in an outskirts town of Mumbai called Nallasopara. I am also working in the Khar area slum inside Mumbai. One! International is a Canadian NGO that has been in Mumbai for about 12 years. I am volunteering as a teacher at the two NGO schools in Khar and in Nallasopara teaching classes in English, Math, Exercise, and Health. I am also building relationships with the children and local families to conduct interviews and follow a small group of families in-depth during my three months in India. The dual roles seemed taxing when I first started, but I realized that I am researching twenty-four seven as I interact with the children, their parents, other volunteers, and NGO staff. Part of my project is to look at how perceptions of food and medicine, both traditional and what we call “Western” are changed by the presence of an international NGO.
One thing I have learned over the last month is that plans are made to be broken. The ethnography process is both challenging and low-maintenance in that it is observation: I’m not running an experiment in a scientific, methodological way with instructions. When dealing with people and participant observation, I have found they lead me to a goal or to a question through how they speak, how they behave, and what they tell me.
Many times I feel as if participant observation, especially in India, is a similar experience to being in a movie.I can just sit outside, overlooking a street, and hear a thousand different conversations in several different languages, see BMWs driving next to bicycles and smell both the fish market and Dominos from the same street. Ethnographic research is overwhelming at times because I want to capture what I hear, see, smell, touch—but I know that a picture, video, or even the most descriptive of words will never do justice to what it feels like walking through the inner mazes of some of the biggest slums in India. Field work is often frustrating for that reason and I find myself contacting my anthropology professor with questions and concerns on how and what and who I should be looking at, asking questions about—and his answer, although guiding, is always vague for which he just says is the nature of this work.
Fortunately, today we finally received good word about a student who had been in a kerosene fire accident about three weeks ago. One of the girls at the Khar school, Kolkila, had been cooking and something went wrong with the stove and she got burned. The flames engulfed her face and went all the way down to her waist. This incident occurred at 5 pm October 6— 35% of her body was burned. Her family immediately tried to get her to a hospital, but was turned down. They went to three different government hospitals, one being a hospital for prisoners and convicts. All of them refused to admit her. Her family immediately contacted One! Teachers, staff, and the director all banded together to see if they could drive her or get her into another hospital.
The wounds Kokila suffered continued to burn from 5 pm until midnight when one of the teachers made a phone call to his uncle. His uncle happens to be the MLA* of the district and because this uncle called the third hospital, Kokila was finally admitted–seven hours later. It took them another hour to take her into the ICU. By then, the percentage of her body burned had increased to 50%. Meanwhile, this girl was conscious and talking. When I heard that she had been waiting for seven hours, I almost hoped that she had lost consciousness so at least the pain would not be unbearable. At 1 am, Kokila was finally in the burn unit where an intern took care of six burn patients. There was no staff—no nurses, ward boys, or attending physicians. The intern had to change all of the dressings for each patient. Each dressing took two hours. He was working non-stop for 12 hours just to provide clean dressings, on top of all of his other responsibilities as a physician.
Walking into a government hospital can be compared to walking into a train station. The only difference is that the hospital has chairs. The school staff that was present when Kokila was admitted pushed her through the wards, transferred her onto the gurney, and wheeled her to her room. A burn patient is generally put into a sterile room, with little to no contact with others because of the risk of infection. Kokila had a possibility of sepsis, organ failure, and several internal infections. Her
entire family, the teachers, and friends were all allowed to walk in without
having to wash their hands or put on surgical clothes. On top of that, there was no air conditioning in her room. The place was unhygienic for a normal, healthy person, let alone a burn victim.
While all of this was going on, I couldn’t help but fixate on the fact that a
government hospital, whose purpose is to provide treatment and health-care for those that cannot afford it, turned away a 14 year old girl who has third degree burns. Although government hospitals are technically free, bribes are basically expected for admittance. Kokila, whose family lives in the slum, obviously does not have money for a hospital stay, let alone an additional bribe. Corruption is present everywhere in India: to refuse to admit a patient because they are too much of a liability is to say that the hospital doesn’t value human life. I know it’s a naive thought and I do not know what kind of pressures these doctors face, however, I just could not and still can not get over the fact that a doctor saw this little girl in excruciating pain, still burning, and refused to treat her. Money is always an issue, but there are also ethics that come along with being a medical professional. Kokila traveled to three different hospitals and if she had not been admitted when she was, she would have died that night.
Kokila fortunately received many donations from One! and this funding allowed for her to be moved to a private hospital, which is more like the hospitals people in the West are used to seeing. She has a full-time nurse, 2 doctors, and is doing well so far. For the last couple of weeks, the doctors continued to say that the next two weeks are crucial and she has a 50 percent chance of survival. Over the last couple of weeks, Kokila has received skin grafts from both of her legs. Now, she only needs a graft from the back of a leg transferred to her shoulders and back. The doctors say she no longer has any internal infections. With the success of this last surgery, she should be back home next week.
The kids at the school all made “Get Well Soon” cards even though they don’t know what that phrase means. They wrote messages that only children can write such as “Kokila, come back soon. I will never fight with you again over the red eraser” or “Kokila, I will share my lunch with you on Mondays.” The slum-area in Khar is a small community, so even the littlest children knew by word of mouth what had happened to Kokila. It really shook the school and getting updates is something that makes everyone feel that they still have contact with Kokila, especially since they have not been allowed to see her. Although we are all grateful Kokila is doing well, I still question how this situation was ethically handled by the healthcare system in India. In the next couple of weeks, the medical coordinator for One! and I will be touring area hospitals and hopefully that will help me better understand how government and private hospitals are structured and operated—shedding light on Kokila’s experiences.
*An MLA is a “Member of the Legislative Assembly.” He or she is elected by voters of a particular district to represent them in the state legislature.