Day 25

My dad's dad's dad's brother's son (my great uncle's grandchild? ........, Charles, (everyone here pronounces it as Char-liss) happens to be a government TB supervisor employed by the Damien Foundation and makes daily field visits throughout the Nellore District. He told me he's been to at least 80% of the villages in the district over the years, which is astonishing. He graciously allowed me to accompany him for the day as he visited patients, DOT providers, public health centers, and DMC labs. 

We stopped at the Chennur PHC, or primary health center, outside of Gudur, a city near Nellore. He introduced me to Dr. Chandrahas, one of the "high up" TB supervisors in the big hierarchy of TB supervision within the state. Upon hearing that I was from the US, he immediately told one of this secretaries to "assemble the staff." Ten minutes later I was sitting to his right at his desk, with all of his staff members seated before us. 

He shook my hand and formally welcomed me into the medical profession, "the greatest profession for serving the people." He gave a long speech to me and his staff about how God gave his power through Kings, and modern day kings are doctors, and insinuated that he himself has god-like power. I felt uncomfortable with the formality of this impromptu occasion, and slightly put off by his message. He was sending me mixed signals about servicing the poor, while he himself sat at his desk, exerting his power "like a king." Although he did credit his power to the busy work of his staff members, I will grant him that. I appreciate him taking the time to show me his health care facility. He was very proud of it and his work. 

I don't know if you can see the shirt I am wearing, but the female staff members ("just some old aunties," Sweta calls them) pulled me aside after my coronation and told me that my shirt was inappropriate because it had holes in it. I explained to them that I wore a camisole so that the holes weren't see through, and they referred to my undershirt as a "petticoat" that shouldn't be seen by "gents." Sweta got really annoyed with the conservativeness of some aunties when I told her this story. 

Today was SO HOT. I have no idea how Charles spends all day everyday for years and years outside in this heat, because I definitely couldn't do it. I have a lot of respect for him! The unexpected coronation took up a lot of our morning time so all of the patients we visited was under on a huge time crunch, unfortunately. This DOT provider has managed at least 20 TB patients on her street in the past ten years, and she's witnessed about 2 or 3 deaths. Quite remarkable voluntary community service by this woman. She said she likes seeing her community get healthy. 

While walking along the streets we passed this really cool, dead tree. I wonder what the story behind it is. 

This anganiwada (government sponsored school for pregnant/nursing mothers and children under five that provides free meals and medicine to reduce infant mortality rates) teacher was the DOT provider for many in her community. One lady who was 20 years old and pregnant, came into her school for her weekly allotment of free food and began coughing. The DOT provider told her to get it checked out, but the lady's mother-in-law didn't like the implications of it. The mother-in-law argued with this teacher for some time, and the lady finally went to get tested to find out she had TB. I applauded the teacher for her defiant social work! 

This DOT provider has a shack-like store front that serves mostly milk. He has managed a lot of TB patients over the years and also serves as a community service worker, referring anyone who comes to his shop with a cough to get tested for TB at the local DMC. 

The woman in the yellow dress is named Ramanamma, 19 years old, and is holding her child in her arms. Her younger sister is to her left, and her husband is the to the far left. She has TB and is extremely thin. Their whole family lives in a dark, poorly ventilated one room house. The husband works as a flowerman, making garlands for weddings and other religious occasions. The finances are difficult when it is not wedding season, when most people come purchasing flower garlands. The husband makes about 100 Rupees (2 dollars) per day. 

In the late afternoon Charles graciously accompanied me to Rapur, where Kalyani lives! This is a picture of her neighbors baby. She was actually the most beautiful child I've ever seen. She looked like a princess! Lots of Indians put charcoal as eyeliner on babies' eyelids, because it apparently prevents germs from entering and causing infection. 

I gave her kids a soccer ball, but I'm not realizing they might not play with it since they are girls. I'll have to ask Kalyani. Here is a group shot of the kids. The girl in white is her neighbor's(? she knows so many people, I'll have to ask her again about the relation) daughter. Kalyani immediately told me that she doesn't have a dad because he died four years ago from alcohol poisoning. I found it really  jarring to say something like that to me in front of everyone, and her mother-in-law did the same thing about thirty minutes later, so I suppose it's in the culture somewhere for that sort of dialogue to be open and acceptable. The smallest girl is Navyasree, total cutie and takes after Kalyani's looks. Middle one is Paramilla, and the oldest is Sharmilla. The kids were so excited about me coming that they all took the day of school and waited around all day for me to come, she claimed. So sweet of them! Kalyani dressed them up in their nicest clothes because she knew I would be taking photos that I will send to her later. 

Me and Kalyani in front of her house! You can see my super scandalous shirt better in this picture. 

Kalyani's house! One room with a cot and one room with a small kitchen.

I didn't think to ask where her husband was until I ran into him for a SECOND at her mother-in-laws house. The second I saw him he darted the other way, and I didn't ask questions. Kalyani later talked to the other patients at the Damien clinic, who told me that her husband was drunk and Kalyani sent him away for the day since she was embarrassed. If I had gotten a better chance to talk to him I would've threatened him for beating her. Seems like drinking is a bad habit among the men in her village. "Not village," Sweta says. "In Andhra Pradesh." Yikes. 

Her family was INCREDIBLY hospitable and spent a lot of money providing food and drinks for me. I was totally undeserving. 

My whole visit lasted only an hour, because Charles had to go back home to his family in Nellore, where his wife served me fresh vadas and gulab jamun. 

On the way back to Nellore we stopped at the world's largest all natural damn, made entirely from dirt. 

This reminded me of what I imagine the Narrow Sea to look like in the Game of Thrones book I'm reading.