Yesterday started with Dr. Deb picking me up at my place at 8:15 to pilot test my survey at a nearby primary care center (they call them PHC's). Dr. Deb is a retired civil servant physician who volunteers full-time for the NGO that's helping me. We went to Karuna Trust (the NGO) and picked up Dr. Sudarshan on our way out of town. Sudarshan is an intense fellow. He's in his mid-fifties, never married, no visible vices, abhorrs all sloth and gluttony. Working with him means moving at a fever pace, constantly drilling me and Dr. Deb from the passenger seat. Deb called him "sir" despite being older and not even on his payroll. I handed him a copy of my survey, and he started making suggestions to change it, add questions, adapt it to Indian English, etc. It was the first time I could get anyone to look the thing over, but was unfortunately after having made 110 copies. After stopping for an unexpected and unintelligible meeting with a local think-tank that no one had mentioned to me, we continued on down the road to the PHC. The care center was off the side of the road, a compound in the middle of a dirt field in a semi-urban spot outside the city limits. Women were waiting on the porch outside, people wandering aimlessly awaiting whatever treatment was available to them. Sudarshan raised his hands and gathered about 10 women and kids, pointing them to a room and speaking authoritatively. This wasn't what I would call "subject recruitment", but what the hell? Deb administered the survey, asking the women the questions in Kannada, Tamil, Telgu, and who knows what other languages. We had time to do about three surveys before being summoned urgently to a conference room on the other side of the courtyard. The room was crowded with hospital staff, docctors, nurses, caretakers, and everyone was facing Sudarshan as he spoke sternly in the mixture of Kannada and English that they use in these contexts. He raised his voice at one doctor in particular, admonishing him for not living in the quarters provided to him. The man whimpered some response that angered Sudarshan more. "I am not coming from Karuna today" he growled, " I am here as a representative of the Lokayukta." This went on for about a half hour, as women came serving tea and biscuits, and I took down some observations. From what I gathered, this PHC had been a pain in his side for quite a while, full of inefficiencies, directionless and dirty. Suddenly, the tenor of the meeting shifted; Sudarshan became jovial and the atmosphere warmed up about 5 degrees. We were escorted out in a hurry, and were quickly on the road back to town. Sudarshan was excited about my survey. It was an oppportunity to establish a baseline of quality and problems in these centers, that could be followed up and monitored for improvements. He was talking about getting the World Bank involved somehow, and scaling it up to more districts. Very cool. Nothing here had been monitored for improvements, no incentives given for performance. It was all top-down discipline, and this was a way to change that approach.
Deb breathed a sigh of relief as Sudarshan drove off. We went and had a beer and a little food. "Please don't tell Sudarshan that I drink beer", he told me. "He frowns on all of those things". We went to his favorite spot, and chatted over a bit of lunch. He was from Western Bengal, near Calcutta, and came down to Bangalore for his medical training. Very nice man, good sense of humor. He's the one who's really helping me to coordinate my work.
By the time I got back, it was around twilight and the mosquitoes were kicking up. I was being eaten for breakfast. I lit up a mosquito coil and left my room, going to read a book while the room got bombed for the buggers. Outside, some of the cleaning women were hanging out with a few kids. One little girl started talking to me in decent English, and the next thing I knew, everyone outside was surrounding us, asking me questions through her, and offering me to come for dinner. After some imploring, I followed the group off the compound and out onto Magadi road, where I live. We wound through some narrow alleys, everyone talking, grabbing me, and the girl asking question after question. We went into her sister's house; a three-room place that slept fifteen people on the floor and a makeshift couch. They brought me a plate of banannas, cake, chips, cookies, tea, and other stuff, all staring at me, insisting that I eat everything. This is one of those classic situations where you really never, ever turn down food, but it just kept coming. They stood over me, fanning me with pieces of cardboard because it was hot as hell in there. The girl said, "we have two house more". The second house was across Magadi road in another portion of neighborhood, back in some winding alleys. They insisted on turning the tv to something in english. It was that movie Monster with the lesbian serial killer. I insisted on watching some inane Hindi dancing instead. More tea, more biscuits. People brought babies in and sat them on my lap. Some little kids shrieked in horror at my presence, and everyone kept insisting that I do things, eat things, trying desperately to communicate through this one little girl. "One more house"
The last house was where the little girl lived. She told me that she loved school, loved geography, and math. Wanted to be an engineer and travel on airplanes like I did. I told her that when I was her age I slept under a map and dreamed of all the places I'd go. We came to the street corner, and everyone passed between a crack in the wall less than three feet wide. Her house was an 8x10 room where she lived with her mother and father. They made me sit in the only chair and ran out to buy me pepsi and ice cream. They kept apologizing for the place being dirty and small. I kept asssuring them that it was no problem, as I'd been assuring countles others during the evenig, and the girl said that no one thought I would have come and done what I did that night. To me it was the chance of a lifetime. Nothing back home meant anything anymore. I was tired, hot and dirty, and it was all barely a taste of these people's daily lives. They walked me back to my place, and I took a cold shower, collapsed on my bed under the ceiling fan and slept in the peace and quiet. Today I went out and bought a set of pens, a notebook, and a pocket atlas for the little girl. It was the least I could do, and possibly the best money I've ever spent.
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