Chembur

Today is Raksha Bandhan – Brother and Sister’s Day. It’s a day when a sister ties a red bracelet, or rakhi, around her brother’s wrist in exchange for candy and money. It must be a big deal because shops are closing early and we had to move some site visits to Friday. Luckily, Americares invited us to accompany their mobile clinic unit to another slum area called Chembur. Dr. Patel and his intake assistant were setting up to see between 100-150 patients that day. It was a pleasure watching them work. The two of them were pros. Patients who immediately started lining up outside the office were seen systematically, one-by-one. Our group of five (everyone else was sick back at the hotel) quickly left the clinic and went off exploring the community.

Chembur is a world different from Chandilivi. It made me realize that even among slums, there is a hierarchy. While Chandilivi was a quiet and kempt living community, the hour we spent in Chembur was engulfed in kids and chaos. Trash was everywhere. The smell from open sewage lines down narrow residential corridors permeated the air. Then again, we get used to it. Nobody held their nose or complained about the conditions. After all, people live here. And they seemed happy. I’m not suggesting we shouldn’t help them achieve better livelihoods. It’s just that nobody appeared to be wallowing in despair. Humans are resilient and adaptable to environments. The kids we saw were energetic and playful like they would be anywhere else. Some spoke English and became our mini-tour guides. This is what I think when I want to be optimistic. When that slips away, I worry about my voyeuristic motives. What do these people gain from me being here? Who do I think I am to come to where they live, take pictures, and get on a bus back to my fancy hotel? What was the point of this?

The Passion to Serve, The Ability to Deliver

Wednesday we started our morning at AmeriCares India, an organization which provides free medical services across the country to the most needy. Their work encompasses three pillars: free primary care services, medication distribution, and natural disaster relief. Today we were accompanying their mobile medical van to one of it's weekly stops to a housing area near the Chandivili Pipeline area of Mumbai. The van provides basic care to residents and distributes medicines to the community. While there, our group helped to create maps of the community counting each home and noting down landmarks. These maps would help the medical staff at AmeriCares to better understand and serve their community, as they would be able to pinpoint hotspots of disease and locate patients more easily. Once arriving on site at in the slum neighborhood it was clear to me why maps were needed. This community was a collection of small alleyways with many twists and turns almost resembling a maze. As our group set out to complete our maps I was surprised at how nice some of the streets were. The houses all were made of concrete and each had a door or front gate sometimes with a patterned piece of fabric draped over. Some homes were painted beautiful bright colors and some had pretty tiles helping to stand out from the rest. Peering in to some homes we could a see large screen televisions and satellites resting on the roofs. While definitely a slum compared to our standards, this place was not as bad as I had imagined. Walking the streets most residents greeted us and some wondered what we were doing and tried to help. The community also had many small local shops and businesses such as produce stands, chicken shops, convenience stores and even beauty parlors.

I was very excited about this project as I felt the work that AmeriCares is doing in India is truly a perfect model of community oriented primary care, which has been focus of my studies over the past two years. It was very exciting seeing this concept come to life in the slums of Mumbai. I was also very impressed with the technology that AmeriCares was using. They have all electronic medical records and use a fingerprint identifying technology to link patients with their record. For an organization working in such sparse conditions this was amazing to see as it was way more innovative than anything I've seen in the States. This immediately reminded me of some of the cutting edge solutions and models that Community Health Centers in the U.S. are using to deliver better quality patient care to the most underserved populations. It's a reminder to all that despite that fact that best practices many times come from large medical institutions, it's mostly these grassroots organizations who are testing out models in the field that we should be looking to for solutions. 

On Thursday, we got to visit another community that AmeriCares works in. More of a camp, this neighborhood was quite different from the first place we visited. Houses here were more make shift with no real doors or solid structures in place. Small alley ways were lined with large drain pipes which women used to wash clothing and dishes as well as for cleaning and brushing teeth. Chickens, goats and dogs roamed freely around and many wide open areas were covered in trash and litter. Immediately upon exiting the bus, a group of children began to follow us around. A few spoke English quite well and acted as our unofficial tour guides, showing us the schools, the clinics and the play ground area. They were all so sweet and very fascinated with our group, we smiled and took many pictures with them which they loved! I wish I could have given them something, and this was a fact that all of us struggled with afterward. We had brought candy along but as we were leaving the crowd got too large and intense for us to hand it out safely. We had felt guilty for basically going on a 'slum tour' and then riding off in our air conditioned bus. But the problems were so overwhelming we didn't know where to even start. We all agreed that the best thing we could do was to talk about it, to educate people and raise awareness of what we had seen and support organizations such as AmeriCares which are working from the ground up to make a real difference for these people.