#YOLO. It is a popular phrase these days, an acronym
for “You only live once.” It is a
somewhat daunting yet exhilarating notion, and although catchy, you cannot help
but recognize its underlying truth. As
another tag line from the title of an old soap opera on television in U.S.
popular culture notes, we have one life to live, and the very real question of
how we want to spend our lives rests on all of us individually. I am not running around screaming YOLO in a
literal sense. In most regards, I love saying
it ironically, as a hit to its wide usage by online status-updaters and chronic
hash-taggers. On the other hand, a tiny
part of me cannot stray from the idea that this moment is fleeting and I better
take advantage of it.
Maybe it
seems as though I am going off on some philosophical rant about how short life
is, and the need to take advantage of it.
Go ahead and laugh, but as we have been visiting the various NGO sites
this week in New Delhi, the starkness of the idea that life is in fact fleeting
resonates on a personal level. As I sit,
listen and watch numerous individuals discussing their work and giving way to
personal memoires, I am ignited by the passion and commitment to social
development and assistance of so many of these individuals. Whether more grassroots or from a more
top-down approach, many of these people are spending every day working to
improve the lives of members of the community through their careers. So as I walk away from the past two weeks,
one question I am left with is whether or not I will do the same.
To some
extent, I believe this commitment and passion to improve the world on some
level has been the drive for many to become involved in public health. At some point in our lives, we saw a need for
change, and it sparked an interest in this social movement to advance health
outcomes and work to prevent disease on a population basis. This brings up another observation about the
work of NGOs and general trends throughout society. It is really interesting to see how many of
the organizations and individuals are making use of social media to spread
their messages and stay connected.
Whether on Twitter, MySpace or Facebook, it was noted numerous times
that this was one way people are striving to enhance their work and ideas. Innovation through technology. These Internet resources are free outlets for
exposure and social networking, so why not take advantage of them?
As I move
into the day-by-day accounts of this trip, it is noteworthy to make some of
these overall reflections about the work and progress at hand. Many group discussions have brought up the
point that helping to improve the world does not have to occur on a mass scale. As many of the organizations prove, helping a
relatively small number of people can still have a major impact with the
potential to “go viral,” if you will, at a population level. My use of the phrase “relatively small” is
intentional, as impacting several thousand individuals is a relatively small
number within a community of hundreds of thousands, if not millions. But as we see on the Internet, several hits
on a Youtube video can turn into millions within a matter of hours. Maybe it is the same with community-based
work, and the tipping point is upon us.
All of these organizations began with an idea and the need for
action. Individuals stepped up to the
plate, and are working to create change.
Although many of these phrases and ideas may sound cliché, it does not
matter. I have to push these thoughts
out of my head. At the end of the day, I
do want to help on some level, and witnessing the work of the individuals we
have met in India proves it is possible.
So all jokes aside, YOLO.
Tuesday, August 7, 2012
My good
friend Halli on the trip often jokes about the need to “tuck and roll” out of
bed when you are in a hurry. She could
not have been more spot-on with this idea than today, as today was the day we
traveled from Mumbai to New Delhi.
Wakeup.
Pack.
Shower.
Email.
Breakfast.
We are in
India, but all of the tasks of everyday life in the U.S. have not
disappeared. As a group, we keep joking
about the fact that many of our friends and family members back at home
continually tell us to have a great vacation.
As I struggle to keep my eyes open on bus rides between meetings, I
cannot help but silently curse those who think I am relaxing on a beach
somewhere or riding an elephant down the street. A bit harsh?
Maybe. But with more than a dozen
site visits in less than 10 days, a bout of Delhi Belly (our group stomach
virus episode), visits to the slums, numerous stops at cultural tourist sites,
daily group discussions and periods of reflections, I am not sure if I would
call this trip your average vacation. This
is not to complain, I feel like we are all taking in loads of information and
being exposed to a side of India we would otherwise never have access to, if
not for the work and connections of our professors and university. But tired, yes.
Anyways,
back to today. We check out of the hotel
and get into cars to be driven to the airport.
Right after we are dropped off, we realized we are at the wrong
gate. With limited time before our
flight, panic sets in. Just what we
need, a group of chatty Americans running through the Mumbai airport like baby
ducks chasing Dr. Vyas and Dr. Parrish.
I mean, it’s not like we stuck-out before here in India. Regardless, we made it to the right counter
and the professors got us on the plane.
Several people outside of our group even thanked Dr. Vyas afterwards for
our group holding up the flight because they were late as well.
Take-off.
Read.
Land.
New city,
same smells. We arrive in New Delhi,
which turns out to be just as chaotic as Mumbai, although a seemingly bit
cleaner. We have a few hours to check-in
at the hotel, and then it is off to the U.S. Embassy to meet with Nandita Chopra,
the representative of the National Institutes of Health (NIH) here in India. Let’s go.
As we walk
through the gate to the Embassy, we are all struck by how similar one of the
buildings looks to the Kennedy Center back in D.C. As it turns out, Nandita informed us that
Jacqueline Kennedy was actually inspired by this building and commissioned the
same architect to design the Kennedy Center in the States. It is always interesting to pick up
historical facts here and there, especially when you are halfway around the
world from your home. As we walk along
the grounds, I cannot help but feel as though I am on the set of an old U.S.
sitcom, such as “I Dream of Jeannie,” as some of the building appear as though
they were built during the 1960s or 70s.
Our meeting
with Nandita takes place in a conference room inside of the USAID
building. As we learned through several
other site visits, USAID’s presence in India has declined in recent years, but
at one point, it was fairly strong. Nandita
does not keep us waiting, and immediately walks into the room to greet us. As our meeting begins, Nandita describes her
role as the NIH representative in India, a relatively new position, and how she
landed the position a little over a year ago.
She encourages all of us to voice our interests, demonstrating the role
this behavior played in helping her to get this job. As most of her career had been spent doing
domestic work in the U.S. other than a global fellowship in Mozambique prior to
this position, Nandita says it was voicing her desire to work abroad that led
to her being considered to work in India.
In learning
about the NIH portfolio in this country, it is incredible to realize that Nandita
handles most of this work alone. Only
until recently did she have a staff member assigned to assist her, and the
realities of these types of positions set in.
Nandita mentions some of her time is spent helping researchers calm down
who are waiting on governmental approval before they receive their grants. In India, government relations are different
than they are in the U.S. The process of
building trust and getting your message across to government officials in this
country is time consuming, requiring a fine balance between coaxing individuals
into the validity of your project and ideas and not coming across as being
overly pushy. Beyond that, the time
difference between India and the U.S. can really take its toll. As the workday is ending in India, people at
NIH are just beginning their days, so the emails and conference calls flood
in. These are all things to consider in
terms of the logistics of global work.
As the
representative of NIH in India, it is really interesting to hear about all of
the coordination and communication this job entails. Not only does Nandita have to represent NIH
as a single entity, she also has to act on behalf the various institutions
within the agency. It is important to
remember that all of these separate research facilities are working with their
own goals in mind to some extent, with the need for funding and support, and to
each one, they are a priority group at NIH.
It can be difficult to find a balance and to represent each one
individually, but again, it is all part of the job. Another aspect of coordination this job
entails is communicating work and information between U.S. researchers and
Indian researchers. Luckily, Nandita
says that Indian researchers are cooperative and willing to share disease and
health-related information with U.S. representatives.
After
meeting with multiple social enterprises and NGOs, it was very informative to
listen to an individual who is working for a government agency, especially one
representing the U.S. abroad. Many of us
in the group are interested in becoming involved in global health, and working
for the government or for an NGO are two options with a wide number of
similarities and differences. In
general, it seems as though the NGOs we have met with are more grassroots in
their work, but this does not exempt them from the bureaucracies of
government. Again and again, it has
struck me how large of a role government relations play in the abilities and
functions of many NGOs. Even if an
organization is not receiving direct funds from the government, it is still
important to for staff to be able to navigate the political system in order to
facilitation their own needs and priorities.
Policies will affect an organization on some level from a top-down affect,
and this must be acknowledged on a broader scope. Politics can often be dirty and frustrating,
but this is the scheme in which we live, and it is vital to learn to navigate
this system efficiently and effectively, especially on a global scale.
Wednesday, August 8, 2012
This
morning we met with Operation ASHA, an organization aiming to reduce the
incidence of tuberculosis (TB) in the slums of New Delhi. Two young American women introduced the
organization and their work to us, one of whom is a completing a fellowship
through iCATS at OpASHA. Their drive and
compassion in their work was immediately evident as they stood before us,
asking questions about our own interests and tying these back into
international nonprofit work. These two
women spoke about their education and work experience in the States, and how
they eventually became involved in international health work in India,
encouraging us to do the same. As one of
them put it, “Work experience abroad is worth its weight in gold.”
The great
thing about this conversation was how candid the women were in their discussion
about nonprofit development work.
International work tends to be idealized, but you do not understand the
hardships and frustrations of grassroots level work in global health until you
step into the field and listen to those who are actually doing it. Beyond language barriers, there are countless
other cultural factors to consider when entering a foreign community to engage
in social development. Gender roles, age
distinctions and other factors may influence behavior, acceptance and
participation of community members in a particular program. Sometimes translating appropriate health
behaviors is not as simple as saying, “A, B, C.” In this regard, forming an effective community
health intervention can be a complicated process, but as the dedicated staff at
OpASHA demonstrate, reducing stigma, effective use of technology and engaging
with members of the community are essential to effectual nonprofit work and
stimulating social change.
After
meeting with the two women, we were accompanied into the field. This means that we were able to go to one of
the sites where TB is distributed on a daily basis. We got to observe the storage of the
medication, and speak with the woman running the site about her involvement
with the organization. Learning about
the long-term task of adhering to daily TB medication requirements from the
perspective of those who hand out the medicine was really interesting. Beyond the stigma associated with the
disease, ensuring individuals show up to the site and take their medications
every other day seems like a demanding endeavor, requiring commitment from both
organizational staff and the patient. It
can be difficult to imagine this type of work being conducted on a mass scale,
but as OpASHA shows, working to do so with any portion of the community will
help to reduce stigma and encourage individuals to seek treatment.
The next
stop we made was to an organization titled India Vision Foundation. This nonprofit is working to improve
conditions within female prison facilities in the country. As we learned, the prison system in India is
somewhat different to the idea of prison life that exists in the U.S. In India, there is apparently less violence
within the prison facilities, and children live with their mothers who are
imprisoned. These children receive
formal education through schools on site, and they sleep with their mothers in
the cells. The women in the prisons
learn how to weave and are taught other vocational skills to help provide
support for rehabilitation and eventually a smooth transition back into
society.
At this
point, we were able to meet with Dr. Karin Bedi, a founder of India Vision
Foundation.
Dr. Bedi was the first
female police officer in India, and since retiring from this job, she has
become one of the leaders in the anti-corruption and female empowerment
movements in the country.
It was really
inspiring to meet with an individual who has been inspired by her own experiences
to create social change through nonviolent political activism.
She spoke of the drive within herself to work
out of her somewhat privileged position in life in terms of education and
opportunity, in order to impact others who have not been as fortunate as
her.
It will be interesting to see where
Dr. Bedi ends up in a couple of years, as she struggles with the decision to
become more politically involved or remain more oriented in advocacy work as a
social activist.
Thursday, August 9, 2012
This morning
we made our last NGO visit to Care India.
This was the first larger organization we met with, and this meeting
provided yet another perspective on the nonprofit sector. Some of the main concern expressed by members
of my class were in regards to the large size of Care, and how different
sectors of the organization are able to cooperate, as well as cooperate. Is it possible for some of the more genuine
aspects and commitment in regards to community development to dissipate through
the hierarchy of such a large organization?
The members
of the Care staff who we met with described the technical assistance provided
by the organization, and how this compares with some of the grassroots work
being done by smaller nonprofits and social enterprises. As one member noted, social enterprises have
their own niche, but there is still a need for technical programs. In order to provide adequate and effective
technical assistance, the need exists to enquire throughout the community and
learn about people’s perspectives on their specific needs. These ideas must be incorporated into the
planning and design of projects in a practical manner. The technical assistance being provided must
exist in the context of the social system that has been in place for
years. The underlying question is how do
we build upon the infrastructure that is already in place based on what members
of the community believe?
These were
all ideas thrown around the meeting, and one member finally noted that
development work should not be thought of in the context of technical versus
social.
Both types of work are
interconnected, and the best practices will develop in respect to both sides of
the puzzle.
Technical assistance should
be planned and implemented through a social lens.
Once an organization reaches the level and
size of one such as Care, it is important to maintain a focus on the actual
needs of smaller communities.
What the
best model should be for this approach is where focus should lie.
The final
NGO we met with on our trip was called Saalam Baalak Trust.
This organization aims to improve the lives
of street children who have runaway from home and arrive at the train station
in New Delhi.
Most of the children
rescued by Saalam Baalak are restored to their families if possible.
Emphasize if possible.
Thousands of children arrive in New Delhi
each year from all over the countries, and it can be difficult to trace their
parents or other members of their families.
If children cannot be returned to their families, or do not want to be
returned due to histories of abuse, etc., then they are placed in one of the 5
shelters or children hopes to help educate and raise the children into
maturity.
One of the greatest things
about this organization is that some of the staff are former runaways
themselves who have grown up through this system and are now contributing back
to the community through this program.
These individuals know the needs and mindsets of runaway children
firsthand, so their assistance is extremely beneficial.
After
visiting the site at the train station where children receive their health
evaluations, we were able to visit the new drop-in center a few blocks
away. This site appeared to be somewhat
of a community center, where young children were working on computers, doing
artwork and socializing with others their age.
There were also several volunteers at the center when we visited. We got the chance to actually speak with some
of the older teens, many of them having runaway from home at very young ages. They were friendly, open to sharing their
stories, and seemingly appreciative of Saalam Baalak Trust.
Friday, August 10, 2012
Well,
that’s it. We wrapped up this morning
with a final group session at breakfast, during which we all introduced ideas
for our business plans. There were a lot
of ideas to throw around the table, considering all that we had seen and done
over the past 2 weeks. It seems that
many of us are revising our original plans based on our broader knowledge of
the work of social enterprises and NGOs.
I think many of us now have a deeper appreciation for the work these organizations
do, as well as hope for community development and social change through public
health. Now to actually write our plans…
YOLO.
