"These Girls will Never Leave"

Day 4 - Thane District

Today will be a bit scattered brained for me as I really not feeling well. It made it really difficult to be a part of the experience and I missed out a lot. However, I was able to take in a lot and learn a lot from my peers and what I saw for the children.

We got up early today and headed over with Neelam, a member of the Impact India Foundation to Thane District, a rural area three hours outside of Mumbai, and approximately 25 kilometers away from the border state of Gujarat. Neelam, was kind enough to be our tour guide of the day. En route to Thane district she also explained what wonderful things Impact India Foundation has done for rural areas in India, such as Thane District. Impact India has been around for approximately 20 years, working specifically in the following three projects:

1. The Lifeline Express - a hospital on a trail that halts for about a month at each rural location which each project.
2. Community Health Initiative (CHI) - decreasing the incidence of existing disabilities through preventive and curative measures
3. Ashramshalas - A model project for improvement of the tribal residential schools for holistic development of rural children.

We had a lot ahead of us that day. We did not get to see the Lifeline Express but heard lots about it. How this hospital on a train is able to reach numerous villages and individuals that normally would not have access to care. The physicians and nurses on the train perform common surgeries to restore movement, hearing, sight and correction of clefts -- giving individuals a new sense of light, hope, and future.

We did have the opportunity to understand more about the community health initiative and ashramshalas. Our first stop was the Bapugaon Ashramshala (Village Residential School for tribals).

I loved it here. For one, the quiet and stillness of the village, coupled with the greenery that spread miles long. It was beautiful. We visited a school here that boarded over 500 students of tribal families. In order to provide these children with access to an education and a future, an association was formed with the Government. Even so, these girls and boys lacked so many resources and access to care. Though between the ages of 11 and 14, they looked six. Physicians, volunteers and individuals such as Neelam, have worked with these children to conduct body mass indexes, A1c testings, counseling on Vitamin A and importance of immunization. The girls we met, were able to tell us the importance of Vitamin A and conducting biomarkers. They were eager to share with us how they have learned to conduct BMI's as indicators to help them stay healthy. Yet, two of the questions they posed to us was: "How come you are so much bigger than us?" and "What can we eat so we can be as big as you?" It was heartbreaking.

After we sat in a group for awhile, we had a few minutes before our next visit, to have some one-on-one conversations. We used this opportunity to ask what these girls wanted to be when they grew up. Many were shy at first but one girl spoke up and said she wanted to be a doctor. Neelam later told us, these girls will never leave and have never left, for there is not even a name for how low they are in the caste system.

The rest of the day, our group went to a Primary Health Centre and a Mobile clinic. Unfortunately, I wasn't well and had to miss these site visits. I was sad to have missed such an experience. From what I gathered from my peers, spending time with tribal families in the outskirts of Mumbai was life-changing. Understanding how medical care is reached to the indigenous people of Thane District and how they seek care is fascinating. I also wish we had an opportunity to visit the Lifeline Express, or as Indians refer to it as "The Magic Train of India".

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This day was hard because back home, I get questions from so many people asking me if the caste system is still in existence. All this time I said it wasn't. Today, I realized that as far as India has come, the country has not done justice in educating so many people and for that reason certain fallacies, will never be trumped. All you can do is continue to bring hope and empowerment through education and expression of education.

Day 4. Thane District

Rural India is absolutely breathtaking. A vibrant green layer of vegetation covers both sides of the road setting up the stage for a few majestic mountains on the horizon.

Today we are learning about Impact India Foundation and visiting a couple of schools for tribal kids in the Thane District.

The fresh air and calm surroundings create the perfect environment for what we were about to witness. As we walk to the school building, lots of tiny faces start to show up on the windows curiously looking at the new visitors, and others were brave enough to come out of their classrooms to take a closer look at the group tourist that were now approaching their grounds. We walk into one of the classrooms where a group of teenage girls await for us, excited to share their health edu

cation initiative. All the girls are wearing white and blue uniforms with beautiful red flowers on their hair, which is perfectly done in either braids or ponytails. The girls sing a welcome song for us and hand each one of us a red rose to show their appreciation for our visit. Then they proceed to proudly show us what they have learned about nutrition and health in general. There are ten girls that have been trained to be health monitors for their classmates to help the doctor in-site check weights, and heights of the other girls as the doctor checks their eyes and listens to their hearts. It is very inspiring to see these girls help and teach each other how to better care for themselves. I can’t help but to think that out here, in rural India these girls are building a better future for each other.

To my surprise, I learned that this is not the case. Even though these girls are educated, fed, and have higher aspirations for their futures, none of the will live the area after school. Most will never live away from their families, either because of lack of financial support or because is part of the culture, and others will simply marry shortly after they complete their studies. There is no other option. During one of our class discussions this issue came up. When will these girls realize that their dreams and goals will never come true?

I still remember their smiles and bright red flowers adorning their hair. As I wave good-bye I leave with the realization that they will never live this place, and will not get to experience a different reality. At least these girls will have the knowledge and empowerment learned in this school, that will help them face the life that waits for them; a life that has already been written for them.

"I want to be a Doctor when I grow up"

Today at lunch we had a group reflection and discussion on the time we spent in the rural area north of Mumbai, the Thane district. We had a lovely representative from Impact India, Neelam, as our guide and leader throughout the day. She brought us to two different schools, a maternal and child health clinic, as well as the government sponsored community health clinic which is responsible for the primary care of over 50,000 individuals.

At the second school we visited one of the young girls, perhaps 9 or 10 years old, expressed her interest in becoming a Doctor. This, of course, thrilled us – seeing a young girl so full of ambition and aspiring to help others. Neelam had a different perspective; however, and upon leaving the girls’ ear shot quickly proclaimed that this sentiment was simply a pipe dream and was out of the realm of possibility.

This specific experience drove a lot of today’s conversation about the entire days’ experience and leads me on a thought path that branches at many different points. On one hand, how heartbreaking to think that this young girl has such a wonderful dream yet currently has very, very few if any resources to achieve it. On the other, perhaps it is almost a naïve bliss that she knows what she wants but perhaps her scope of understanding is narrow enough to spare her from extreme disappointment. Even yet another thought leads me to believe that it IS entirely possible for this astute young woman to pursue a career in medicine but perhaps not as a traditional American might view it. I would find it entirely possible for her to achieve some level of ayurvedic or tribal education and then be able to practice her medicinal trade throughout her village. Even though she wouldn’t be a Doctor in the sense of the word that we understand it, wouldn’t she still be providing the same type of support, care and service?

For every child we met on that day, there is a story. There is a story of who they are, where they came from, where they want to go and ultimately where they will end up. As budding social entrepreneurs and practitioners of both public and clinical health, it is our job to understand the present and future of our patients and community members, and also to truly understand their past. Without this knowledge, I feel that it may be impossible to impart information, treatment or any type of appropriate care.

Through the eyes of the one little girl, who so aspires to help people through medicine, it is possible to begin to see a global landscape that so greatly affects every part of each human on this planet. Understanding where we come from is the only way to truly understand where we can go.