Meandering In and Out of Leprosy clinics

Laundry day in the slums. Time to dry.
see all photos »

This week we went to the Leprosy Hospital, heard some great lectures on Mumbai and Leprosy as well as a little bit about other infectious diseases.  The four most common infectious diseases in Mumbai today are Malaria, TB, Dengue fever, and Leptospirosis.  We also went to some clinics in the afternoons, which were interesting and informative, but a bit repetitive and cramped (tiny quarters around here!).  A great experience to get a sense of what is most common in this area in the monsoon season, and to actually see all sorts of cases first hand, but the learning began to halt when the signs and symptoms were all the same as were the treatments.  The Leprosy lectures were fantastic though, as I was incredibly naive about the disease coming here.

There are just clothes hanging everywhere. This is what they do when they cant afford to have their clothes sent out to be beaten.
see all photos »

Some Leprosy facts:

Beat the dirt out of them

1 It is a communicable disease, and you cannot get it any other way, so to eradicate it, we must eliminate it from others.

2 Leprosy always first affects your nerves, then your skin (but not always), and then can cause deformities because of the nerve damage.  The most effected nerves are the ulna and median nerves of the arm.  If caught early enough, ithe patient can be completely cured.

Alex and Isquished into Dr. Mhatre's tiny clinic in the slums
see all photos »

3 White patches are numb...so to test for it they poke the patch.  This is a doctors duty anytime a patch appears.

4 They treat leprosy with MDT (Multi Drug Therapy) which is a combination of three different drugs.  Its pretty awesome because the effect is immediate, and as soon as an infective case is given the doses, they can no longer spread the disease.  So the first order of business is to get treatment ASAP!

In clinic on Wednesday, the doctor was telling us about this "miracle ointment" that regenerate cells and heals things really quickly, how awesome is that?!  Its made from human placenta.  I thought that was the coolest thing ever, I got a tube of it for like a dollar.  Its good for cuts and sores in the mouth, and really good for people who dip (their lips), not that I do but still cool.  Its actually also an antihistamine with a cooling effect (sweet for me!).  I think Im addicted to it, and I havent even used more than the sample they put on my finger yet =)  The doc also told us about a anti parasite pill, Wormectol, that we could take two days before we left, just chew it with dinner and we will be parasite free when we get home (another sweet med!) but its an azole...which I am allergic to.  No more fat lips for me!  Darn.  That was only 40 cents too.  Im just gonna have to tough those bad boys out if they decide to infest.  Ah, well.  Anyone know anything else that might work?

A boy in the slum area
see all photos »

This trip has really opened my eyes and changed my perspective towards medicine itself.  I used to be all about toughing it out and being able to fight whatever was making me sick without taking anything, but seeing how well things work for anything around here is fantastic.  I really thought this trip would actually make me think even worse about medicine because of how overused they are, but honestly, no.  I dont think I will ever hand it out like candy like they do here (one girl in the program got sick and they gave her four types of pills, an anti everything to kill whatever the heck she might have had) but it definitely does kick butt when it works.  And prophylaxis is something else, Im telling you!  This doxycycline is kicking everythings butt!  Go doxy!  He and I are getting along pretty well.

Hangin out outside of her home, probably after a morning excresion in the streets. Yes that tarp is the "roof".
see all photos »

Something strange I have noticed here is some men have a long left pinky nail, and some paint their big toes and pinky finger nails.  Maybe superstition maybe home remedy??  I have no clue...but I am curious.  How do you ask someone something like that?  Excuse me, why is your left pinky nail so long and painted like a girl?!  Um...no.  Also I have notices that it is common for women to have tattoos on their forearms or wrists.  It looks religious of sorts.  Most women also have their nose pierced, and we tried to explain the connotations that might go along with such at home, and Kate said when she came home with it from college, her parents made her sit at the other side of the dinner table (hey, i bet it was cute!) but the doctors really got a kick out of that.  Here, it is common to see even three year olds with such piercings.  Its probably more abnormal not to have one.  Its quite pretty.  Dont worry tho, mom, its not my style =)

Victoria Terminus
see all photos »

As for other jewelry habits here, women usually have symmetrical items on other than the nose ring.  Almost always they have two anklets, two toe rings on the second toe, bracelets up and down both arms with matching patterns, matching earring (or five) that all dangle and interconnect.  Even many of the beggars have this.  Makes me wonder how they buy it...But the most common thing I have noticed amongst Indian women is the silver and gold combination.  It is a subtle combination, as they wear gold where it is normally visible, so on the face, ears, arms, etc.  But as for the ankles and toes, it is usually silver.  And it is very uncommon to see anything other than this.  Except, of course, the occasional glass bangles.

The water by Taji Ali
see all photos »

Each and every day, the number of people in this city amazed me.  Not to mention, the car situation.  Obviously, not everyone drives, but those who do create enough traffic to make a sane person go nuts.  Thank goodness I do not have to drive here.  I will be leaving that to the taxis and the rickshaws!  But sometimes, Im telling you, these people maneuver in ways I did not know possible.  It can get freaky being in the back.  The other day our taxi went flying down these tiny roads of the slums after clinic.  There was absolutely no room other than for the width of that taxi.  People just kind of scoot left or right to make room.  Its ridiculous.  Even the highways are packed all of the time.  Imagine if there were more accidents (I cant believe there arent) and having to get an ambulance in that traffic and then back out while someones life depended on it?!  I bet you those EMTs are pretty awesome here.

Absolutely astonishing sky at Taji Ali
see all photos »

Another wacky thing here, is the bus situation.  The buses just stop at stop lights and for traffic as if no one was in the back, and the doors remain open and you just get off when your chance arises.  If you are at a red light a block from your home, jump off now.  If you miss the light, you can jump off while the bus starts to move!  You can also jump on as the bus is moving.  Its absolutely insane, and I think I will not be doing that.

The rain here, when it decides to rain, is totally unpredictable and absolutely astonishing.  Alex and I were walking around Victoria Terminus (a beautiful train station at the end of the line) and she was taking a picture while I was looking in her direction.  Behind her I see this rush of rain come at us like a stampede.  I said to her, Alex, here comes the rain, and she was like what?  Then she turned around and we both just watched the rain swoop in as if it were a car coming at us.  Its really actually the coolest thing.  The ominous sky is always lurking over us, and then its that one cloud here and there that just decides to dump, usually accompanied by an even cooler dark patch of clouds, and it always lasts like ten minutes and then disappears as quickly as it came.  At least, with an appearance like that, you can almost always run and take cover before you really get soaked!

The ulna nerve, most effected nerve in Leprosy patients. Sorry its just too cool not to post.
see all photos »

I finally made it to that crazy mosque on the causeway I was talking about from the first day.  We made it at low tide, awesome!  It is called Taji Ali.  There are tons and tons of beggars lining about 1/4 of a mile causeway leading up to it.  When you get inside, it is beggar free, but you must take off your shoes (normal for temples and mosques here) and ladies must cover their heads with a shall of sorts.  I knew this so I brought one.  There is a women's side and a men's side, so we hiked our way to the women's side, some Muslims telling us who knows what that we were doing wrong in Hindi (cant you tell Im white?!).  I think it was the fact that Alex hadnt taken off her socks.  But then you can bring offering to the alter, but we decided to just take a look.  The inside, which you cannot take pictures of, was stunning.  It may have been small and ugly from the outside (sorry, but it is) but the inside was covered in these cut glass tiles that just glistened and sparkled all sorts of colors, but mostly crystal like.  It was gorgeous.  I could have sat there all day just watching it sparkle.  And when we were leaving the mosque area, the sky lit up with these streaks of light, which made the atmosphere that much cooler.  We walked by all the beggars and didnt give them any money (there were hundreds!  How can you choose?) But I think the weather was trying to get us back for this because it blew us right off the causeway.  Wind was literally pushing people sideways as we were walking away, and the rain was trying to come down but it was being blown to the side.  There was no way the umbrella was going up, because it would have just been blown away! It only lasted for about five minutes (typical) so we covered up and trekked on.

Dhobi ghats, where the clothes are sent to for a cleanly beating
see all photos »

Laundry here, their "dry cleaners" when you have it sent away to be washed and dried, goes to this area where workers scrub your clothes and then beat the dirt out of them against rocks, and then hang dry them on lines.  Its insane.  You can actually go and see this all happen.  We went to the area, and its just like a cement maze from above (it is not recommended or accepted to go watch, however you can get an illegitimate tour that we did not do) with pools of water in every other square or so with drying lines streaking everywhere, and steam coming up from one place, and of course tarps to cover them when it rains.  It looked like a giant tic tac toe board, sorta.  I didnt quite know how to make sense of it, really.  I do know, however, that I will keep my clothes to my bucket and tide while I am here!

Fact of the week: 98% of the population is naturally immune to leprosy!

Lesson of the week:  Do not skip breakfast while on doxycycline, it will lead to feeling light headed and faint...and it is hard to pay attention like this.

Hindi phrase: "Aapke naam kya hai?"  (what is your name) sounds like: Op-kay-nom-kay-hay

Cool thing of the week:  Gelati two train stops away!  Calcium yay!