http://picasaweb.google.co.in/hrsnyder1293/IndiaFour?authkey=Gv1sRgCJjDjc3G-viXqgE&feat=email#


New batch of photos! I’ve been going a little camera crazy lately, since I am leaving in a mere two weeks! Holy crap!!! I think I figured out how to caption my pictures, so the explanations should be with the pictures this time.

I went to a rockin MSM party last week. The leader of an outreach organization, Krishna, was “adopting” a younger MSM and his “wife” (a man, of course!). Because many MSM have been kicked out by their families, and because they are a very close knit community, they tend to form these unofficial family relationships. We drove out to the middle of nowhere, among fields of rocks, where there was a Hindu temple. We pulled up to a parade of dancing guys led by Krishna who was dancing like a CRAZY man, they were on their way to do pooja (puja? Its Hindu worship). There were three tents, one for cooking the curries and rice in huge cauldrons, one for the community elders (a heavily transgender group), and one for the rest of us. Dr. Schneider, Sabitha, and I had already had lunch, but it was clear that we had no choice about eating this meal. Chicken curry, dahl, bean curry, and rice (duh. I have not had a rice free meal in months). The chicken curry I got was heavy on liver, skin, and fat. What an honor. But on the whole, quite tasty. They were also passing around a vat of watered down whisky, Dr. Schneider and I hit that up (out of politeness) but Sabitha refused (she would never ever ever drink). She did, however, giggle a lot and take pictures of me, threatening to blackmail me and tell the rest of the family that I drank. What a poo butt.

On a less cheery note, I went with Dr. Schneider to visit HIV patients. We went to Sivanada Rehabilitation Center, the leprosy (and HIV) home where I spent my first night in India. Their HIV patients were incredibly complex and mostly terminal cases. Most of them had been abandoned by their family because of the stigma associated with the disease. Most also had tuberculosis. HIV/TB is not a pretty combination, I have never seen such skinny people in my life, many were also struggling to breath, coinfected with other random diseases, and physically or financially unable to eat. The doctor there was a really sweet woman who was proud of her clinic and cared about her patients. She was also facing some major issues. Of course there was the funding problem, that’s basically a given here. Additionally, the CD4 count machines in the state are rarely functional. That’s a big problem, because national policy says you cant start ARVs until you have a CD4 count that is low enough. One patient was clearly end stage AIDS, but he couldn’t get medicine because he had just been diagnosed and there were no CD4 machines available. Holy shit, what a waste. The doctor herself also had some training deficiencies. She couldn’t accurately read a chest X-Ray to figure out the TB status of her patients, and there were no available radiologists to help. Dr. Schneider said one time he came to visit and looked at an X-Ray and she had totally missed a collapsed lung, which is a huge problem that needs immediate medical attention. So then, here I sit, the sort of idealist sort of jaded college student. What do these people need? And what am I willing to do, from a selfish what-seems-interesting perspective? They need money, that’s for sure. But I can’t be a philanthropist, because I’m not interested in the accumulating wealth part. Better trained doctors. Okay, that’s good. I’m working on that one with the MSM cultural competency curriculum I wrote for doctors, and I could see incorporating that work into my future. But honestly, most of all, the whole thing just makes me want to pack up my American life and move somewhere that really needs good doctors. Because, let’s be honest, I like getting my hands dirty, I like feeling like my work is useful, I like different cultures and I hate desk/computer/bureaucratic work. And insurance companies, and malpractice, and all the bull. But I’m being idealistic again, I would be mad at the hurdles like the CD4 crap. Still though. Who wants to move with me to somewhere filled with adventures and patients who could use a hand???