Dirty Wall Project

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I look across the clinic waiting room and watch the young mother. Her face is held in contempt, her eyes stare straight ahead and her lips are curled down and I can’t help but wonder what she’s thinking.

An hour before, while I was walking through the community, I noticed her youngest daughter wobbling after her older brother towards the school, barefoot and filthy, her stomach protruding prominently over her shorts. I stopped the ragged twosome and asked where their house was. Ashley and I went to their home and found out the family had only recently moved to the community in the past few weeks. This family’s story is a familiar one across India and our community. Meager earnings and six children leave the young mother over-burdened and unable to cope with the numerous medical ailments of the children and she has begun to turn a blind eye to the obvious health problems her youngest daughter faces.

I nudge Ashley and whisper to him to look at the mother and ask why he thinks she looks so angry with us? He’s uncertain as well and we think maybe it’s because she’s unsure of us and might be wondering if we are as well meaning as we say we are. A few more minutes go by but I can’t take it. I ask Ashley if he’ll sit beside her and ask her what’s going on and if she is still OK with us taking her children to the doctor?

Ashley gets up and quietly sits beside her and speaks to her. I watch as his face turns from concerned to frustrated and I fear what she has said. He puts his hand up in frustration and sits beside me. He tells me she wants to know why we are causing her trouble and why we can’t just leave her alone? I look down at her daughter who stands below me gently tugging at my leg hairs, her huge unblinking eyes are dark brown, nearly black. She is unaware of her problems and I’m saddened, not by her mother’s comment, but by the situation so many families find themselves in and the lack of knowledge they possess to pull themselves out. This mother, no doubt, came from a family just like her own, starved of nutrients during her early years which stunted her development both physically and mentally, setting in motion her current situation.

It seems everywhere I look since my return to Mumbai I see insatiable greed that is ruining the lives of those at the bottom of India’s economic pyramid.  Money drives our world and in India’s boomtown, money means everything, including access to proper education and healthcare.

India’s Healthcare system is divided into two parts, municipal (government) or private.  The private healthcare option ranges widely from the mildly affordable to the ridiculously posh with deluxe surgery suites. But the municipal level is even across the board with crumbling buildings, overworked doctors and packed, filthy corridors where the the sick come to get sicker.   The cost of care is low for surgery and medicine at the government hospital but the chance of infection and long waits are guaranteed. India’s upper class often speak highly of these government hospitals speaking frankly, saying that these hospitals are there and free so why do the poor patients still want to come to the private hospitals? I have met with countless cases in Mumbai where adults and children have contracted HIV through blood work at municipal hospitals. (Read my blog post about our friend Ganesh’s final hours at Sion Municipal Hospital last year). I have had the opportunity to work helping poor patients in dozens of hospitals both private and municipal across this city and each time I am no less appalled and embarrassed for a city with immense wealth to house patients in crumbling buildings, with rusted bed tables and stained sheets. Two weeks ago, while funding an angiography for a DWP patient at a municipal hospital in Mumbai, I decided to attach my small Go Pro camera to my backpack as I wandered the halls hoping to show a glimpse of what India’s healthcare system looks like from the bottom up. Two hours later as we still struggled to get the appropriate forms filled to even gain admittance for our patient, I suddenly noticed I was surrounded by tan coloured uniforms and one angry hospital supervisor yelling at me in Marathi. The gig was up and I was quickly escorted out of the hospital for illegally filming and taken to the hospital police headquarters to meet the sergeant. Nervous and ever thankful that Ashley was with me to translate for me, we found ourselves sitting on metal chairs in a dimly lit and dank room. Behind the desk sat a young sergeant with a pleasant demeanor. He was told by his officers what I had been up too and gave me the opportunity to explain. Explaining that I only wished to document our patient’s procedure for our records, I apologized profusely while thinking how Ashley was going to break the news to my parents that I was now in jail?! After a few tense moments he looked at me and thanked me for helping his country and people.  I was shocked and relieved and finally relaxed. He then went on to say that the healthcare system is terrible and sickly and the government does not want any filming or photos making it out of India or to the media. He was embarrassed for his country…but what to do he said??

The state of the healthcare system does not stop at the hospitals, but spreads deep into each community across the city in small decaying clinics and pharmacies. India’s drug market is also split in two, selling prescription drugs by “branded” (quality) or “generic” (low quality and sometimes completely fake). Prescriptions from government hospitals are often given using the generic names which sell for a fraction of the cost. A branded pack of pills will sell for 100 INR($2 CAD) where their generic counterpart will sell for 20 INR (.40 cents). This is great in theory because generic medicines are somewhat affordable for all sectors of society but…nothing is ever as it sounds. I have filled hundreds of prescriptions over the last few years and finding these generic drugs can sometimes be next to impossible. As a business pharmacies are not interested in selling drugs which are one quarter of the price, as they stand to make less money.

The next major problem in the system comes in the systemic abuse of antibiotics across the city. Small shops turned into “clinics” and “hospitals” hand out cheap antibiotics like candy to nearly every patient through their door. Just yesterday, an article in the Times of India wrote about all the new viruses including a new strain of drug resistant TB which antibiotics and the rampant abuse of them has surely caused. Every slum community has a small clinic nearby where the majority of people go because the cost of drugs is cheap. The clinic near our community is a ten minute walk away and deals with any type of case. Patients complaining of upset stomachs, diarrhea or with open wounds are all given the same generic blue or white pills which sit in the clinic’s only drawer in two separate containers, wrapped loosely in newspaper and cost 50 INR – $1 CAD. The antibiotics clear up the problem quickly, but not forever, and both patient and doctor are happy.

Malnutrition is so rampant throughout India (1 in every 3 malnourished children worldwide live in India) that it is believed to be double that of sub Saharan Africa where massive droughts and food shortages are abundant and pandemic. Yet, 48% of India’s children are malnourished, underweight, under height and developmentally challenged due to poor nutrition and hygiene habits where food is available and within reach for nearly all urban slum dwellers in the city. Perhaps the way to help this next generation of India’s poor is to educate their mothers about nutrition and hygiene, to ensure, despite their economic standing, the improvement of their children’s health and well-being as well as the need for birth control. With no money for birth control and no control over their own bodies, women must endure multiple pregnancies, miscarriages and the premature deaths of their children because of illness and abnormalities.

Eight months ago I briefly came into contact with relatively new NGO in India called the Foundation for Mother and Child Health (FMCH). FMCH has done extensive work through South East Asia and has expanded their field of help to Mumbai, India. I became immediately interested in their work and visited their clinic a few months ago and followed up, bringing several malnutrition cases from our community across the city to see their doctor (Dr. Rupal) and the team of health care providers. The thing that struck me is the care and passion they have to truly bring about change in these young families by nurturing the babies and teaching the mothers practical and useful knowledge. FMCH concentrates their efforts on children 0 – 6 yrs. old, holding daily clinics, cooking demos and awareness campaigns all geared towards the developing child and their mother.

Two days ago I sat in front of our school during our monthly health camp and watched as mother after mother with swinging babies on their hips and children in tow lined up to see a doctor and I realized that these young mothers need help and access to the knowledge to help their children, and not just another blue pill. A few hours later, I travelled across the city to FMCH’s offices in South Mumbai and met with their committee. In our meeting, we took turns discussing our work and what we both had to offer one another all in the hope of fighting the same battle. FMCH is currently looking to expand to other communities and I have pitched for that next community to be ours. This will be a big project and partnership, but one that can truly have a lasting and meaningful impact on hundreds of families and India’s next generation.

FMCH will be visiting our community in a few days to view first hand our centre and projects and with any luck to set in motion a health commitment to an entire community.

Sincerely,

Kane Ryan

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Pushpa enjoying the GCB picnic!

-Another instalment in the interview series with the women of GCB, written by Cindy Ryan.

“If you are rich people pay attention to you, but if you are poor no one asks you about anything.”

Pushpa’s hands were busy stuffing small balls of newspaper into the plastic carcass of a heart. Sitting in the women’s centre in the heavy heat of early afternoon she was huddled with the other women who were chatting and busy with the task of making heart shapes out of plastic bags. Regardless of the heat the women sat so close to each other they often touched; their sari’s pooled together on the cool tile floor. Guddiya stared open-mouthed at nothing, and her hands moved slowly, mindlessly tearing strips of newspaper and crunching each strip into a ball.  Pushpa’s two children wandered into the room and yanked at their mother’s attention. Her son pulled at her sari while her daughter dangled her arms around her mother’s neck. Tended to warmly by their mother, the children finally dawdled out of the room happy to play outside in the lane way.

I wanted to interview Pushpa as was my plan with the other women. I took my small notebook out of my bag, searched through the boxes of sewing supplies for a pen, and finally settled, sitting cross-legged on the floor in the tangle of women amidst the litter of cut plastic, torn newspaper, skeins of embroidery thread and sequins that stuck to my pant legs. More children filed in to the room, twirling, expectant, curious always, eager to stay in this wonderland of women. Kane joined us and the kids used his body as a prop to swing on, sit on, lay on and sleep on. Pushpa shyly agreed to talk about her life but was suspicious about why I would want to know her story.  Threading a needle, she stared straight ahead and said,  “if you are rich people pay attention to you, but if you are poor no one asks you about anything.” A lump of emotion welling up in my throat I replied, “I am curious about your life, how you arrived in Mumbai, when you came here, what you think about and what you want for your children.” With some gentle prodding from Indu, Pushpa stretched her perfectly shaped lips into a shy grin and began to talk.

What I was beginning to find out about most of the women living in the community was also true about Pushpa. She has no formal education and she has endured the death of more than one child.

Pushpa and her husband are from the Gwal caste (traditionally milk and curd sellers). They started their married life in a large village in the northern state of Uttar Pradesh when Pushpa was 13 years old. On the day of her marriage, devastated to leave her parent’s home, she moved to the home of her 15 year old husband’s parents, living in a separate room for  two years. While she gave birth to her first child at age 16 her husband struggled to find employment in the village. He left his young family in the care of relatives and travelled to Mumbai by train; an arduous, tedious third class journey that takes almost 24 hours. Mumbai beckons impoverished yet optimistic villagers from all parts of India with no assurances of a better life, but with more options for making dismal money and the dim hope of better education for their children and better living standards which might include running water, electricity, and hope. The reality of Mumbai for Pushpa’s husband was a deal with an unscrupulous relative who provided him with a job but refused to pay him. In lieu of wages he was given food, clothing and crude shelter. For three years he toiled under these conditions and visited his growing family when he could. Pushpa remained in Uttar Pradesh caring for their two young daughters, enduring the death of a 10 month old son and the stillbirth of another child.

After a fight with the relative who enslaved him, Pushpa’s husband managed to find a job driving a truck that paid him 4000 rupees ($80 CAD) a month and he was able to rent a small room for himself. It took him 4 years to save enough money to bring Pushpa and his two daughters from Uttar Pradesh to Mumbai. In Mumbai, Pushpa gave birth to two more children and the two oldest children returned to Uttar Pradesh to live with their grandparents. The family has called the Saki Naka slum community home for four years, with Pushpa living one year with her husband and their two youngest children in Mumbai, and the next year she and her two youngest children gather some belongings, and board a third class train, returning to her two oldest daughters in Uttar Pradesh while her husband remains in Mumbai to work. Although Pushpa travels every second year to Uttar Pradesh, she otherwise rarely leaves the Saki Naka community. The family has no extra money for rickshaws and Pushpa is reluctant to venture out of the community. Instead, covering her mouth with a swath of her sari to avoid the choking, black fumes from large trucks that rumble over the bridge that dissects the slum below, she waits for her husband to deliver supplies to his family while driving his work truck, clutching her two young children to keep them from wandering into the jumble of erratic traffic.

Pushpa starts her day by preparing chapati and a pot of  spicy dal, while her children, asleep on the floor, wake slowly. The children’s donated school uniforms are plucked from nails on the walls, their faces are scrubbed under a community tap and teeth are rubbed with a stick. Skipping down the lane way in front of their mother, the kids are excited to be dropped off at the Balwadi for their morning of kindergarten classes. Pushpa then quietly makes an entrance to the women’s centre, looking regal in her sari, her black hair glistening with coconut oil which keeps any stray hairs from escaping the neat braid that drops down the middle of her back. Her gold coloured earrings and her nose pin are a beautiful complement to her coffee coloured skin. She is always serene and much quieter than the other women. When asked if she liked her job at the centre, she replied, “Yes, I can send money back to Uttar Pradesh for the care of my oldest daughters”. She is proud that her two daughters, aged 15 and 16, are taking science classes because she hopes that will enable them to have a job with some prestige, where they will work in an office while waiting for marriage,instead of living in a hut in the shadows of the glass and steel towers. The future she imagines for her daughters comes with a thick coating of tradition as Pushpa is planning to return to Uttar Pradesh in a few months to begin the hopeful search for suitable husbands for her daughters.  Managing three dowries for her three daughters will further drive her family into precarious financial strain. Each daughter will ‘cost’ Pushpa and her husband up to 3 lakh ($1800 CAD) in dowry payments to future in-laws. In turn, she will demand a generous dowry from her son’s future in-laws, continuing the tradition which financially hobbles poor families..  When asked what she thinks about the caste system (which keeps her life in a perpetual dead-end), she surprised us by saying she doesn’t agree with the caste system, but she will strive to choose husbands from higher castes for her daughters.

The rent on their room in Saki Naka costs the family 1500 rupees a month, with bills for water and electricity added to the monthly cost. Her father-in-law is ill and requires treatment costing 50,000 – 60,000 rupees ($1000 CAD) pushing the family into using a money lender who will tack on interest charges at 10% per month. The additional cost of three dowries will contain Pushpa’s family in an insufferable, dangerous relationship with an unsympathetic, unscrupulous money lender, who will use physical force when necessary to collect his loans.

Pushpa’s life seems grim with the realities of poverty based on the caste system, a system that ignores the grueling, punishing life that is lived in slum communities. However, she maintains that she is happy even though she would like for her children to live a better life. I suspect, she has no imagination about what life would be like if she weren’t poor. Her knowledge of the outside world is so limited that she doesn’t understand why I am light skinned and she is dark skinned.  She understands that Canada is a country (whatever that means to her) and I have to fly in an airplane that she sees overhead to get to Mumbai. Watching her two youngest children wander in and out of the women’s centre, I hope their world is full of possibilities; that the ‘new India’ that is both burgeoning and groaning under the weight of government corruption, might reserve a place for them in the glass towers that pass shadows over the slum community.

For now, Pushpa is content sitting among the women in the centre, creating beautiful products, making a wage, and tending to the possibilities that she hopes lay ahead for her children. Although shy, she is calm, determined and confident in her ability to create something beautiful out of nothing, whether it is a plastic heart ornament or a future for her children.

- A week ago we helped Pushpa, her husband and two children into a rickshaw with all their worldly possessions. They have decided to move back to their village in the north of India and it’s very sad to see them go. On behalf of the ladies of GCB we wish Pushpa luck on her journey north. She is a part of DWP/GCB and is welcome back anytime. DWP donated 1000 INR – $20.83 CAD to help them on their journey.

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I hear the faint sound of running water and I sit upright quickly from my position on the floor. I sit motionless for a moment. The overhead fan squeals, the sound of evening prayer from a nearby mosque drifts in through the open window competing against a symphony of horns from passing cars. The sound is faint but I hear it again. Could it be??  Excited and anxious I run towards the bathroom and look up at my water tank above the kitchen but see no sign of water. Opening the door to the  bathroom I can see a drip forming under the tap and my excitement resumes. I open the tap and hold my breath and hear a quick creak and a guttural sound from the wall, and like magic, water gushes from the tap! I quickly fill all the buckets in the bathroom and take a shower immediately. I have been without water in my apartment for the last couple days and the weak dripping water feels and looks like Niagara Falls.

I arrived back in Mumbai just about a week ago, sleepily moving
through customs and eagerly awaiting my first “head bobble”. The humid
heat of the pending monsoon coupled with nearly 20 million people
living far to close together hits you seconds after you get off the
plane. It’s smothering but welcoming all the same.  As Ashley and
Fatima greet me just outside the the gate, I look up to see hundreds
of people running towards us and I step back confused? A second later
we are surrounded as families jostle for position near the arrivals
gate. I scoop up my bag and Ashley asks what’s going on.  “Guru
Ji..Guru Ji is here!”, a local man proclaims, a photo of “Guru Ji”
clipped to his shirt pocket. Moments later a small pudgy man clad in
orange is whisked passed security and people begin to shout and
scream, all hoping to get a glimpse of the holy man or at best to
touch his arm and offer him a garland. Guru Ji, surrounded by
security, moves quickly past the throngs of people, pausing to collect
a garland from a few lucky devotees, and then he disappears into a
waiting car. Families had waited hours for the experience that lasted
only seconds. The three of us then piled into one of Mumbai’s rusting
black and yellow Fiat taxis for the short ride to my apartment in
Marol, passing Guru Ji worshippers making the long walk home on the
dark and dusty streets.

My first night in the apartment is sleepless. Restless, I make my way to the roof top and sit overlooking Mumbai and wonder what the next few months will have in store for both DWP and myself. Morning finally comes and I head by rickshaw to the community I left two months ago that has been my second home for the past two years. Walking into the community I’m greeted by children and soon I hear ” Kane Sir” being yelled down the main lane way.  Children pop their heads out from  doorways and I reach out to shake hands and say hellos as I move towards the school. The community is quiet because many families have gone to their native villages for their yearly visits. The temperature hovers around 35 degrees but it feels hotter. For the next several hours I walk through the community greeting families, DWP sponsor children, and friends. Ashley gives me a tour of the work he has done since I left and we take a few minutes to sit near the large garden that DWP built last year. The colourful mural wall of the garden still looks beautiful and I watch as 3o kids play cricket. A few families sit in the shade on the benches and as word gets out about my arrival more and more children stop by to say hello.

I walk back to the centre and see that the door to the GCB centre is open and I am greeted by a smiling Indu. Indu has done an amazing job over the last few months while I have been away and we spend the next hour viewing the products that the ladies have made in my absence. Indu is excited to show me the account books and receipts she has carefully maintained and she fills me in on the gossip of the community. Megha, Ranjana’s daughter, comes running into the room and gives me a big hug and pulls at my arm to come to her home for tea. I agree and head next door and sit down for a cup of sweet chai with Ranjana. The taste of chai and being in Ranjana’s welcoming home, brings me back and I feel at home and at ease, excited to be back in the community.

With all the excitement and smiles, I forgot why I am here, but the realities of slum life lie just below the surface and behind every door in the community. Soon mothers and fathers come knocking, knowing that my arrival also means a chance at a helping hand. I sit down with Ramesh Pujari’s wife and she explains to me that Ramesh is in need of a surgery and will I help. Behind her is another family waiting patiently for a chance to be heard and I slowly catch up on all the pending medical cases that need urgent attention. A new strain of drug resistant TB has hit Mumbai and this disease is causing problems for several families along the pipeline.

Over the last few days DWP has begun to put the last two months of fundraising to work.

• Ramesh is taken to Sion hospital and undergoes Angiography surgery. 5500 INR – $110 CAD (Includes medicines)
• DWP makes a visit to a new sponsor case and subsequently adds Riba Shaik as DWP newest sponsor child. 6167 INR – $123.34 CAD (Full years fees)
• Kajal a twelve year old girl was taken to a Doctor to see why she has been suffering from high fevers. Blood tests and medicines and have taken and we are now waiting for the last results to find out more about her condition. 830 INR – $16.60 CAD
• DWP has paid the women of GCB their monthly wages plus cash bonuses for all the women.
• To celebrate being back together and to mark Pushpa’s departure from the community the women of GCB brought their children and we all sat down to a special lunch. 16 people ate for 1200 INR – $24 CAD
• GCB received a donation of fabric from Deutsche Bank employee and DWP friend Leon Cohello.
• DWP purchased a new pair of sandals for a young boy who works collecting garbage in the community. 60 INR – $1.20 CAD
• The biggest and most exciting project over the first few days was the purchase of two new swing sets for the big garden! Cost including delivery and local masons and labour  – 40,000 INR – $800 CAD
• DWP paid the medical bills for a young boy with Cerebral Paulsy today who was suffering from Typhoid fever. 5500 INR – $110 CAD

In great news, the latest rumour in the community is that we will be safe from demolition until possibly 2014!! We don’t know if this is fact or fiction quite yet but the community is excited and hopeful.

What this means for DWP is uncertain still. I plan on working hard over the next six weeks here in Mumbai getting all of our DWP sponsor children back in school for the upcoming year and adding as many new children as I can, while also funding the many medical needs of the community. I’m thinking of heading north for the month of June to meet up with a few other organizations and fill needs as I move through the country.

It feels good to be back and helping again and I look forward to keeping all of our DWP supporters and friends up to date on the needs we fill over the next several months.

Cheers,
Kane Ryan

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