Making Difficult Decisions

We make decisions every day regarding how to spend donations so lovingly sent our way to help lessen the devastating financial burdens that families in this community face. We’re face to face with people who remain astonishingly stoic while appealing for help for themselves, their children, or their relatives. Poverty provides innate coping skills from the moment of birth. Indu’s one-room home is our ‘office’, and it’s there where most people find us when they need help. They arrive with their medical history in a plastic bag, or a school fee card that’s almost blank. They tell their personal problems out loud, surrounded by children or visiting neighbours who suddenly become silent so they can eavesdrop. They reach into the plastic bag, pull out their personal medical records and beg us to read them as proof of their need. Additional details about their marriage, their family relation, jobs lost and found, and their need for rations is spilled out for all to hear. Our decision about how much to help someone, or whether to help someone is made with an abundance of empathy, bolstered with Indu’s input, and the knowledge that comes from being immersed within this large community.

Here are a few stories of decisions we’ve made in the past few months:

On the way to the free medical camp for breast cancer screening

Waiting for a follow up mammography at a charitable trust hospital in south Mumbai

Jyoti

A few months ago we attended a free medical camp for breast cancer screening held in a nearby community. Indu walked the lanes of our community to inform the women and encourage them to attend the camp with us. Seven women decided to come, a few very reluctantly. Most of the women Indu talked to at their curtained doorways said they didn't have any pain or issues so why interrupt their day with this nonsense. Of the seven women who agreed to attend the medical camp, Jyoti tested positive for an abnormality. Two weeks later, she received a free follow-up mammography, this time performed at a charitable trust hospital. The medical camp hasn't released the results yet, so we discussed taking her to have another follow-up mammography at a nearby clinic so that we could obtain results in a few days, not a few weeks. For a low fee of $30-$50 the test would be performed immediately with results possible the same day. However, if her result is positive for breast cancer, the required treatment will be unaffordable for her or for us to consider. So, we are anxiously awaiting the results from the free medical camp, held by a respected charity in Mumbai. They are to follow up with any patient who tested positive, and herald them through the low cost government medical system for treatment of their breast cancer. Outside of this system, the costs to treat breast cancer is up to $8000, an amount unaffordable for her and for us. Should she need treatment, our role will be to continue to help her when necessary to purchase medicine, alleviate travel expenses, and pay for medical tests that might be required outside of the charitable trust hospital. We're continuing to advocate on her behalf for the results of her mammogram.

- To date we've paid for transportation (rickshaws, train, taxi) for us, Indu, the patient and her husband, to the two separate follow up appointments in south Mumbai which included snacks for the hours of travel and wait time at the hospital and the initial doctor consultation.

2525 rupees/CAD$50

The baby's mother, Rukayya (r) and aunt (l) at the hospital fee window

Photo courtesy of the parents

Rukayya

"There's a sick baby”, Indu told us as we settled crosslegged on the floor of her home for the tuition class. She made a quick call and within minutes two women, wearing niqabs, arrived at her door. The children in the class shuffled to make room for them and they quickly sat down to tell us their problem. Although we could only see their eyes, their sadness and anxiety was palpable. They had come go speak on behalf of their relative who’d come to Mumbai from another state to have her baby in a hospital here. Her first child was born in her village and had serious medical problems. Not wanting to take chances with her second child, she traveled to Mumbai for the delivery. The baby girl in question had been born eighteen days earlier suffering from hydrocephalus. The charitable trust hospital (KJ Somaiya Hospital) was providing pain management to the baby, but per the rules of the hospital, the doctor couldn’t operate on the baby until the parents paid half of the outstanding bill accrued to date. The two women faced us and quietly and humbly advocated on behalf of the relative who was sleeping on the floor at the hospital with her husband while their baby remained in PICU. The bill was already at $3000 and climbing daily. They’d taken loans and borrowed from relatives trying to raise the money for the operation. The next day, along with Indu, we travelled to the hospital to pay a portion of the fees. We met the baby's mother and father in a crowded waiting area where all eyes and ears were upon us during our conversation with the them. People moved closer to us and tried to listen in. They all needed help. We moved to a quieter spot and asked the mother to come to the fees window on a different floor. We counted out $400 (20,000 rupees) and pushed it through the window to the clerk who slid a receipt back to us. The very young mother looked on, exhausted, stoic, and helpless. Her relative spoke again on her behalf and asked for more funds. Indu explained that this was the amount we could give, that we have many other people to help. The relative didn't give up asking us for more, and I don't blame her. We had to walk away, which we did slowly and reluctantly. On the ride home in the rickshaw we all remained quiet, wondering if we should do more. We do that often. The baby had the operation, but sadly passed away about a week later. The grieving parents will have to pay the outstanding bill to the hospital before they can take the baby's body away for a Muslim burial. For that they will rely on relatives, money lenders, and selling what they can. The baby had yet to be named.

Usha

She was relentless in her ability to cajole us to come to visit her at her home near the airport in a slum area quickly being swallowed up by development all around her. She was born in the tin and tarp home 53 years ago, as were her two children, a son in his late teens and a daughter in her early 20’s. A teacher by trade, we met her years ago when she worked at the kindergarten in the community. That job was taken from her for no discernible reason years ago and she has struggled to find work other than preparing tiffins for neighbours. Always sick with back problems, and now the problems of ageing, her health issues have contributed to her current situation of relying on her daughter to provide food and medical care for the family. A painful medical issue recently resulted in her going to a government hospital for an operation. The operation was botched and she came home in more pain than when she went in. Her daughter, (a full time office assistant earning 15,000 rupees per month/CAD$300), took a loan from her employer to pay for a subsequent operation for her mother, this time performed at a private hospital. The daughter’s employer will deduct funds from her pay check until the loan is paid in full. The cost of the operation performed at the low cost private hospital (Dr Das Hospital) including doctor fees, medicine and the hospital bed was 127,100 rupees/CAD$2500).

As she prepared us lunch we talked about many things, but her focus remained on her medical problem coupled with the probability that her home will be demolished clear the area for airport land use. While she was busy cooking we quietly discussed how much help to give her as this was the premise for the lunch invitation. The decision we reached was to give her $200 (10,000 rupees) to pay down her daughter’s loan, or to buy rations. That was up to her. On our walk back to the road to catch a rickshaw, she clung to me, one hand grasping my upper arm and the other hand wound around my hand so tightly I winced. She begged us to please return for lunch again. We know what that means. She requires more help than we can give her. The cash payment will help the family and they will manage, in the way that they always do. -- paying for one thing at the risk of not paying for something else. She called out to rickshaw drivers to take us back to Saki Naka while she continued her plea for us to come back soon. Usha's hand remained entwined with mine as we settled in a rickshaw. When she let go and the rickshaw started to move into traffic, we stuck our heads out the side, waving and watching as she grew smaller in the distance. We were silent for the rest of the ride.

There are many upsetting stories in this community, but we're all thankful that those stories are tempered by celebrations, healthy babies, excellent progress for many of the students, and families who’ve never needed our help. We try to manage the requests for help of any kind with Indu’s insight and our own understanding of the family and the culture. After much discussion, we always pay something to the family in need, if not all of the bill. Every family problem we are presented with is another difficult, but heartfelt decision to be made.

Below is a list of payments for other patient’s medical issues, school fees, and some fun, since the last post.

Karan and Sneha received an eye exam and new glasses

December 18, 2022 - February 8, 2023

Abhipraay Crystal Eye Clinic/Optometrist fees/eye drops/testing for Karan and Sneha: 2400 rupees (CAD $48)

-Prescription eyedrops: 483 rupees (CAD$9.50)

Lenscart/two pair of prescription glasses/Karan/Sneha: 5824 rupees (CAD$116.00)

Saijeevan Hospital/Doctor fees-2 visits) for Wasema Shaikh: 1000 rupees (CAD$20)

Medicine: 553.23 (CAD$11.00)

Wasema is a mother of 6 children who was having stomach and chest pain.

Ashirwad Hospital/Doctor fees for Akansha Pandey: 1100 rupees (2 visits)

Abhipraay Diagnostic Clinic/Sonography: 2000 rupees (CAD$40)

Abhipraay Diagnostic Clinic/Ultrasound: 2550 rupees (CAD$51)

Shree Siddhi Ganesh Medical/medicine (Evacure) for 6 months: 3111 rupees (CAD$62.62)

Akansha is a 19 year old female diagnosed with polycystic ovary disease.

Dental Paradise/fees for Siddharth Ingle (root canal/cap): 7050 rupees (CAD$141)

Indu’s Tuition Class

Indu’s tuition class benefits greatly from donations. This is where the donations are spent on fun, learning and extra special outings. We purchase paper, paint, crayons, assorted craft items, treats from time to time, work books when needed, sports equipment, and this year transportation to a Christmas party, plus gifts for those who couldn’t attend.

19,562.90 rupees (CAD$391.26)

Birthday Parties

Nine children’s birthday parties shared with the tuition class of 44 children (a gift/cake to share/chips)

14,363.60 rupees (CAD$287)

Miscellaneous Costs:

-One time monthly rent payment for Karan’s unemployed aunt whose husband left her without a home or a job: 5000 rupees (CAD$100)

-Gift of fruit for Roopa and Nirmala’s families as a thank you for inviting us for dinner with Indu and her children: 400 rupees (CAD$8)

-Text books (2) for college prep NEET Exam/Itaba and Ritesh: 625 rupees (CAD$12.50)

-Water supply hook up to main outlet for Indu’s home/tuition centre (her water supply was cut off for 5 days because of tampering with her line). She decided to install her own line and canvassed the neighbours to help her pay for a new line that would service them. We paid 8000 rupees (CAD$160) toward the new water pipe.

Sakina, Aagya, Aaradhya and Lavisha leaving the community to attend their school Sports Day

School Fees (always ongoing)

This year has been a year of tough decisions regarding school fees. Many families haven’t paid even partial school fees since March 2020, the month when India locked down for the next two years. Many of the families lost their daily wage jobs and left for their villages to wait out the pandemic. They owe hundreds of dollars for their children’s school fees and will never catch up. It’s these cases that are the hardest to help. We decide on an amount to pay for each child on a case by case basis. By the 10th standard, if the fees aren’t paid in full, the student will not receive their final grades and will be unable to continue their schooling. The schools are also lacking funds due to the pandemic which makes it hard to argue these cases.

Nandchhaya Vidya Niketan English Medium School (paid Dec 18/22 - January 31/23)

7 children: 44,500 (CAD$890)

Our Lady Of Good Health High School (paid February 2023)

4 children: 20,000 (CAD$400)

Your donations, support, and kindness have allowed us to make the hard decisions on behalf of the families in this community. The families are forever grateful for the help they receive.

For up to date information, check out our Instagram/Facebook pages where we post short stories and photos a few times a week.