Indian Antics VIII

Greetings to you all! This will be my last letter from Malkangiri, so I'll take the opportunity to reflect with gratitude on all I've received. Reflect on Malkangiri, on the clinic and the villages, but mostly reflect on the people - patients, staff, friends and the strangers in the street. They are the reason I came here, and it is memories of them I will keep. So as we think of Malkangiri and its people, please keep them in your thoughts and prayers.

Just to keep you up to date, here are my plans for the next month. On Thursday 23rd I travel to Vizakapatnam, and from there to Mumbai. In Mumbai I will spend five days seeing the work in one of the slum areas, before finally flying back to Australia. I'll be back in Tasmania on Feb 3, then in Melbourne on Feb 23. I look forward to seeing many of you again soon, and should have plenty more photos and stories for you to share.

Recent News
Sitting here at the computer, I'm hot and sweaty from walking through the dusty Malkangiri streets. We have finished at the clinic for the day, so I took the opportunity to have perhaps my last slow walk from the clinic through town back to the office. With the stench of diesel fumes floating in the air I dodged the Jeeps and trucks leaving from the market place. Most of the sellers had closed up but, with the sun almost set, many villagers were only just leaving. Families walked, rode and travelled in Jeeps back home to their small villages. The market today was as busy as I've seen it. The colours as bright as ever, noises and smells as intoxicating as ever - great things to be etched on my mind as I leave Malkangiri.

Elephant Riding
Earlier today I had a ride on an elephant through town. As a 'holy' revered animal, it brings in much revenue for its owner. From three metres up, swaying and jolting on four tons of flesh, the view of Malkangiri was very different to any I've seen before. As we plodded through the market place, passers by would place coins on the elephant’s trunk, making gestures of reverence. Well trained, the elephant immediately passed the coin to its 'mahut' riding high on its back. The slow relaxing journey gave me time to really appreciate this small town I've lived in for two months. But while the town itself if lovely, it will be the people I will miss most. The staff, friends I've made and even the friendly stranger, eager to say hello and shake my hand.

The clinic today matched the market in its demand and intensity, finally seeing around thirty patients through the day. I guess this is not exceptional compared to some suburban GP’s, churning patients through every ten minutes. But throw into the eight hours of the market five X-rays, three ultrasounds as well as in-depth examinations, and it is pretty hectic. Among the presentations were a handful of veneral disease patients, a healthy pregnant woman, a few with urinary tract infections, kidney disease, digestive problems and some for re-evaluation. One young man, Denabandu, came in with eye damage he'd received from a rooster. His eye is now infected and has opacity due to the healing process, but he should recover well. Altogether, it was a very pleasant note on which to finish my clinic work.

Last Week
Last Wednesday turned out to be a quiet day at the clinic. Kutlamuji, the man with dizziness and fainting, was stable but still not recovering well. He'd stayed at the half-built hospital for two nights, so it was decided to refer him to an ear specialist in Vizakapatnam - 10 hours away by Jeep. We've not heard from him since, so hopefully he got on well there. We also dressed the wounds of Omar and Sharada. Omar's is healing beautifully; Sharada's is healing reasonably well, but slowly. Since all the NZ volunteers were departing the next morning, a dinner was arranged for all the staff and volunteers to attend. As the shadows grew longer, and the sun dipped toward the horizon, we gathered on the roof of the office. The great thing about bring houses here is that they all have large, flat rooves - great for parties. After singing a few songs and chatting, the food was brought. Sitting in a circle we unwrapped the bananna leaves, each with individual portions of rice. We were then served generous helpings of dahl and chicken curry - ah, wonderful. Matthew, Charlotte and Rebecca, the NZ medical volunteers, said a few words of thanks before accepting a gift from the staff. Matthew was given a shirt, while the girls were given saris (conveniently bringing Charlotte’s total sari haul to 20!).

Goodbye New Zealanders
Thursday morning I was up at 3:30am to see the New Zealanders off on the early morning bus. Getting a few more hours sleep I was up again at 6:00am to head off to the Kalimela clinic. It was a quiet ride to Kalimela in the van, without most of the volunteers. But we did have two visitors from Hebron school in Ooty, where David and Mary (Dr Iris' children) go. One of these ladies, Lois, comes from Melbourne, so it was good to be able to talk with another Aussie again. My final clinic day at Kalimela was fantastic. We saw over 25 patients, many of them children. I love kids; they're so honest, and so expressive even without speaking. The children this particular day included 9yo Manoj and 10yo Mithim (who weighed only 15kg), both with malaria. Another boy called Manoj came in with a skin rash. It turned out he had an enormous spleen, giving him a pot-bellied appearance. AN ultrasound showed that it was of uniform density, which means it is probably not cancerous. Dr Iris put him on her 'goodies', an assortment of vitamins, minerals and digestive enzymes, and will review him in a week. Surobi, a cute 9yo girl with a permanent smile, presented with digestive troubles. Stantheshi, a 10yo girl who'd had cerebral malaria as a child (often fatal in these areas), presented with apparent recurrence of malaria. All these children were a real pleasure to examine - makes me wonder about paediatrics for the future.

Among the adults who came were a couple of pregnant ladies, one of them, Padma, had dizziness and fainting, but fortunately the baby is developing well and she was soon feeling better after fluids. A couple of old men also came, one with advanced TB, the other with bad malaria, and a younger man, Herivayan, with a big abdominal hernia. We left the clinic at around 7:00pm after an extremely enjoyable day. Making our way through the now almost empty market place we began the two-hour journey back to Malkangiri.

Friday began with a morning of prayer and fasting as usual. During my morning run I'd noticed it was an overcast day, which had kept the muggy heat in. It improved little through the day, but did manage to keep the direct heat from the sun from beating down too hard. I handled the clinic with Guerdien (the Dutch nurse) and Amid (the newly employed lab assistant) throughout the early afternoon. I saw only a couple of patients, including Omar and Sharada, back for re-dressing of their wounds. The other patients were easily dealt with except for two women - a mother and her 19yo daughter. After taking a history and examining the daughter I was very confused. Examination was normal but she was complaining of pain down the right side of her face, neck and arm, dizziness, occasional fever, stomach pain and cold feet. Her mother’s history was just as vague - only she wouldn't let me examine her. Try as I might I could not elicit any more useful information, so I decided to wait for Dr Iris. Dr Iris had the answers within seconds of arrival. Apparently they both had profuse white discharge and had not wanted to tell me since I was a guy. In fact, the entire history I'd carefully gathered had been made up! In any case, Dr Iris was allowed to do a partial examination of the daughter, but the mother still refused any examination. After seeing them off, we closed the clinic and had a relaxing lunch together with the other staff.

Mission School
The plan for the afternoon was to go to a Christening in a small village out towards Mundiguda. While waiting for the others, I wandered through the local Indian Missionary Society (IMS) School. It had been started by Dr Iris's husband, RAC Paul, some thirty years ago and was handed over to IMS not long before his death. Many of the children, dressed in maroon shorts or skirts, and white shirts with matching maroon ties, were practising their marching for an upcoming competition. The smaller children were playing around the dusty, dirt playground. As I toured the dormitories, offices, church and classroom, I developed a following of curious children. A group of giggling girls came up and said politely "Hello, how are you?” "I'm fine, how are you?" I replied in Indian English fashion. They collapsed in giggles and ran back to the safety of their classroom. A few were a bit more confident in their English. Suman, a young boy whose family I'd visited a few days back, came up and said hello. We talked for a while, and then he asked if he could come for a run with me one morning. I hesitatingly agreed, and we settled on Sunday morning.

Village Christening
It was soon time to join the rest of the RHS staff in the van for the village where there was to be a christening. After two hours of bouncing along rutted, pot-holed dirt tracks we turned off the main road onto the village road. After manoeuvring through a paddock to avoid the branches overhanging the road, we made it safely to the village at around 6:00pm. The blaring music from the speakers along with the paper decorations and bamboo shelter, made the atmosphere reminiscent of many of the village Christmas programs. After a few songs from the local children and RHS literacy workers, the Reverend (I can’t remember his name, but I distinctly remember his hairy ears) spoke about names and children in the bible. The baby boy was brought forward and named, before we all broke for food. The dahl and curry was well dosed with chillies, so by the time I finished my face was glistening with sweat. The journey home was enjoyable, messing around with Probakar, Laban and Ramesh in the back of the van.

Saturday was a very relaxed day. Dr Iris had visitors from down south, so I ran the clinic for a few hours through the morning. After seeing only a handful of patients, we closed up and I headed back to do my washing and cleaning. Later in the afternoon I wandered outside onto the dirty street and squatted bare-footed with some of the neighbourhood kids. Passing around coins from Australia, New Zealand and England we talked as best we could in a mixture of Oriya and English. But just playing is communication enough with kids, and even without words, the effort in understanding brings a real sense of intimacy.

Delhi Belly (or Malkangiri Mess)
On Sunday I rose early for a morning jog. Suman, a young boy from down the road had begged to come along, so at 6:30am we met and set off. It turned into a morning walk, rather than a jog, but I didn’t mind since I was feeling a little queasy anyway. While returning from our walk we stopped by a river and watched an elephant bathe. Lying on its side, half submerged in the water, its owner splashed water up its legs, rubbing the dirt off. It was such a peaceful sight to see as the sun rose from behind the mountains. Unfortunately the peacefulness of Sunday ended there. I was sick the rest of the day with vomiting and fever.

Lakeside Party
By Monday morning, dosed up on Dr Iris' 'goodies', I was feeling much better. After seeing a few patients in the morning I set of for the children’s picnic program. Ramesh brought together all the children from the surrounding Koya tribes with whom he does literacy and evangelical work. After carting fifty kids to a lake just out of town we began the task of preparing food for them. While they were entertained with music and song, a huge pot of rice boiled, dahl bubbled and chickens were killed, plucked and cooked (that's what I call fresh meat!). Since it was Dr Iris’ birthday, she arrived a bit later and was greeted by a bright pink cake. Cake and chocolate was shared around - a treat for children and staff alike. Seated on the grass, with leaves on the ground in front of us, we enjoyed the rice, dahl and chicken curry in an eating position that I was now very comfortable with.

Later in the afternoon I indulged in a swim. Though cautioned about crocodiles, currents and other lake monsters, the swim was beautifully refreshing. I swam, floated and dived for about an hour, before getting out dirtier than I'd got in. But it was a swim, and that was all that mattered! The tribe’s children were taken home later in the evening and we packed up while we waited for the van to return. Lying on the bridge I looked up at the northern hemisphere sky, enjoying the serenity and clarity of the night sky.

There will be another picnic tomorrow, this time with Malkangiri town children. A beautiful note to leave Malkangiri on - children's voices floating in the air.But for now I must take care of logistics. I've got washing to do, cleaning to do, and then finally packing. Though I say goodbye to Malkangiri and its people, their joys, pains and problems will still remain. Please remember them here, and the workers among them, even without a 'man on the ground'.