On Vivekananda's birthday...

Sunset in Saragur--and right outside my housing unit

A 1.5 hour drive from the city Mysore, Saragur is situated practically in the midst of sheep herders and tribal communities—the vast countryside. Swami Vivekananda Memorial Hospital, dedicated to the Nationalist spiritual leader Swami Vivekananda, is a mission hospital whose vision is “a caring and equitable society, free of deprivation and strife.” Actually, January 12 is Swami Vivekananda's birthday and the hospital staff were commemorating this in the prayer room which I unexpectedly passed. Ushering me to join the cross-legged crowd, an elderly lady sat beside me on the floor as incense and chants enveloped us. The finance officer later walked around with a fire on a plate of stainless steel, and everyone put their fingertips in the heat, following through by either wafting the heat to their faces or bringing their hands in prayer to their chests. The prayer ended with a coconut sweet for everyone to have! Caloric—yes, but I need it according to a physician there!

Vivekananda Memorial Hospital (VMH) runs India's first rural-based comprehensive HIV/AIDS program, and Karnataka (where Mysore and Saragur are located) is a high-risk state in India. Also, VMH just co-integrated HIV+ and HIV- patients in the same building—a first of its kind. This is a big deal for a country in which HIV/AIDS is highly stigmatized. Now how do I fit into this picture? (other than randomly joining a Hindu prayer?) Simple, I am conducting a patient satisfaction survey that aims to detect patients' perceptions of discrimination. Do seropositives (HIV/AIDS patients) perceive more discrimination than seronegatives (HIV- patients)? What may the hospital be overlooking in its quality of care? And how may the hospital improve their services to reduce stigma and discrimination?

The survey is being translated into Kannada as I speak! The Kannada script is bubbly, but block-like, and I'm mesmerized as I see people write in it.

Below are eye-candy (from my two road trips from the city to the rural hospital & a local school run by the same organization):

Woman leading oxen

See the hay rider?

Sheep grazing

Locals washing and sunning clothes

Yesterday, I had the opportunity to meet my first HIV+ patient in a hospital setting! I sat in on a counseling session where this semi-hollow cheeked 7 month pregnant woman came in, with her mother-in-law waiting outside the office. She was a fair-skinned, female whose eyes emitted a dimmed vitality. Here, counseling is considered part and parcel of the medical services. One receives counseling for anything really—financial counseling for medical fees (to establish a fair price—a sliding scale fee), spiritual counseling (suggestions on meditation techniques), STD/HIV counseling, etc. Of course, everything was conducted in Kannada—Karnataka's language—so I had no idea what was going on except she was pregnant. Afterwards, the counseling coordinator asked, “So, what do you think of her?” What an odd question to ask! I just told them she looked drained. Turns out, she's HIV+ and received HIV from her truckdriver husband. (In India, truckdrivers and migrant workers have been spreading HIV rapidly in rural areas.) Of their family, only husband and wife knows about their disease. Confidentiality is crucial—even the mother-in-law sitting outside had no idea what transpired in the counseling room. So, when will the rest of the family find out the couple is HIV+? The coordinator's response: “Relatives can usually guess it because of the frequency with which they obtain medicines. Eventually however, the rest of the family will know when couple cannot hide their physical conditions anymore.” However, the great news was, that the unborn child had a 99% rate of not having HIV transmitted! It just takes taking 4 tablets immediately after birth and some serum drops (if I heard correctly), and the infant can breastfeed without being infected. That is amazing!...minus the pains at which the infected feels the need to hide their status.