8 January 2001
I am not supposed to look straight ahead for fear I’ll catch some man’s eye and give him the wrong idea. So, I look down and I’m forced to see the filth, poverty, and beggars on the street. And in an attempt to avoid that, I look up towards the sky, but the pollution fills my eyes and they well up with tears. So I close my eyes, and India begins to pass me by. As a result, I force myself to open my eyes and survey my surroundings . . .
I remember those first days in India and how overwhelmed I felt. I was confused, tired, and unsure of what I had gotten myself into. The sights and smells were almost more than I could bear. Sure, I had been to Third World countries and lived abroad before, but this just seemed like more: more poverty, more people, more excitement, more unknown. I was absolutely unsure of what to expect from India.
When I decided to go to India, I felt a strong desire about going, but I was not sure exactly why. I had some ideas of what I wanted to accomplish, but they were also vague, and I had no idea what I would do in a village in India. So I set off with a goal to learn and serve, but without an exact plan of how to do it.
14 January 2001
After stops in Bangalore and Coimbatore, we have finally made it to our village, Chavadi Pudur, and it is nice to be getting settled for a while. I have to admit I was a little nervous about coming to the village. However, I am really enjoying it here. Life is calm and peaceful, although significantly slower than what I am used to. I will have to be careful about not getting too frustrated with the pace of life here. It is definitely a change from my busy life back in Provo.
One of the hardest parts about living in the village was the lack of things to do. At first it was fun, almost a novelty. I felt relaxed and could do some reading and try to begin to understand how things were done in the village. The relaxation eventually began to be replaced with anxiousness. Sure, we could find things to do. After all, it took us most of a day to do our laundry and we did have to haul water daily, but I was finding myself wanting to spend a few days a week outside the village. Communication was a major barrier with the villagers, and I didn’t have a research project to do like some of the other students, so I decided to look for something to occupy more of my time.
Past students had worked with an organization called “Shanti Ashram,” so Loryn, a fellow student, and I decided that we would go and see what kind of projects they had going on.
23 January 2001
Today we went to Shanti Ashram, in the village of Kovai Pudur, and met with Vinu Aram. Her father originally founded the NGO many years ago, but recently passed away. Vinu went to medical school in Coimbatore and then worked as a doctor and with the Ashram for a few years. For the last year, she was at Harvard for a master’s in public health. Now she has come back to India to work for Shanti Ashram. She is trying to get some health programs started, as well as to continue to document and enhance their current programs.
Shanti Ashram literally means “a place to come together for social action.” Vinu’s father began with the idea that it would focus on projects at the community level. Vinu is trying to continue in her father’s footsteps and make sure that any project they took on could be managed on a small level. They work in conjunction with traditional village leadership and all of the workers come straight from the community. Currently, they have programs that focus on literacy, education for children ages three to five, vocational training, selfhelp groups (similar to microcredit programs), inter-religious activities, and agriculture. When Vinu returned, the staff decided they would branch out into the health sector. At the time of my arrival, this was the area that needed the most work as it was only in the early development stages. Accessibility to adequate heath care was an area of major concern that had not been addressed in past Ashram programs.
After talking to Vinu, I realized that it would be an amazing opportunity to collaborate with her on some of her health projects. She seemed to have a strong grasp of current ideas of “good development” along with the technical skills and knowledge to see them through. I have a great deal of interest in health care, having worked in township and rural health clinics in South Africa and having received my EMT training while in Utah. We decided to set up another time to meet and discuss what exactly I could do to work with the Ashram.
6 February 2001
I met with Vinu again to talk about the health program they are going to start. They are going to focus on three main areas in the seven villages where they have Bala Shanti Schools (preschools). This would include over 200 children ages three to five. The first step will be to create a health card for each child, with birth information and immunization details and also questions about the general health and nutrition of the child. Because Vinu thinks (and I strongly agree) that no project should be without an aspect of education, the second area of focus is a health education cycle. The workers will go to the children’s mothers and explain why they are taking the measurements and asking so many questions. The third step would be to create a complete database from the children’s profiles. With the data, they can request help from the government, thereby making the Ashram the facilitator for better services. I am really impressed with both Vinu’s foresight and insight. She is very organized, determined, and especially aware of the people she is serving.
There are also a few other things they are working on, including Vitamin A screening and giving hepatitis B vaccines. With today’s technology, there is no reason for blindness due to a lack of Vitamin A, even the villagers have access to papaya, an excellent source of the vitamin. As far as hepatitis B goes, it is not a very common vaccine in India. However, 3 percent of the population gets it. When you consider India’s population of almost one billion, that is three million people!
Certainly, there was a lot going on in the health department at Shanti Ashram. It was easy to become involved. I was very interested in the idea of preventative measures for the villagers and had a little bit of experience with emergency medicine, having finished my instructor training for first aid at BYU and volunteering with both the BYU EMS and with an ambulance service in Cape Town. Vinu and I decided that a basic yet essential component of the health program would be first aid training. Many of the Shanti Ashram staff would be trained as first aid instructors for the course, then they would be able to go to the communities they were currently working with and present the information to the people.
We soon realized that we needed training resources. We wanted to present only very basic ideas to the people, but with concepts and examples that were specific to their situations. Unfortunately, we could not locate the necessary resources. Shanti Ashram is in Kovai Pudur, halfway between Chavadi Pudur, the village where I lived, and the city of Coimbatore. In Coimbatore and the surrounding villages there are almost one million people, but not one first aid training course was available for someone not directly involved in the health care field. So we had to start from scratch. We decided that I would work on creating a manual that would be used for the courses and we would develop the teacher training course based on that manual. Vinu and I brainstormed on what the most important topics were to cover in the manual, and then I compiled basic information on how to treat the problems. I used my own knowledge, a wilderness first aid manual, and the book Where There Is No Doctor: A Village Health Care Handbook by David Werner (India version) to write the manual.
22 February 2001
The first aid manual is coming along really well. Vinu met with the medical school yesterday, and the man that does the translation was not there, but hopefully he will be around next week. Our goal is to get the translation done next week. On 3 March we are going to present the course to the Bala Shanti teachers and then to another group of women on sixth or seventh. Then, hopefully, I can watch one of those ladies give their own presentation to the mothers of the Bala Shanti children. They should be trained well enough to do their own training after two sessions with us. So, the goal is that we won’t have to do any more teaching other than doing the initial training with the teachers. We are going to give all participants a training manual along with their own first aid kit.
We had more of a struggle getting the manual translated into Tamil than we had originally expected, but, luckily, there were several people at the medical school that were very interested in the project and were willing to use their resources for the translation. When we actually started training the instructors, only the English translation manual was finished. Vinu spoke directly to the participants in Tamil, but I had to work with a translator.
3 March 2001
We started off with prayer/meditation, and then I gave a brief introduction on what first aid is, who gives it, why we give it, and how to give it. It was all very general, and I followed with a brief introduction to the manual. Some people have questions about how much they can and should do, and shouldn’t a doctor be doing these kinds of things. We told them that anyone could do first aid. It was awesome to see the women realize that they were capable of these skills. It is so amazing to see someone empowered with that kind of knowledge. Everyone took the course very seriously; they were taking notes, asking questions, and were very involved with the whole session. Vinu continued with information on the importance of first aid and how to identify things in the home or school that might potentially cause problems. Next, she talked about specifics of the manual and how to use it. After the course was finished, we got to introduce the first aid kit to the women. We were going to have someone translate for me, but the women were so anxious and confident that they gathered around and no one needed to translate. Afterward, one woman was even able to repeat everything back to the group in Tamil. I am impressed with the dedication of those at the training and am excited for the cycle of education to begin.
Vinu and I were both surprised at the interest and dedication of those at the course. We broke the course down into three sections: precaution, prevention, and treatment. The idea behind the course was not just to train someone to treat extreme emergencies, but also to allow people to effectively deal with everyday minor ailments. For example, it is common practice to put coffee grinds or cow dung on open wounds to help them heal. After taking the course, we hope that people will abandon some of their past ideas about health care, and use some of the new sterile techniques we suggested. We would also like to establish a way for the women and men to refill their first aid kits at a low cost once they use up their supplies. Vinu suggested that we allow those that have completed the course to go back to their instructor and get the supplies they need through Shanti Ashram.
As a second phase for the course, we decided that the women should have time to actually do some of the skills hands on. They need the confidence to use the knowledge they have learned. Therefore, the second training session would focus on practical experience.
One of the women in the training group was interested in being a sort of coordinator for the program and ensuring consistency within the sessions. I am hopeful that the training will eventually turn into a sort of certificate course, where the men and women can have something to show for their hard work. I really feel like the course has been a great success. I ache knowing that I had to leave before everything was finished. I feel as if I left the project up in the air; however, the truth is that I am sure the project will be fine without me. I only wish that I could have done more before I left. I miss everyone.
12 March 2001
Tonight I gave a sad and somewhat abrupt goodbye to Shanti Ashram. I have gotten so attached to everyone there. It has been a real blessing to be involved with such amazing people and such interesting work. Vinu and I held the second session of our training. It is meant to be in two parts, but I think it is going to take at least one more class if they are going to be instructors. We did a more hands-on approach to some of the skills. The time was not nearly long enough, but I think it was still very valuable. They got to do some bandaging along with practicing what to do for someone who is unconscious. We also got more feedback on what they would like to change or add to the class. Everyone agreed that they wanted even more hands-on experience practicing some of the skills instead of just reading about them.
Vinu has done some research, and if this program gets going, it will be the only first aid course in the Coimbatore area. Many years ago, a doctor in town used to allow youth to come observe for a week, and he considered that giving someone training. A year or two ago, the medical school did a sort of one-time, two-hour lecture and gave out a first aid pamphlet. So if this program is successful, there is potential for great impact on the Kovai Pudur community and eventually the entire Coimbatore area. It was really exciting to work on a project that is so basic yet so necessary and important. Also, I feel like it will be really good for the people of Perur Block but can also serve as a template for future programs in other areas. Once the manual is translated it can be used anywhere in the state of Tamil Nadu.
It was extremely difficult to leave Shanti Ashram. I had formed great friendships with many of the women. We had been having an English conversation class on Saturdays combined with the first aid training; we had spent a lot of time together. It was hard to say goodbye, but I knew that they would be awesome in their new jobs as first aid instructors.
As I was sitting on the bus leaving my experiences in the village behind, I began to reflect on those days when I first arrived. I remember how confused I was in looking for something meaningful to work on. I can safely say that I found what I was looking for in Shanti Ashram. I was able to observe an NGO in action and see what it takes to go to the community with these programs. Along with seeing good development in practice, I was also able to use my own skills to help out the first aid program. In the end, I felt a great certainty that my time was well spent working with the people at Shanti Ashram, and the first aid program will be a great success.