Jennifer Hicks’ Blog

July 7

July 7, 2007
So…the internet went down in the entire state of Bihar for nearly two weeks.  It just came up again now that I’m in Delhi.  So, another 27 hour train ride of fun.  I got to eat McDonald’s today.  I took the girl that picked me up at the station for a feast.  The girl taking the order was laughing at us becuase I just kept ordering so much food.  I’m so sick of rice.  No more for a while.  You can only have so much rice and mangos.  Seriously.  Anyway, I’m safe in Delhi, staying at the YMCA again.  I saw the Jantar Mantar (spelling??) today, some wacky historical clock down the street.  Look it up, it’s pretty.  Some guy in the park proposed to me and started singing about how he loves me.  Don’t worry mom, I ran away from him as fast as I could :)  I already miss my new friends from the hospital.  They all took off work to see me off and Rimi came with me to the train station.  I cried when she left.  It’s been so long since I got to write home and so much happens every day that I don’t even know where to start to catch up.  There’s one case that’s really been stuck in my head the past week.  Pawa Kumar-botulism poisoning.  They tried to send him to patna, but on the way, they didn’t use the ambu bag properly and had to turn around because he had a pneumothorax.  His eyes are opening now which is a good sign, but he’s still got such a poor prognosis and now a collapsed lung on top of it.  The staff is getting frustrated with the father b/c they keep explaining the poor prognosis to him and he won’t give up and keeps on them.  It’s very sad.  I finally got to see the father the other day.  He’s so sad and exhausted.  Of course he doesn’t want/can’t accept what they’re trying to tell him.  I’m exhausted from the train ride and the feast and the running away from the crazy man, so I’m going to get off here and go to my room and sleep like rip van winkle for awhile.

June 29

June 29, 2007
I have no idea when this email will finally be sent.  Communication is such
a huge frustration here, both with the people that don’t speak English, the
people that know but refuse to speak English, and with the internet.  All
that aside, I’ve been dying to share some things with you.  It seems way too long since I last wrote.  A lot has happened in the past week or so.  I went out to see what the community health programs are doing.  One group teaches midwives safer practices, a skill here that’s passed down generationally with no formal training.  I think maybe I told you about this already..but they are so ignorant about deliveries.  It’s a really good target to reduce maternal deaths.  There’s also a physical therapy team and these guys are so cute!  They’ve trained two or three guys on exercises to do with disabled kids and they go out on their motorbikes to visit each kid weekly.  The families are generally very receptive.  It’s really important to motivate the family to take interest in their kids; otherwise, it just doesn’t work. On my last trip to the community I remember the last two houses clearly. The first was such a cute baby!  Dipa.  She’s a cerebral palsy patient. Once they started coming out and made some progress with her the family got so excited.  When I was there, the grandpa came running and couldn’t wait to show us that she could stand by herself.  They work with her every day and are so proud of her.  I couldn’t wait to find a connection that worked so I could write home about the poster child for physical therapy success.  Then I got to the next house.  The girl that we had come to visit died four days before.  I stood there like a total intruder, a foreigner in the wrong place at the wrong time.  Even if I’d known the language, I wouldn’t have known what to say.  I wanted to cry with them.  The family was so upset, especially the grandmother.  I waited while Silas offered condolences and collected her little wooden yellow chair.  The hospital loans out these chairs for physical therapy.  He strapped it behind me on the motorcycle and off we went, that little yellow chair slapping me all the way back.  I think I still have a bruise.  I was so uplifted before we got to that house, and then so so humbled.

I spent the first part of this week in OB/GYN.  One patient that came in a
few days ago is still haunting me.  Asha Devi (everyone here is either a
Devi or a Khatoon).  Anyway, she’s 20 years old, married, 30 weeks pregnant with her husband’s child, and her chart reads, in broken English, ‘wants to abortion’.  Dr. Anand counseled her for a long time and gave her a track about Christianity.  She cried and cried.  It was obvious that she doesn’t want an abortion.  I learned something new about the culture here.  Girls are married off as early as 13, but they don’t join their husbands until later; they continue to live with their families for some time.  When they do come together, there’s a ceremony and until then they are not supposed to consumate the marriage.  They hadn’t had their ceremony yet.  It’s so sad. She’s so far a long.  Everybody has to know she’s pregnant anyway.  Please pray for her and all the other women here.  Their husbands and families dictate everything for them.  They’re so ignorant, but even so, I see some hope in them from time to time, some obvious desire to do what’s right for themselves and their kids.  The next president of India may be a woman. Things may be changing, slowly, but non-the-less…

I keep noticing children that come in, girls dressed like boys..I can’t get
a straight answer about why, nobody seems to know.  I’m wondering if it’s
because people want boys so badly that they just want people to think they have a boy or maybe they’re so ignorant they think if they dress like a boy they’ll be a boy.  Nobody here seems to have much regard for the
intellegence of people here.  They really are so so ignorant, but if having
a girl is such a hardship for the family (because of the dowry they have to
pay for marriage), I don’t understand why they don’t just keep their girls
at home.  I’d like to think that maybe they’re being sneaky and trying to do
that by letting people think they have sons instead of daughters.  Maybe
not, but as wierd as these people can be, I have to think there’s got to be
a reason.

Now that I’ve written a novel for you…it hit me yesterday that I’ll be
coming home soon.  I’m going to miss Raxaul.  At the same time, I’m really excited to come home again with a new appreciation for the things I’ve taken for granted.  Even here, I think I take things for granted, like electricity and food and showers and toilets, things that aren’t an issue for us in the hospital compound, but are hard to come by on the outside.

June 23

June 23, 2007
Hey all!  I get to use the broadband connection in the director’s office today!  Such a treat!  Thanks for your emails.  I finally got to read some of them today.  I’ve been out in the community for the past week and it’s been a really good experience to see more than the problems everyone has, but to see how they live and get along.  Bihar doesn’t give a person a good first impression, but it’s grown on me.  As with everything, even if it’s hidden, there’s always some beauty.  I can’t wait to get home and sit in the airconditioning and share my stories with you :)  I have so many stories and not enough time to get into them.. but know that I’m learning and growing a lot.  I’m more sure than ever that I belong in a mission hospital.  I hope you’re all doing well.  Keep praying!  I’ve started riding on the motorbikes even!  (Don’t worry mom, I won’t be going out on the motorbike anymore and I’m still in one piece).

June 21

June 21, 2007
So..I THINK you’re supposed to drive on the left side of the road in India, but that’s about as predictable as the oncoming traffic and the rain.  Anyway, I don’t have long.  I just wanted to let you all know that the internet connection I was using isn’t working anymore so you probably won’t get many more messages from me.  I’ll keep trying though.  Anyway, I’ve been going out to the villages this week and seen a lot of really interesting things.  It’s good to see families in their home context.  The families I’ve visited are very sweet.  It’s been a very eye opening experience so far.  I’m learning as much about myself as I am about India I think.  Sorry I don’t have time to write more for now.  I’ll fill you in on all the details later though.  But I am having fun and learning a lot.  I hope you’re all doing well too.

June 13

June 13, 2007
Hello again!  The trials continue..today was an emotionally exhausting
day.  The kids here are often literally at death’s door before they’re
brought in.  And so much effort goes into reviving babies that are
practically dead, that well babies don’t get the attention they need
and crash too.  Please pray for 10 year old Ajay Kumar.  He was
brought here and abandoned.  I met him two days ago wondering around
the children’s ward with tennis balls in his pockets, a very sweet and
innocent boy.  Today he is in ICU.  It’s shocking to see how quickly
kids go here.  I think I’ve fallen in love with this one.  I wish I
could adopt him.  He’s so innocent and so alone, the story of a lot of
kids here, neglected until they’re practically dead.

The woman that I mentioned that was poisoned is still in the ICU.
Today when I went in to check on Ajay, she was having a psychotic
episode due to the drugs she was given (I’m told that this was
actually a good thing, a sign that the drugs are working), anyway, she
latched on to me and wouldn’t let go, screaming Didi Didi! (Sister,
Sister!) and a bunch of other things I didn’t understand.  I tried to
find out what she was saying, but was only told that she had gone mad.
She seemed terrified.  I felt as if she was begging for someone to
save her.  I asked Dr. Baby last night what will happen to her.  She
said that in these cases, they are stabilized and they go away
smilingly back to the families that poisoned them.  There’s not much
else to do since there aren’t really any enforcements for women’s
protection.  It’s very sad and scary for these women.  There are two
Indian doctors here I’ve made good friends with, Sofia (dentist) and
Rimi (paediatrition).  They say that things are better in the other
areas of India, especially the south and the east; they say that this
place is the worst.  Dr. Baby was telling me that Bihar has the
highest of everything except for AIDS, highest illiteracy, highest
mortality, etc.

On a less depressing note, I ventured out yesterday with Sofia for an
adventure outside the compound.  We walked over to a lepor colony
about 15 minutes from here.  I have to give them credit. They’re doing
well for themselves there.  They’ve created their own little society.
They raise chickens and cows, weave their own fabric, and sell it all.
They’ve created their own local economy.  Each family has a house
with two rooms and a kitchen.  It’s actually very impressive, the
cleanest most civilized corner I’ve seen in Raxaul so far, by far.
It’s run by catholics and funded completely by a source in Canada.
The kids were fun too.  They all wanted their ’snaps’ (pictures)
taken.  I felt like a celebrity.  They all ran up to me ’sister
sister!’ and posed and had a good time.  It was a good relief from
life inside these walls, knowing that life goes on outside of the
hospital.  On Saturday I leave for a week with the community health
projects.  Until then, I’ll be in the ICU, so I’m sure I’ll be ready
to get out of here.  Just walking through the ICU is intense.  So many
people gasping for breath..or clinging to you in a psychotic
episode..usually they’re tied down to their beds b/c they writhe so
much.  Today I saw a young boy with a head injury, his head swelling
intensely before our eyes.  He needs a hole drilled in his head, but
we have to wait for the family to deliberate about it and by then it’s
probably too late.  I didn’t see the outcome, but I’m sure I’ll hear
about it tomorrow.  If I never see another case of tetanus, I’ll
consider myself blessed.

Sorry!  I somehow got back on a depressing note..um..there really are
good things going on.  It’s just hard to focus on the happy cases when
there are cases like Ajay’s.  He was begging an old woman the other
day, calling her grandmother, to stay with him.  I’ll have some more
happy stories for you next week, I promise!  In the meantime, please
keep these kids in your thoughts and prayers.  There’s a baby in the
nursery whose mother died during delivery; we don’t know if the family
will take him or not.  He’s such a sweet baby, number two on my ‘want
to adopt’ list.

June 11

June 11, 2007
Day 1 in paediatrics…so a crying baby after a delivery is a
fantastic sound, today though, in the outpatient unit, not such a
fantastic sound. I think the peds ward is the most insane chaotic
mess I’ve seen yet. The doctors’ office is right next to the
immunization room, which means, babies go into the room next door, get
poked and start screaming bloody murder. So all you hear while you’re
trying to see patients is crying and screaming. Both paediatritions
use the same office, and desk for that matter, to assess outpatients.

We started the morning rounds in the ICU this morning. I told you
about a young man whose family had poisoned him. Now there is a young
woman in the ICU, also for poisoning from her family. This seems to
be fairly common and very sad.

I saw a baby die today. He had meningitis and had appeared to be
doing much better this morning. I watched uselessly as Dr. Rimi tried
to revive him this afternoon. They have very high death rates here.
The nurses aren’t trained well enough, the doctors are short staffed,
and they need equipment. They don’t even have a proper incubator or a
ventilator. This particular baby needed a ventilator. Dr. Sunil says
that the hospital has several donors, but they all want to earmark
their donations for projects, something they can assess the outcome of
with graphs and charts and whatnot. He says it’s very hard to get
donors to donate for equipment and facilities, the hospital’s most
dire needs at this point.

I was reading in the ‘Hindustan Times’ paper yesterday. India finally
came out with its own statistics about their HIV statistics and how
they’re “only” (it actually said ONLY) 3 million and something, not
the 5 million and something that came out in the UNAIDS report. I
wonder how much time and energy and funding was poured into this
report. The government is a lot of the problem here. There’s a woman
from Brittain here, Edna; she’s one of the community health project
directors. We had a long conversation about politics last night. It
seems that there is a lot of corruption and little consequence. When
scandals are found out here, it’s not the embarrassment that it is in
the US. India is a huge democracy, but unfortunately, the people are
ill informed and don’t understand their power. Their votes can be
bought fairly easily either with actual money or empty promises.
There’s not a whole lot of accountability here. Things are made to
look good on paper, but are not what they seem. There are seats
reserved in offices for women, but if they are unable to attend, their
husbands go in their stead, so you don’t know if you’re electing a
woman or her husband.

I’m feeling a bit overwhelmed for several reasons. Obviously, this is
nothing like anything I’ll see in the US. On top of the sheer
intensity of the cases and the people, not understanding their
language is stressful. It’s exhausting even to talk with the doctors
because of their accents and because they are so soft spoken. I feel
very foreign here and I’m staying in the guest house alone. They tell
me that there are usually other students, but for now I am the only
one, so it’s a bit lonely, especially since there isn’t much to do
outside of work. I’m realizing how much I have to learn too, also
exhausting, but a good thing. I think I’ll leave here with a renewed
focus. There’s so much to learn and review. I’m wishing I had my
text books with me. I’m learning so much about medicine and life.
Keep me in your thoughts and prayers.

June 9

June 9, 2007
So!  Day three in surgery is over, and I’ve seen so much!  I’ve scrubbed in for several surgeries including a circumcision, hydrocoele repair (if you don’t know what a hydrocoele is you probably don’t want to; for you fellow medical nerds in K-ville..I can’t wait to tell you how to fix it!), bowel decompressions, bladder stone removal (the size of a marble!), mastectomy, tubal ligation (female sterilization), I&D of abcesses, cervical C&D’s, and two C-sections.  They see a lot of incomplete abortions here.  Because they are a mission hospital, they don’t offer abortive services.  The sad thing about it though, is that that doesn’t deter people.  Instead they try to perform their own abortions and end up at the hospital anyway with complications, so I’ve seen several C&D procedures already…and today I saw a three month fetus (a bit bigger than a marble, but not much..).  Mostly, what I’ve noticed is a lot of patients with abdominal complaints.  Dr. Sunil (the medical director and general surgeon here) says they’ve seen a lot of necretizing enteritis lately and they’re not sure what to make of it.  Basically, patients come in with a whole lot of symptoms, but when they’re opened up, the surgeon can’t really pinpoint the problem.  I’ve seen so many things..I don’t even know where to begin or where to end!  I could go on and on!  Aside from the plethera of medical fascinations I’ve seen recently, life is good.  The doctors smuggled me into Nepal last night for a very lovely dinner.  It turns out that there’s nothing to do here in Bihar.  People used to go to Nepal a lot more too, but due to some political problems, Nepal isn’t much better these days.  I wonder how they keep from burning out without any outlets nearby.  I think they have a high turnover here.  Many young people are lured here through hospital sponsorship of their educations, both nurses and doctors.  They don’t stay long after their obligations are filled though, or women that come to work get married and leave.  Somehow the hospital sustains itself though.  Every morning is started with an hour long devotional at 8:00 and every surgery is prefaced with a prayer.  I think faith has a lot to do with keeping this place and its people going.  As for the people who come here for services, there are all kinds.  It’s tempting to categorize them, but as with everything, things are never as they seem.  I’ve seen all sides of the spectrum here.  There are those who have little value for life.  The first day I was here, I saw a man and his family bargaining surgery prices over his death bed.  The doctor kept telling them not to worry about it, that they would work something out; they just kept fussing.  Then, there’s the man who’s got a terrible case of TB.  He came in with abdominal symptoms, and unfortunately, he also had ascites..apparantly, a condition for which you should most definately not open the abdomen.  It wasn’t caught though until the abdomen was already opened.  He’s being kept here, but they don’t know what more to do for him.  He’s very poor and couldn’t afford to go elsewhere even if he could.  He has two friends staying with him.  Every time the doctor comes to talk to them, they look like they are about to cry.  They don’t seem to have any regard for the price; they just don’t understand why he’s not getting better.  Then there’s the case of a young man that came in with poisoning.  He was stabilized and ready to go when he had a total relapse of symptoms.  The staff strongly suspects that the visiting family members re-poisoned him.  He died this morning, over a land dispute.  But, then I see a certain baby girl’s father stalking the doctor.  His eyes are so pleading.  He looks near tears every time I see him.  She had an appendectomy and is actually recovering well.  He just doesn’t understand what’s happening.  Again, I can go on and on and on.  Every case here is intense.  People don’t come here for frivelous reasons, and many times there’s an underlying personal story developing that’s as equally as shocking as their clinical presentation.  My biggest frustration is the language barrier.  Next week, I’m assigned to pediatrics though.  Kids don’t seem to care so much if I can speak their language.  After seeing two C-section births today, I have a new appreciation for their little lives, watching them come out all blue and praying that they start to cry, and then watching the mother’s vitals drop and praying that she makes it too.

Outside of hospital life, it’s been sprinkling here and there and cooling off quite a bit.  I’m told that monsoon season has just begun.  We’ll see what else the weather brings..

If you’re feeling adventerous or bored or miss me so much you can’t stand it another minute (I know you do!)…you can try to call me.  There’s something like a 14 hour time difference.  I don’t have much time here, so you’ll have to look it up, but your best chance of catching me is in the evening or early morning between 7-8.
011-91-6255-220 653 extension 252
If a surly man answers and refuses to speak English, that’ll be the cook.  Don’t mind him.  He’s not so bad and he makes a really good mango sherbert ice-cream something or other…

June 6

June 6, 2007
I’m sorry..did I say 20 hour train ride? I meant 27! At any rate, I survived the train ride. It was a long, crowded time to go without hearing any English. Despite having entirely different interpretations of rudeness here (public urination, belching, farting..all completely acceptable here), the people were very hospitable even on the train. I was offered many cups of chai and begged to try their Indian sweets and samosas. Bihar is good so far. I got in last night. Today has been a general orientation of the campus, which is actually much more impressive than I had expected. There’s a lot going on here. I’m going to spend the rest of the week in the surgical ward, next week in pediatrics, the next week in the community health projects, and some time in OB/GYN and ophthomology as well, and then settle in wherever I’m most interested after that. I’ve already seen quite a bit just wandering around today. I’m very glad I was delayed in Delhi a couple of extra days. It gave me a little extra time to absorb some of the cultural norms and practices. In response to your question about the kids working, Angelina..they sell trinkets and food on the streets and some of them are maids. The conditions they work in are deplorable in many circumstances. Zarema told me that it often happens that a child’s father will, in affect, sell their children when approached in exchange for a lot of broken promises of certain wages and conditions. She says that she won’t give them money because she knows it won’t go toward them. Instead she offers them food when she can. We went out to dinner and watched as a family ate in front of their maid. She was brought along to watch after the children. Toward the end they gave her a little bit of food, but Zarema said that that was actually very generous of them compared to many of the families she’s seen. It’s very sad how readily and often childhood innocence is stripped away here. It would be very easy to be detered by many of the sights here, but despite it all, there is still a lot of hope here. I think empowering and educating women will have a lot to do with improving the future of these people. This is a culture where children and women are very dependent on men. If a woman does not have a father or a husband or a son to take care of her, she is pretty much powerless here..it will be interesting to see how they percieve me. Anyway, on a lighter note, the cook here is notoriously grumpy. I was warned well in advance. I’m quite pleased though. He’s either smiling at me or laughing at me, but either way, at least he’s not being surly. I’ve already been invited to two houses for tea. The first was an eccentric old man who is a patient here. Neither one of us understand a thing the other is saying, but we were thoroughly entertained with each other. The second was Dr. Helen, an optholomologist here. I’m excited to meet with her. She is the senior doctor here, having been here for 30 years. Enough yammering though. I must go have some tea before the 6:00 faculty meeting.

June 1

June 1, 2007
Namaste! (it means hello AND goodbye!)–
I just wanted to let everybody know that I am in New Delhi, safe and sound.  I am being well looked after by a pastor’s wife (Zarema) here.  Last night and tonight I am at the YMCA (they’re everywhere) and it’s actually a very nice hostel.  The next two nights I’ll spend at Zarema’s house..and then she’ll load me onto the train to Raxaul.  She’s done very well so far at easing me into this chaotic culture, so well that it’s starting already to seem a bit less chaotic.  Life here is different in many ways, but at the root of it all we don’t seem so different after all.  I saw my life flash before me in the taxi..several times..but alas, they really do seem to have driving insanely down to an art form.  I’m not sure how long I have on the computer.  I may not get to all of my messages, but I will continue to give you all updates whenever I get access again to a computer.  I went dress shopping today, a bit of an adventure in itself.  The market is an interesting place.  It’s full of color and life, but at the same time, you see many beggars and homeless people here.  On a happier note, I woke up to something much better than an alarm clock.  At 5:00am it sounds like a tropical jungle outside.  There was a man in the courtyard mocking one of the louder birds.  I found it quite entertaining.  So!  Long story short, I am here and safe and already learning a lot.  Thank you for your prayers…I’ll need them as long as there are taxis in this country

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