Eye on my foot

Namaskar

Yesterday I got a piece of eye on my foot.

I was in the operating theatre. The surgeon had just extracted the lens from a cataract patient. Passing his tools and the lens to the nurse, she threw the lens at the bin – which missed and landed on my foot. We all had a bit of a laugh – being hit by a piece of a patient’s body is funny in any culture.

The view from my room at dusk

That’s about the only exceptional thing worth reporting. The rest of this post deals with the mundane, to give you some idea of what life is like in this part of India. Forgive my tardiness in posting, but the hospital internet tubes have become blocked again, so I have to walk 30 minutes each way to the internet café in the village.

                           

Accommodation

Despite the Orwellian overtones, room 101 is good without being plus-good. The bed is un-good. The roof fan is a life-saver, although power cuts at night leave me uncomfortably hot.

Food

Something I love so much, I engage in it at least three times a day. Breakfast usually consists of a selection of (in descending preference):

-         2-minutes-noodles-in-a-vaguely-curryish-sauce

-         bananas, which are about 10cm long over here

-         breakfast-vege-curry-with-peas

-         deep-fried-bread-with-curried-potato-stuff

A surgeon investigating a patient using the slit-lamp

If we’re heading out to the vision camps, we’ll stop at a local restaurant, which serves the vege curry with either bread (pudi) or funny little rice cake things (idli). I can confirm that a sample of available Orissans and Bengalis do not like Vegemite and think it tastes ‘like medicine’ – not surprising, as few raised outside Australasia can tolerate Vegemite (apart from a couple of Québecois).

Lunch usually consists of rice with dhal on top (yellowy curried lentil sauce), plus some combination of fried/curried vegetables with the occasional fried egg. I’ve had fish twice and chicken once in 20 days. Dinner is pretty similar, but with the addition of chapatti (flat bread, like tortillas).

Orissans eschew utensils and eat with their (right) hand – I think this occurs all over India. I have progressed to the hybrid right-hand-plus-fork-in-left-hand method, because frankly it is pretty tricky eating rice with your hands. I aim to be proficiently utensil-less by the time I get to Nepal.

The food isn’t bad, but it makes me realise how spoiled for choice we are in the West – particularly Auckland and London. In the week before I left London, I ate Chinese, Polish, Eritrean, Vietnamese, South African and a massive bloody steak (oh how I crave red meat). Here – it’s pretty much the same food every day. Sadly, the Indian dishes I love the most are from different parts of India (i.e. Vindaloo is from Goa, on the other side of the country). I haven’t managed to find a curry to beat the balti chilli masala from the brick lane Clipper, but I think I can by November.

Language

Wow, this is tricky. There are many, many languages in India. They speak Oriya here rather than Hindi. A few hundred clicks up the road they speak Bengali, although is similar enough to Oriya to allow cross-communication. Most of the staff here speak English to varying degrees, although the tricky thing for a native English speaker is to adjust to Indian English which has very different pronunciation. I was asked one lunch if I wanted ‘peas’ – I said yes, and some fish showed up. Oh, ‘peas’ is fish. Right. Being white usually means people (usually) speak English to me, although a few have tried speaking Oriya and appeared shocked when I stared blankly back at them (Oriya is hardly the first-choice Asian language to learn in New Zealand…).

Cultural differences

We’re certainly not in Kansas anymore, Toto. I should have written about ‘cultural similarities’, which would have been a shorter paragraph consisting of one word: cricket. I’m trying to get my head around just how populous India is. Orissa has 37 million people – about 9 times New Zealand’s population. Orissa has only about 3% of India’s population. ZOMG. New Zealand is tiny.

Elmo is a God here?

I get stared at a lot here. To be fair, I’m in a pretty rural part of India (think of flying into Gore then driving a few hours into the wops) where foreigners are pretty sparse (again, we forget what cultural melting pots London and Auckland are). Orissans apparently don’t have the same taboos against excessive staring that we do in the Anglo world – even returning the stare doesn’t stop the staring. I’m starting to get used to it now, but it does make you feel a bit paranoid.

Strangely enough, barely anyone smokes over here. Instead, all the cool kids chew a combination of tobacco and betel nut. This results in a lot of spitting, and red spots all over the ground; in addition to staining teeth brown. I have seen a few shops selling beer, but alcohol certainly doesn’t have the same visible presence it does in NZ & UK. Needless to say, I’m looking forward to the first beer in Mumbai when Nick and Ben arrive!

Rush hour in Orissa

Transportation

Wow, I’m glad I don’t have to drive here. There appear to be no road rules, and eternal horn use is the price for, um, partial safety. The only norms I have picked up is that traffic gives way to those coming on to a roundabout, and that it is the duty of the oncoming vehicle to avoid a collision – people will cross the road or pull out at any moment without looking. Oh yeah, and try to avoid the ubiquitous cows, goats and pigs on the roads. Buses are full of people (both inside and on the roof). I have yet to see the iconic ‘train with people clinging precariously to the sides’, but I will be taking a train in a week so we’ll see.

Some of the decorated trucks that grace Indian roads

Oh, and there are countless thousands of trucks painted in bright colours, like these:

I only have a few days left at the hospital, before I am off on my own again. I will be spending a few days around Orissa, heading to the beach and checking out a zoo with white tigers.

Until then, Namaskar!

My first two weeks in Kalinga Eye Hospital in Orissa, India

Namaskar from Orissa!


Having been in Kalinga Eye Hospital almost two weeks, I thought I had better fill everybody in on how the experience has been (yes Mum, I am still alive), and how your generous donations of money and glasses have been utilised.

After a rainy couple of days in Mumbai, I flew across to Bhubaneswar in Orissa, on the east coast of India (just down from Kolkata). I was met by a driver and taken to Dhenkanal, a small town in the rural interior of the state of Orissa – the location of Kalinga Eye Hospital (KEH), where I am spending the month. Orissa is one of the poorest states in India with a population of 37 million people, 85% of whom live in rural areas far from health care facilities.

The doctor screening patients at an outreach
camp

KEH operates outreach camps, in which a team of ophthalmologists and paramedics drives to remote villages and screens patients for eye problems. Patients are brought back to KEH for surgery and further care if required, or treated on the spot when possible. Most patients brought back to the hospital require treatment for cataracts – a common condition where the lens inside the eye has become opaque over time, leading to loss of vision. Treatment is a quick operation involving the removal of the affected lens and insertion of an artificial intra-ocular lens (IOL). It is interesting to see how much more severe cataracts are here, and how they occur in much younger individuals than in developed countries. At Moorfields Eye Hospital in London I saw patients with cataracts, but they were nowhere near as severe as the cases here.

The surgeon and nurses in theatre

The efficiency and productivity of the staff is amazing – each surgical list can involve up to 40 patients in a morning, and some cataract surgeries take as little as 6 minutes! There are two side-by-side operating tables and nurses prepare one patient while the surgeon is operating on the other, enabling the surgeon to switch to the new patient once he is finished (see picture). For the ophthalmologists reading this, the surgeons primarily use the SICS technique with locally-made IOLs on patients under local anaesthetic and peribulbar/retrobulbar blocks. As your donations pay for these surgeries, the hospital requires a Unite For Sight volunteer to be present in the operating theatre, so it is good to be able to physically see how the money is being spent. After surgery, patients are provided with sunglasses to prevent sun damage while the eye is healing, and reading glasses to see close objects (as, unlike a natural lens, the artificial lens cannot change shape to focus on close objects).

I am holy. Go around me.

Conditions here are very hot and humid. I am here during the monsoon season, so heavy rain is a frequent occurrence. Electricity and internet work most and some of the time respectively. I am eating tasty vegetarian meals thrice daily, although I am really hankering for a steak! Cows are holy to Hindus, so beef is strictly off the menu (at least until I get back to Mumbai). I suspect that cows know this, and wander freely around town and country – including on the roads, where they will frequently stop and rest (see picture). The hospital staff are friendly and speak varying amounts of English, although I am sure they think me odd for putting vegemite on chapatti bread, and being 1-2 feet taller than most of the people here. However, I think I made up for the strangeness by showing my love of cricket, and not being too smug when New Zealand thrashed India by 200 runs the other day!

 

In the operating theatre

I have spent the first two weeks with Alina and Pallavi, two American students who are also volunteering with Unite For Sight (Emma – Alina goes to Cornell, I asked, but sadly she doesn’t know you). My days are spent either traveling to outreach camps, in the operating theatre, or working on projects with hospital management – I am researching ways the hospital can market itself to attract more paying customers, and improve its sustainability by reducing the dependence on charitable donations and NGOs.

Paramedic taking a patient's blood pressure

I want to thank everyone who has contributed to this worthy cause, in particular Sue Boucher and the Chichester Lions club, Peter Ring and friends and family for the donated glasses (they all made it here unbroken!), and Mr. Alex Ionides, Mr. Gus Gazzard and Mr. Sai Kolli at Moorfields Eye Hospital in London for the training and use of the focimeter. Thank you to all who have contributed to this very worthy cause, and I hope this email has provided an insight into how these donations have made an impact on people’s lives here.

James