Co·co·nut:
1) Cocos nucifera, a drupacious palm fruit endemic to South India
2) an American born Indian who's brown on the outside, white on the inside, exploring his tender core, and exposing his nutty shell

Namaskara-Welcome-Bienvenidos

If you're interested in global health, cultural conundrums, social innovations, and life in India then read on!

Dec 12, 2009

Shit Luck & Slum Health: Dropping Your Phone into Sewage Slush

DISCLAIMER: FECULENT TEXT AND PHOTOS BELOW
VIEW AT YOUR OWN RISK

What would you do if you dropped your cell phone in raw human sewage in the middle of a slum?

This was my dilemma last week in Bhopal. I was rushing to the airport, navigating my way on foot through a slum in Old Town, dodging potholes with my roll-a-luggage, when I bumped my cell phone off my hip clip and it flew into the gulley of raw human sewage, right where I had seen boys pooing the day before. The image of one lad was fresh in my mind. He must have been 3 years old. While maintaining his squat nicely throughout the download, he waved at me with one hand and screamed "Hello, Hello, Vat Yer Name, Vat Yer Name, Hello, Hello?" The image vanished as I realized the task before me.

Option A: Don't even think about going for it. Head to airport.
Option B: Look dejected and deeply troubled until a good Samaritan comes and gets it out for you. Offer them a cash reward.
Option C: Start screaming "Oh No, Hurry Hurry - Aye-oooooo, Julthee, Julthee" As people gather, wave a 100 rupee note and see who goes for it.
Option D: Delve in with your hands and pick it out.

I pondered for ten long seconds.
Mind you this wasn't your average plastic Nokia Indian cell phone, it was my Palm Treo PDA-Personal Digital Assistant. Basically, my secretary was drowning before my eyes and I had to take action. Given my rush to catch a plane and the thought of all the necessary information I had stored in that phone (all my Indian contacts, my calendar, my medical drug encyclopedia and clinical software programs), I chose Option D and fished out the phone. It was submerged in brown tarry goop. A lady in a nearby shack brought me a bucket of water to wash my hands and gently rinse off the phone. I dropped the phone into a spare plastic bag and rushed off to find an auto rickshaw. After airport security clearance, I dashed to the bathroom and used Dettol soap to scrub my hands and my phone. The smell wouldn't go away. While trying to use the phone, I discerned that clots of gunk had gotten stuck in the ports on the bottom of the phone. The phone was optically sensing the micro-poo-pieces lodged in the ports and thought it was the cable connecting to my laptop so the phone was stuck in "Synchronizing with Computer, Please Wait....." mode.

On the plane, I asked the air hostess for a plastic tea stirrer that, to my luck, looked more like an olive spear. I broke it into pieces and used it as a tool to dissect out the poo pieces. After 15 minutes of using my cadaveric trained surgical precision, with full sterile procedure taking care not to fling pieces on my neighbor or get my hands dirty, I had managed to dislodge all the major pieces. "Synchronizing with Computer" had disappeared. Victory! Unfortunately, I had more hurdles ahead. I quickly learned that none of the buttons on the phone worked. I reached home and scrubbed the phone more. The following day, I took it to a phone repair center for a thorough inside clean-job. 250 rupees and 24 hours later, I had my phone back in order with 80% of the buttons working and only 10% of the stench still present.

In a perfect world all kids would poo like this boy from the classic Japanese children's book Everybody Poops.

"washes his hands" "with soap and water" the cartoon forgot to add

Unfortunately, the situation in slums is quite different. Due to the rush to catch my flight and my acute traumatic reaction, I was unable to photodocument my experience. But with a little imagination, you can put the following 3 pictures together (obtained from Google Images) and recreate the exact scene.


I gained great compassion for those who don't have toilets and especially for those slum-dwellers who may occasionally drop something into the sewage gully. This is more than a few little boys. 32% of humans currently live in slums. The UN predicts that before 2030, two billion more people will be crammed into urban spaces. Slum health is a serious issue that I will write more about in future postings. If you'd like a nice overview you can read this article titled Slum Health: From Understanding to Action, co-authored by one of my professors Dr. Lee Riley.

But for now, in honor of going into sewage to get what you really want in life, I present my favorite movie vignette of all time, from the award-winning Slumdog Millionaire. Although I got my cell phone back and was able to rehabilitate it, I didn't get an Amitabh Bachan autograph like this brave soul.

Dec 7, 2009

B'eauPal Stunt- The World's Finest Water Aged 25 Years

25 years of finely aged water, with toxins leached from the world's most notorious chemical disaster, served fresh to Londonites and delivered to the doorstep of Dow Chemicals.

The Yes Men, International Campaign for Justice in Bhopal, and the Bhopal Medical Appeal bring you none other than B'eauPal.

Watch this video of the B'eauPal stunt in London.


Learn more about the stunt here:

Dec 5, 2009

On the Ground for 25th Anniversary of World's Worst Chemical Disaster



Adil is one of a thousand stories of struggle and survivorship in Bhopal. You can read Adil's story here

Last week I had the fortune of attending the marches of the 25th anniversary of the world's worst industrial disaster in Bhopal, India. Over 2 days, I marched with over a thousand survivors and their families.



To see their conviction, courage, and empowerment 25 years later was humbling. 


To see their suffering, anger, and deep-seated sense of injustice was tragic. 


Today I got permission from the government to tour the abandoned Union Carbide factory, the ill-fated American-owned pesticide plant which exploded on "that night." Sadly I witnessed a lack of corporate and governmental responsibility for the neighbors. Little environmental clean-up has taken place. 


Walls between the contaminated area and the nearby slums had fallen down as children played cricket 50 meters from the infamous tanks which leaked tons of methyl isocyanate shown in the below photo. One kid was collecting firewood next to the tanks.  Goats and pigs were feeding inside the contaminated area. While I filmed and photographed near the tanks, I felt light-headed and nauseated. Later, something landed in my eye which burned like acid and I had to wash it with water for several minutes.




You can learn more about the ongoing tragedy through this brief video titled Hush, Baby.



What do they want?  Justice
When do they want it?

If you find yourself concerned, compelled, and would like to help take action  go to Amnesty International's website to contact either Indian Prime Minister Manmohan Singh or Dow Chemicals who now owns Union Carbide. You can also get involved with the International Coalition for Justice in Bhopal.


Rather than use my words to paraphrase what happened and what's happening, you can read these excerpts from the Bhopal Medical Appeal.

Remembers Aziza Sultan, a survivor: "At about 12.30 am I woke to the sound of my baby coughing badly. In the half light I saw that the room was filled with a white cloud. I heard a lot of people shouting. They were shouting 'run, run'. Then I started coughing with each breath seeming as if I was breathing in fire. My eyes were burning.

Another survivor, Champa Devi Shukla, remembers that "It felt like somebody had filled our bodies up with red chillies, our eyes tears coming out, noses were watering, we had froth in our mouths. The coughing was so bad that people were writhing in pain. Some people just got up and ran in whatever they were wearing or even if they were wearing nothing at all. Somebody was running this way and somebody was running that way, some people were just running in their underclothes. People were only concerned as to how they would save their lives so they just ran. 

"Those who fell were not picked up by anybody, they just kept falling, and were trampled on by other people. People climbed and scrambled over each other to save their lives – even cows were running and trying to save their lives and crushing people as they ran." In those apocalyptic moments no one knew what was happening. People simply started dying in the most hideous ways. Some vomited uncontrollably, went into convulsions and fell dead. Others choked to death, drowning in their own body fluids. Many died in the stampedes through narrow gullies where street lamps burned a dim brown through clouds of gas. The force of the human torrent wrenched children's hands from their parents' grasp. Families were whirled apart," reported the Bhopal Medical Appeal in 1994. 

"The poison cloud was so dense and searing that people were reduced to near blindness. As they gasped for breath its effects grew ever more suffocating. The gases burned the tissues of their eyes and lungs and attacked their nervous systems. People lost control of their bodies. Urine and feces ran down their legs. Women lost their unborn children as they ran, their wombs spontaneously opening in bloody abortion." According to Rashida Bi, a survivor who lost five gas-exposed family members to cancers, those who escaped with their lives “ are the unlucky ones; the lucky ones are those who died on that night.” 

On the night of Dec. 2nd and 3rd, 1984, a Union Carbide plant in Bhopal, India, began leaking 27 tons of the deadly gas methyl isocyanate. None of the six safety systems designed to contain such a leak were operational, allowing the gas to spread throughout the city of Bhopal.[1] Half a million people were exposed to the gas and 20,000 have died to date as a result of their exposure. More than 120,000 people still suffer from ailments caused by the accident and the subsequent pollution at the plant site. These ailments include blindness, extreme difficulty in breathing, and gynecological disorders. The site has never been properly cleaned up and it continues to poison the residents of Bhopal. In 1999, local groundwater and wellwater testing near the site of the accident revealed mercury at levels between 20,000 and 6 million times those expected. Cancer and brain-damage- and birth-defect-causing chemicals were found in the water;

Dec 2, 2009

For Emergency Dial Auspicious 1-0-8, not 9-1-1

Get your cell phones out and put 1-0-8 on Speed Dial in case you find yourself in India with an emergency. Although certain Indian states tried using 911 as the code to dial (based on  Western movies and TV shows), some locales faced excessive prank calls and the number 911 was discontinued. Furthermore, the average Indian can remember 108 much easier than 911 based on its cultural significance (read on!).

Surprisingly, India has never had a coordinated Emergency Response service until a public-private partnership sprung up in 2005. The Emergency Management and Research Institute (EMRI) has handled emergencies in an increasing number of Indian cities and is now present in 10 of India's 28 states. It is a toll-free 24-7 service for health, fire, and police related emergencies.  Testimonies vary from hour long waits to prompt service. Some people still prefer to take their loved ones directly to an Emergency Room, or they have the number for an ambulance based at the closest hospital to where they live. However, most people panic and don’t have such prepared plans, thus 108 is providing a niche service to many in unanticipated need.

In Tamil Nadu, the Southeastern Indian state where I’m based, Mrs. G. Saraswathi got up close and personal with this new service when she delivered twins in the ambulance at the hands of paramedics. So far 15 deliveries have taken place inside the ambulances in Tamil Nadu. Since the service was introduced, 1,709 calls have been attended to reports a Special Correspondent from The Hindu on November 5th.

Why 108
It's a favorite astrological number in Hinduism, Buddhism, Jainism, and Sikhism that has many meanings.
*The prayer beads that Indians use (japamalas) have 108 beads.
*Ancient Vedic scholars correctly predicted that:
-The distance between the Earth and Moon is 108 times the diameter of the Moon
-The distance between the Earth and Sun is 108 times the diameter of the Sun
-The diameter of the Sun is 108 times the diameter of the Earth
*Ayurveda, Indian traditional healing system, believes there are 108 pressure points.
*Lord Shiva's cosmic dance, Nataraja, is done in 108 poses
*Lord Krishna flirted with 108 gopis: cow-herd-girls
*Most Hindu deities have 108 names that are ceremoniously recited
*Many Buddhist temples have 108 steps
*In mathematics 108 is a semiperfect number and a tetranacci number
*Hundreds of other 108 significances can be viewed here:

108 for 1.1 Billion
1.1 billion people become a challenge for scalability of such emergency services. In addition, crowds and Indian traffic create extra hurdles for 108. This photo I took shows a 108 ambulance trying to penetrate a huge crowd of pilgrims taking up the road.

At this pilgrimage I attended ~500,000 people came to walk a holy circuit and the one lane road was packed like sardines for over 24 hours straight. The pilgrimage was a challenging 14km around a mountain, which must be undertaken barefoot, in a sea of people, which I equate to a 5-hour moving mosh pit. Children, the elderly, and the disabled do the circuit as well for many believe that completing the pradakshina (circumambulation) will bestow you with good health and success. I saw one man with a shortened leg hobbling along in makeshift crutches and suddenly my toes (which I stubbed 3 times amongst the crowd) didn't hurt as much. Throughout the night I saw several 108 ambulances battling the crowds trying to get through and I wondered how 108 is faring in other parts of India.

Dec 1, 2009

Sexual Slavery's Biggest Challenge-Civil Society Silence


                                                                   Image from Prajwala
Can you break your culture of silence? Can you offer compassion to survivors of sexual slavery? Will you hire them, let your children study with them, treat them as equal human beings?


TED reports "Each year, some two million women and children, many younger than 10 years old, are bought and sold around the globe. Impassioned by the silence surrounding the sex-trafficking epidemic, Sunitha Krishnan co-founded Prajwala, or "eternal flame," a group in Hyderabad that rescues women from brothels and educates their children to prevent second-generation prostitution. Prajwala runs 17 schools throughout Hyderabad for 5,000 children and has rescued more than 2,500 women from prostitution, 1,500 of whom Krishnan personally liberated.

Krishnan has sparked India's anti-trafficking movement by coordinating government, corporations, and NGOs. She forged NGO-corporate partnerships with companies like Amul India, Taj Group of Hotels and Heritage Hospitals to find jobs for rehabilitated women. In collaboration with UN agencies and other NGOs, she established printing and furniture shops that have rehabilitated some 300 survivors. Krishnan works closely with the government to define anti-trafficking policy, and her recommendations for rehabilitating sex victims have been passed into state legislation."


In this courageous talk, she tells three powerful stories, as well as her own, and calls for a more humane approach to helping these young survivors rebuild their lives. See her harrowing TED India talk below.