Another day, another dollar

Today was another day of class. We had a doctor from Pallium speak to us about communication skills, focusing on communicating bad news to patients and their families. It was very interesting because in the United States the patient is given all of the information and can choose to withhold that information from their family. However, in India the reverse is true: families get all of the information and choose if the patient should learn the truth. It was very enlightening.

Adam and I didn't do much after class today...being abroad can be tiring and I think we just needed a relaxing night in. We read a little, watched "Ocean's Eleven," and ordered room service.

One thing I wanted to mention was our trip to the beach on Saturday. About half of us contributed money and we paid a taxi bus to drive us to one of the popular beaches which is 19 km away. The driver also stayed at the beach and gave us a ride back!! Talk about service. The beach was so pretty and the water was perfect! One thing that was a little different was the swimsuit attire. We were the only girls wearing two-piece swimsuits. Add that to our "bright" skin and I felt like we stuck out a bit! But it was really fun and we hope to go back again before we leave.

The beach at Kovalam. 

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A message found on many walls in Trivandrum. Apparently, writing this ensures that no one can place "bills" or posters on your wall in the hope that your wall won't turn into this:

A houseboat, more class, and a birthday!

These past two days have been quite busy for Ryanne and I!  Yesterday we took a four hour bus ride along with our group to Lake Alleppey, which is about 140 kilometers north of Trivandrum.  It was a very bumpy ride that included our first stretch of Indian highway driving.  This made the driving within the city look quite calm (with highway speeds for a bus heading up to 80 km/hour).  After arriving at the lake we boarded a large houseboat and were served a mango fruit juice while we pulled away from the dock.  We traveled around the lake for the next six hours where we saw a bird sanctuary, ate a delicious lunch, and played a few games of cards. Most of us were quite tired, with bad sunburns, once we hopped on the bus to head back up to Trivandrum.  We stopped for dinner on the ride south at a nice lakeside resort where I had one of their specialty dishes, a chicken curry on top of a fritter...to me it seemed like chicken on a pancake, DELISH!  We got back to our hotel around 11 PM last night and slept in until about 9:15 this morning to make it to class at 10.  We must have been absolutely exhausted from such a long day in the sun and 8 hours total on an uncomfortable Indian bus.

Our class this morning was one of the best so far.  We had one of the doctors from Pallium India speaking to us about good communication skills for much of the day.  The man was very bright and was able to not only teach great communication skills, but do it while crossing into the context of another culture.  This seems to be an ongoing theme for us here in India within our home visits and lectures.  We may be able to do a great job caring for patients within the comfort of our cultural setting, but how would we do things differently in another culture?

It was one of our friend's, Taylor, 21st birthday today.  We went out for the most American meal possible, pizza, for dinner as a group (and brought our professor along too)!  We got a her a couple of Hindi dance music cd's, a very nice cake, customized birthday drinking glass, and a bottle of Bacardi!  She posted on Facebook slightly after that it was one of the best birthdays she has had!

We have lecture again tomorrow (Tuesday) followed by 3 days of home visits.  It should be a great learning experience getting home back into the home visit experience after just one day of it last week.  We will be sure to post all the latest and greatest exciting things from the other side of the world!

                Here are some fishermen we passed on our boat ride on the lake!

Here is a picture of a whole line of house boats traveling through one of the canals to get to the lake.

The delicious lunch prepared by the boat crew.

The Pallium Experience

Shout out to Miss Spencer Ann! Today she turns 26 and I wish that I was able to spend time with her on her birthday.

As Adam talked about yesterday, we got to go out on our first day of home visits yesterday. Talk about a reality check. Several of the patients I met had dirt floors that had been packed in with cow dung. They slept on simple wooden or metal bed frames, often without any real mattress. One patient's family had even attached wheels to a plastic lawn chair to create a makeshift wheelchair. But these people were incredibly warm and welcoming with just their smiles! One family even gave Adam's group flowers!

Pallium India sees patients for a number of reasons besides pain, including diabetes, cancer, and hypertension. One of the doctors we were with told me that Pallium India received 1,300 new patients just in the year 2012. This does not include patients from previous years who are still participating in the Pallium program. Can you imagine? The craziest part is they do it all with six physicians and less than thirty nurses. Holy buckets. In addition to nurses and physicians, Pallium India uses social workers to take care of the family as a whole, whether it be by providing a commode for in the house or providing a soap-making kit to help bring some income to the household.

Today was another class day. Because Pallium's Dr. Raj had some unexpected things come up, he was not able to teach as much as they had planned. So Jo stepped up and taught for probably three more hours than she had planned on! After class today, one of the social workers brought in some jewelry made by one of the patients. A 50 year old, paraplegic woman earns a living for her and her family by crafting earrings, bracelets, and necklaces. She was recently featured at a Kerala art festival. They brought in samples of her jewelry and we were able to place orders for what we want and they should be ready in a week and a half! It is great to get real Indian jewelry while helping one of Pallium's patients....needless to say, I felt justified in my purchases and kept adding and adding to my list! Whoops!

Another thing about India is that tea breaks are important to the culture. Everyday we have had class, we have had tea breaks both in the morning and in the afternoon. It's serious business here. Both breaks are 30 minutes and they offer chai tea, coffee, regular tea bags, cookies, and small appetizers. I could get used to this.

Dr. Senil walking to a home. The log to the left was the old "bridge." The cement one is new.

Dr. Arun working on a chart. 

The flowers Adam's group received. He brought them back to the room for me!

Dessert at one of the best places in Trivandrum, ZamZam.

Pallium nurses walking to a home. 

A few pictures

First Home Visits!

It is 7:45 PM, and Ryanne and I have just returned from eating dinner at ZamZam.  It is a delicious place that serves mostly contemporary Indian food.  I had the butter chicken masala, while Ryanne had the mushroom masala...we split a side of naan (which is my favorite).  Both were quite spicy and took quite a bit of white rice to get both dishes down.  Luckily for us, this restaurant has a vast selection of unique ice cream treats to cool your palate after dinner.  I enjoyed a mango sorbet sandwich and she had some extravagant contraption of layered ice cream with what looked like graham crackers sticking out of the top (delish!)

We may have been so hungry during dinner because today was our first chance to go out into the community with Palium to meet with patients.  I spent my time with a physician, nurse, and a social worker in an a little rural area about 20 kilometers north of Trivandrum.  The first patient we met suffered a stroke a few months back and was paralyzed on his left side, had uncontrolled diabetes that led to multiple missing toes, and a few other diseases that pretty much left him bed ridden.  We met with him and his family and they chopped up down coconuts off the tree and we had some very delicious coconut with the family.  I brought a  huge bag of candy along and passed it out to some of the village children and you would have though they had just received a bunch of new toys they were so happy!  I forgot to bring my camera on this trip but will be sure to do so on future trips.  The next few patients brought us to a much more densely populated section.  The second home we came to had a man with a few different kinds of cancers and spent his entire day just laying in his bed.  However, the problem is that his bed is made entirely out of WOOD (no cushion/mattress whatsoever).  The Palium Care team brought a soft egg shell type foam and some sheets for his back to make him at least a little more comfortable.  In this home, the family made us freshly squeezed orange juice while we carried out our cares.  Home visits number 3 and 4 were rather short and I wasn't able to help out a whole lot because the home was so small, there was no more room in the area the patient was at.  

One thing stood out to me more than anything today actually getting out into the community.  As very very little as these families had, they always made an effort to find some way to show us gratitude and to make us feel comfortable in our home. I really wish I would have brought my camera just to give these words justice as to how poor these living conditions were....there will be three more home visits and I will be sure to document the rest with pictures!  

Tomorrow is another day of lectures, Saturday we will spend helping out at the hospice clinic, and Sunday we are going on a day long boat trip as a group!  Should be fun!  Hope everything is going great back home!  I think Ryanne and I know are going to alternate days posting to the blog so be sure to expect one new post everyday!  

Things I've learned

Things I've learned so far in India:

As Jo says, "The lines are merely suggestions." Seriously, most of you would freak out if we drove in Iowa like they drive here. Little regard for traffic lights and lines, pedestrians cross at their own risk, and enough honking to give you nightmares. We have seen three people on one moped so often I doubt I will ever be phased by seeing two football players run around on one back in Iowa City.

When they say spicy, they mean spicy! Adam and I tried to prepare ourselves for Indian food by going to Indian restaurants beforehand but we quickly found out that you can't really prepare for this. Apparently, Kerala, India is considered the spice capital of the world. And they've earned it. But the food is so good, you just have to fight through the pain!

Rickshaws are more scary (and more fun) than any rollercoaster at Adventureland (and that's saying something!). They are doorless tricycles with a backseat that can hold up to three passengers besides the driver. There are literally so many rickshaws, you don't have to look more than thirty seconds to find an available driver.  They weave in and out of traffic and I can never decided whether to laugh or cry.

People here are so kind. Many people come up to us each day just to say good morning, ask us where we are from, and wish us well. Some even ask for pictures with us (Adam is my arm candy). And while it was startling at first, I feel very welcome in Trivandrum.

-Ryanne

Adam and I ready for the New Year's Eve party!

Jenna getting wrapped in her saree. You can't see it now but workers and bystanders were circling around to watch!

A craftsman at the exhibition sale. This is a hand-carved piece done onto several  slabs of wood. I think he said this one took him 4 days. 

A view from inside a rickshaw. It is hard to get a sense of the traffic here from a picture but hopefully you can see just how close together everyone is and how the lines aren't exactly being followed. 

A new bus from Hewet-Packard to Pallium India. Teams will take this bus out to home visits. It is equipped with some awesome technology and even a shade awning. 

We have so much to tell you about!

Sorry we have not updated the blog recently! Adam's computer happens to work with Indian plug-ins but for whatever reason, we cannot get the blog website to work on his computer. My computer does not work on Indian plug-ins and so we had to wait until we received our adapters today!

So much has happened I am not even sure where to begin. We had our first day of class on Wednesday and one of the first things that struck me was that we stopped once in the morning and once in the afternoon for a tea break. Two 30 minute breaks dedicated to coffee, tea, and cookies....we need this back home. 

We are so fortunate to be able to learn from Pallium India and particularly Dr. Raj. Dr. Raj is one of the most special people I think any of us has met. With his team of doctors, nurses, social workers, and volunteers, he tracks down candidates for palliative care and identifies not only the patient's physical needs (pain control!!) but also their social, emotional, and spiritual needs. In addition, they look out for ways to help the families. By building roofs onto houses, installing toilets, and donating chickens and crafting equipment, Pallium India helps families become safer and more self-sufficient! 

After class on Monday, we went saree shopping to find some clothes for the New Year's Eve party being thrown by the hotel. It was quite the experience. Workers and bystanders surrounded us, suggested colors, and wrapped us all in sarees. Adam was so patient because all of the girls couldn't decide. Finally I picked one and we headed back to the hotel to get ready. Easier said than done. No one could figure out how to rewrap the sarees. After thirty minutes of painful struggling, Adam found a hotel worker who agreed to help us. She was so kind and spent a lot of time wrapping six of us in our sarees for New Year's.

The party was very fun! An announcer led us through a series of games, drawings, and Indian dance performances. Jenna was chosen to sing a song to the entire crowd and she performed like a champ. Adam and I were chosen to be in a dance competition as well. After six minutes of dancing, we had completely depleted all of our go-to moves (the sprinkler, grocery cart, etc). It was rough to watch I am sure, but surprisingly we actually placed second!!!  After a couple of drinks, we all headed to the roof to watch the fireworks go off all over Trivandrum.

Fortunately, our itinerary allowed us to sleep in the next day. We went on a tour of the city and toured the local zoo. Following the zoo, a bunch of us decided to go out to find a local place to eat supper. Adam got on a Trivandrum travel website and found a highly-rated restaurant called ZamZam. Apparently it is where all of the college kids go to hang out. The food was delicious but the ice cream was amazzzzing. Coldstone has nothing on this place.

Today we had our first yoga class on the roof of the hotel at 6:30 am! A man associated with Pallium Indian has volunteered to come teach us yoga in the mornings free of charge. Today was mostly an introduction to the history of yoga, basic loosening exercises, and breathing techniques. I suspect that we will begin harder practices as the weeks go by but what an opportunity to learn yoga in India! It may have been difficult to get up so early but the view from the roof easily made up for it.

Later we had another round of all-day class and discussed ethics in end-of-life care, Indian culture related to dying and illness, and spirituality. A social worker named Jess from a New York organization HealthCare Chaplaincy called came to discuss spirituality with us which was very enlightening. Her organization works to provide board-certified chaplain services to ten New York hospitals, including both patients and staff members and all walks of faith. 

After class, a few of us headed to an exhibition sale down the road where craftsmen and salesmen had set up shop. We were all able to get very neat souvenirs, gifts, and Indian artwork for incredibly good prices.

Tomorrow is our first day of home visits. Our class is divided into four groups and each group will travel with a team from Pallium India as they go out to rural areas to visit patients. I can only imagine what type of impact these home visits will have on me. From what I understand, we will be visiting some of the poorest people in India. Pallium is able to do so much to provide dignity, comfort, and resources for their patients and their families. So excited!