A Day in the Field

The teacher at this balwadi is 19, and she just got married a few days after we recruited here. She's back in the working-version of her bridal finery, teaching the children rhymes as I sit by and watch.

They stand in a loose huddle as they try to navigate their tongues around the "chukupuku"ing of the rail-vandi. Inexplicably, their repertoire includes English rhymes from I-don't-know-where, although they know them only as a series of sounds randomly strung together. Their enthusiasm for them, though, is apparent:

I seethamoo
An themoo see me
Gawbleff themoo
An Gawbleff me!

Laxmi moonwalks in a corner all by herself, then claps her hands at a painted tomato on the wall. She's already 3 and hasn't started saying more than the simplest words. Her mother is understandably worried but access to a developmental paediatrist is limited when you are living where they do. They all leave her to her own devices, only making sure she's fed or sleeping when the other children are; they cannot understand her but neither will they neglect her. During our Community Orientation Program in our second year, we saw grown women who probably started off as she did: from children to be taken care of, they grew into adults not responsible for their actions. In the economics of survival you can eat if you work; If you can't work and other people must work to feed you, you are a liability. Luckily, the extended family structure that rural neighbours seem to adopt is as rich in support as in censure.

Lunchtime, and the children set to picking their own pet hates out of their food. Little bits of tomato or drumstick leaf gather in heaps beside the plates to be swept away later along with the day's debris. Some ask for more, some refuse to eat unless they're fed and the ayah soon has three open mouths and rapidly-emptying plates in front of her. The others have finished and raise their plates to slurp up the last vestiges of their sambhar. One little girl wheezes between slurps.

Now the mats are spread and they all have to lie down. The teacher sits waving the flies off their faces for a while and soon, the only sounds are those of deep breathing and the occasional snore. Traffic is infrequent at this time and for a while, all I hear are rustling leaves and crows exploring the brightly coloured buckets I brought with me for our sample collection. The government school in the village just broke for lunch and four girls in uniform huddle at the doorway. I turn and smile at each of them and go back to my book, but they still stand and stare - either satisfying curiosity or a mute appeal for attention. I recognise Divya from the last time I was here. Jeyalakshmi seems to be the leader of this pack, and introduces the others as well as herself when I ask her her name. My scant knowledge of Tamil limits my conversation, andI can just stumble through the barest niceties - an exchange of names and basic information, punctuated by profuse smiles and vigorous nodding when I hear a familiar word.

These girls are bright-eyedly lovely. They're too sophisticated and grown-up to come pulling at my clothes or mock-charge me like the little kids, but their curiosity is unabashed. It's amazing how many of the women and the girls in these places only need an opportunity to assume social responsibility to become women who make a difference, in their villages or outside. Several women whom the hospital has involved in its outreach programs or given basic training to are now pillars of their communities, encouraging other women and giving them what seems like sound advice.

A moped just sped by and I can hear the growl of a line bus. Soon, the vehicle from the hospital will roll up and the most tearful of these little study-participants will rush around to shake hands or wave goodbye. I will leave with my assorted paraphernalia, the plastic buckets and little bottles now full. They will go home and come back tomorrow as they have done and will do for so long. I can just hope that what we're doing will actually make a difference to their lives, be a butterfly effect that ripples outwards. Intervention is a strong word and we never know to the fullest what differences we ever make. For now, we will roll away and happy chants will waft down the roads.

Vovezaraad
Vilessabiloo
Suka isswee
Asoaaru!

Comings and Goings

Perhaps, one day, the winds will bear up,
Accommodate the heavy whisperings
That waft hopelessly into the night sky.
Anonymous, they drift into the passing light
From aged stars thrown through prisms
Invisible in the blinding light of a cellphone screen.
"Do Not Disturb" post-its that I ignore -
A licence to enter your room, and the secrecy
Of every day of your life.
A text message, coffee (because you can't stand tea)
And forgive me when I spill it as I stir
Come look for me as I pretend to work
And we will speak of what we want to.
I closet myself in shortness and impatience
Thinly veiled, but deserting is not an option
Unburden, and what we talk of can bear no repetition
And tolerate no one else's hearing
And if I want to be angry, I don't think I can.
Your exile here is ended, your conscious life
Among walls with eyes and ears
And hushed voices that sit in judgement
Growing upward and outward will take its toll
And I will try my best to ride the wave.
Will you have changed the next time that I see you
Or can we pick up where we left off
And will you stride back in with laughter
That means that nothing matters
Or must I sit at the very edge for very long
And wait for you to drift back into sight?

Recipes - The Student's Guide to Boston Cream Pie

Actual cooking time: 1 hour
Preparation: 2 days

Ingredients:
For the cake:
1. 4 eggs
2. 1 1/4 cup flour
3. 1 1/4 cup sugar
4. 2 cups milk
5. 2 tbsp unsalted butter
5. 1 1/4 tsp baking powder
6. 2 tsp vanilla essence

For the filling:
1. 4 egg yolks
2. Sugar (I forget how much)
3. 3 tbsp cornflour
4. 2 tsp vanilla essence
5. 2 cups milk

For the glaze:
1. Chocolate - lots.
2. Cream - even more.

Equipment required:
1. An oven
2. Something to heat things on
3. Kindhearted friends who will lend you their mothers' cake tins, sieves and measuring equipment.

Procedure:
1. Plan ahead for days to the point of obsession to make sure you know exactly what you have to get. Go shopping for ingredients the day before, forget the butter.
2. Wake up, swear at yourself for forgetting the butter. Borrow the hostel kitchen's keys from the mess secretary. Laugh at the sign that tells you to return them in 4 hours because everyone knows you will take three times as long.
3. Haunt the corridors like a spectre by daylight to borrow a baking tin before everyone leaves for class. Borrow tin, realise that your measuring cups still haven't arrived. Swear again.
4. Walk to friend's house, borrow measuring equipment and sieve. Stop to check your mail, buy butter, return to hostel.
5. Carry ingredients down, open kitchen. Experience a moment of dismay because (a) it's small (b) there is no cooking range, only a hotplate and (c) because there's no source of running water in the room.
6. Realise (c) is not too much of a problem because of the bathroom next door. Experience another moment of dismay when you realise that the only vessels in the kitchen are a few ladles, a wok, a non-stick pan and a sauce pan, and you will have to whisk your eggs with a knife.
7. Arrange ingredients. Switch on the electric oven, to preheat. Switch it off again when you realise the hotplate uses the same plug and you can only use one at a time - a realisation that dawns simultaneously with a knocking sound that seems to come from the oven.
8. Prepare creme filling, stirring constantly. As it cooks, hope and pray that the recipe really does require that it turn into a glutinous tumour-like mass. Take off the heat. Taste. Taste again.
9. Let it cool and transfer to another container, refrigerate. Wash saucepan.
10. Prepare cake batter in wok, whisking eggs and sugar together with a ladle. Substitute knife for ladle because there is no fork to be found this side of the veil. Impale yourself on the knife while rinsing. Swear again.
11. Heat milk and butter, add to egg mixture while praying that it will not congeal. Be glad when it doesn't. Add flour. This time it does. Mix vigorously.
12. Pour into lined, buttered (borrowed) cake tin. Bake for 35-40 minutes at 350 degrees.
13. Prepare glaze - heat an obscenely large quantity of cream, bring to boil. Pour indiscriminately on broken pieces of a chocolate bar in a plastic(!) bowl. Stir. Let cool.
14. Once cake is ready, let it cool. Slice horizontally into two largely unequal parts.
15. Assemble - spoon creme filling onto the bottom half, cover with the top half. Top with glaze, letting it drip down to the sides. Eat any glaze that isn't directly attached to cake, and some that is.
16. Chill in your newly-purchased refrigerator for twenty minutes or until you are ready to serve.
17. Consume, with the gratifying realisation that it actually tastes and looks pretty good. Store in above-mentioned refrigerator, eat for breakfast, lunch, dinner and midnight snack for the next three days.
18. Join the gym.

For a real Boston Cream Pie recipe, check out:
http://www.marthastewart.com/best-boston-cream-pie

The Pitfalls of Evidence-based Medicine

Randomised Controlled Trials are supposed to be the gold standard of clinical trials.

Here's what happens when you carry a good thing too far: http://www.bmj.com/cgi/content/full/327/7429/1459

The Amazing Technical Dreamtown

Gandhi Road, opposite the hospital's second gate, is known for dirt, crowds, an outbreak or two of amoebiasis and the place where most of your shopping gets done. Walking down the small shop-lined street I was dazzled by Dawn Bakery, newly painted, that stood out against the bleak greyness of the sky in bright yellow paint with orange edges. I could be classy and call it marigold with a tangerine trim, but either way it would still hurt.

There seems to have been a revolution in housepaint sweeping the town. Standing on ASHA terrace you can pick out a house in fluorescent green, a pale blue, two yellows and a lavender. From a distance they seem forgivable. Up close, it takes some getting used to. There's a house on the 2 route that's a deep, dark blue. Pleasant, though unorthodox. There's another one that has a hot pink facade. I've heard rumours of a bright yellow one behind Schell, the eye hospital, but I haven't seen it yet. I'm not sure I dare.

Leaving housepaint alone, some of the houses have - interesting motifs on them: there's one, again on the 2 route, that has two huge human eyes carved into its parapets. Or rather, the parapet's carved into eyes, with blank spaces where the sclera ought to be.

Although a lot of house owners seem to be opting for unorthodox colour options, not all of them choose to dazzle - one of the most common is the colour of the hospital - a blue-grey that makes the building look a little like a large, sprawling thundercloud. Superimposed upon this are the temples at the streetcorners, which have large ornate figures of mythological characters mounted on their roofs. All painted. Brightly.

Few of these would meet any demanding aesthetic standards, but they're always interesting to look at. And if they make the people who live in them happy, I suppose that's all that matters.

http://www.bmj.com/cgi/content/full/327/7429/1455

A Change of Mind

I never wrote of love, I never once
Wrote of the things I ever wished to keep.
Never of all I chose to leave undiluted,
Not once among those things I pressed so carefully
The flattened petals among the brittle leaves
Of heavy books, did I count those bouquets
Whose heady perfumes brought to mind
Autumns long past, or longing that was so scarce
I could not afford to adulterate or lose it.

I never wrote of love, I never
Had enough to have enough to give away
Never enough of anybody's heart
To commit to paper, to lose a part,
To leave it behind to gather cobwebs.
They would grow their musty stories
Weave in glistening bands of brittle steel
Wind tighter, tighter still until they snap
And hang in mocking streamers, gather dust.

I never wrote of sunlight as it filters
Through gulmohar leaves, or when it mingles
with the ripples in the stillness
To lap at the concrete of its containment.
I never wrote then, nor when I lay
Enveloped in the true, the rare, the fleeting.
What torrent this that sweeps away the habits
Of twenty years?

A First

My first study proposal - submitted. : )