Things I will and won’t miss about living in India

I’ve been reflecting a lot on the things that make India unique, the things that I’ve become accustomed to and the things that still irritate me about living here. I think there will be a bit of reverse culture shock when I return to the UK!

Things I will miss:

The food: It’s mostly been incredible, and my tolerance for chillies has definitely increased! Highlights: masala dosa in South India, amazing lassis in Rajasthan, chaas or buttermilk – like a thin spiced yoghurt drink, really refreshing), chai, crispy aloo parathas with curd and pickle, biriyanis, fresh fish in Goa, Kerela parottas (not parathas, these were different)….oh, and that weird 8 course tasting menu in Bangalore. That was special. It wasn’t all good though – if you ever visit an Indian McDonalds don’t have the McPaneer burger. It’s rank (trust me, I tried it so you don’t have to).

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Masala dosa in Bangalore

Value: I love a bargain, and it’s mostly pretty cheap to live a comfortable life out here. I particularly love having my washing done for a few quid, stuff comes back sparkling clean and properly ironed (even my pants!). Fruit and veg is bargainous as well – jt’s mango season at the moment, and I’ve been feasting on amazing mangos for unbelievable prices. I won’t be able to keep up that habit in the UK!

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Weather: The monsoon rains have just started here, but before that I could count the number of times it has rained on one hand. There’s no denying that endless sunshine does wonders for the mood (and the vitamin D levels) and although it was uncomfortably hot at times I’m lucky to have escaped the horrible winter back home.

Optimism: People say that “anything is possible in India”. And it really does seem to be true. I feel that people here are more content with what they have, even if that is very little. We seem to have a constant sense of dissatisfaction in the Western world, the more we have the more we want. A lot of people here have nothing, and want for nothing. Of course, that’s not true for everyone, but it’s true of a lot of the patients I’ve met, particularly the poorer ones.

Indianisms: Words unique to Indian English. There was an article about this on BBC News a few days ago. Words like “prepone” (opposite of “postpone” and used a lot in my friends’ offices), “revert” instead of “reply”, “very less” instead of “much less”. You don’t get off the bus in India, you get down from the bus. If you go away, you are “out of station”. People also wish you “happy journey” which I love.

Rickshaws: Even though they’re bumpy, noisy and you have to constantly haggle with dishonest drivers I have a certain fondness for rickshaws. Certainly beats taking the tube to work! Plus, its fun to see how many people can be crammed into one (I’ve seen 10 people at the most!) I also play a game of “spot the weird thing in the rickshaw”. My favourites were bananas and a goat (not in the same rickshaw!).

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Things I won’t miss:

Traffic: There are no traffic rules. It is INSANE. And noisy due to the constant use of horns all day and night. To cross the road you always have to look both ways, even if it is a one way street as more than likely there’ll be a scooter coming the wrong way, or a stray cow or two. No one gives way, it’s survival of the biggest.

Dirt/bad habits: I’d written before about the constant spitting/urinating in public, and the litter everywhere. I have to say that Pune is better than Bangalore, but it still gets to me!

Overly obsequious service: Shop assistants follow you around constantly asking you what you want, waiters serve everything to your plate from the serving dishes (a pet hate of mine). Especially as they then watch you eat, and spring across the restaurant to wrestle the dish from your hand if you try to serve yourself even a tiny spoonful of rice. In some places you can barely eat as you’re always being asked if “everything is OK Madam”. I also hate being called Madam but that’s a different story!

Sexual harassment: I knew India was notorious for this, but it is constant, and very wearing. Staring, catcalling, getting honked at by cars, being offered lifts. To be honest, as bad as all that was I’m very grateful it wasn’t worse. The media spotlight on rapes has waned a bit, but the statistics are incredibly scary.

Endless bureaucracy: Again, covered before, but it’s everywhere. Yesterday I went to print out my flight ticket. The guy wouldn’t let me use the internet without photo ID ( a Govt rule apparently). I didn’t have my passport so showed my driving licence. He wouldn’t accept it because it didn’t have “a number” on it. I’ve no idea what number he was referring to, but he sent me home to get my passport before I could use the printer. Sigh..

Mosquitos: Enough said. I’m covered in scars from scratching bites, I look like I’ve had a pox. Classy. I am awesome at killing them now though.

 

There’s loads more that I can’t think of right now. The craziest things happen every day and that’s just the way of life. You can be walking down the street, turn a corner and suddenly see this:

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I have plenty of stories to bore you all with when I’m home. Wish me a happy journey!

 

 

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A week in Malaysia

Normally when I go abroad I’m very prepared: I buy and religiously study a guidebook, Google for hours to find recommended things to do/places to stay. For this trip to Malaysia I was surprisingly laid back – I Googled a bit but mostly for food related stuff (I’m not gonna lie, I’m a bit fed up of Indian food). I booked places to stay almost at random based on price and TripAdvisor reviews. I didn’t have a guidebook though, and I felt strangely lost without one. Thus, I landed in Malaysia with very little idea of the customs, dress code etc, or really what to expect. Because of my somewhat restrictive budget, I’d booked flights which necessitated an overnight 7hr wait in Chennai Airport (hideous, don’t ever go there) so I was a bit spaced out when we landed. The first thing I became aware of at the airport was a Malaysian girl wearing the shortest of short shorts (basically denim knickers) being followed by a huge gang of blatantly staring Indian men from my flight. At the time I thought this was quite amusing (remember this for later).

Malaysia is terribly well organised, particularly in terms of transport. I hopped on a quick bus ride into Kuala Lumpur city centre and checked into my hotel. I’ve already raved enough about that, read here if you want to.

I’ve been hearing great things about a restaurant chain called Din Tai Fung, and as luck would have it they had a branch near my hotel, located in a shopping mall. So, off I popped, after revelling in the novelty of being able to wear a dress without leggings underneath. The mall in question is called Pavilion. I hadn’t really looked into what else was there. I was talking to a friend back home who Googled it and informed me there were lots of amazing shops there. Excitement started to build, off I popped after revelling in the novelty of being able to wear a short dress without leggings underneath, and being able to cross the road without fear of being killed! I got there. And my jaw dropped.

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Floors and floors and floors of beautiful familiar shops, good restaurants and air conditioning! It may sound stupid, but from being away so long I’d kind of forgotten that places like this existed. Sure, India has malls, but they’re not like this, and I haven’t been to one in months. Call me shallow, consumerist, whatever you like, but I like shopping and pretty things (and cooling off when it’s super hot outside) so I was incredibly happy.

Dinner was good too. Their speciality is xiao long bao, or soup dumplings which were amazing, especially the ones with pork and truffle

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I spent a very enjoyable evening wandering around KL, it was a bit of a shock to be in such a clean, well ordered and surprisingly peaceful city after the all-out chaos that is India. It was also nice to be able to walk around without being hassled and without the constant staring! Plus, they have a monorail (which always reminds me of this episode of the Simpsons). I’m easily pleased…

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Next day I jumped on a bus to Penang, on the west coast. This again was a revelation, especially compared to the shockers of buses in India. I remember being surprised not to hit the roof when we went over speed bumps (thank God for proper suspension and decent roads!). It was a 5hr journey, but with a TV, food and drinks provided and a comfortable reclining seat, the time soon passed.

I stayed in Georgetown, the capital. The city centre was turned into a UNESCO world heritage site in 2008, and has loads of interesting colonial buildings, winding streets to explore, food hawker centres and street markets. The national pastime of the Penangites is eating, and I happily got stuck in. I spent the rest of the time forcing myself to walk off the calories, exploring, a bit more shopping, getting a decent haircut (I wouldn’t risk it in India after seeing someone’s hair get cut with paper scissors and a ruler!) and meeting a few fellow travellers. I also rediscovered my love of frozen yoghurt and iced coffee, consuming both in vast quantities.

A few pics:

The seafront (Gurney Drive)Image

Char kway teow (wok fried noodles) – about 80p!

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Amazing dim sum breakfast

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Served by little old grannies from old-fashioned huge steel carts. They wheeled them round tight corners like Formula 1 drivers!

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Highly recommend this place by the way, Tai Tong Cafe, 45 Cintra Street. Dim sum available only at breakfast and dinner.

Georgetown streets

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There are lots of quirky little cafes. I particularly liked one called The Mugshot on Chulia Street next to the Rainforest Bakery, both of which served proper bread and bagels, somewhat of a novelty in Asia! They also have a great bathroom sign

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Back in KL on the final day, I made a trip to take some pictures of the Petronas Towers at night.Image

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I got a bit carried away with last minute shopping/packing/eating and underestimated the journey back to the airport –  I arrived in a bit of a flap just 20 mins before check-in closed to find an enormous queue of all different flights. I’d intended to change out of my shorts before getting on the plane, but in the confusion I forgot to take a change of clothes out of my bag before I checked it in. Big mistake! I have a lot of sympathy for that Malaysian girl after the gawping I got when I landed in India. I don’t suggest any of you try it…

Travels round Rajasthan: Colours, forts, camels and a marriage proposal

I never got round to writing a post about the quick trip round Rajasthan that I did back in March. I’ve mostly let the pictures tell the story (it’s very hot here and my concentration span is limited!)

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Traditional Rajasthani puppets

Rajasthan is in the north-west of India, and the largest state in the country. I’d visited Jaipur once before (nearly 10 years ago!) but was keen to see more, mostly based on the tales of other travellers I’d met along the way in India.

Firstly, it is a long way from where I was based! I’d flown back into Bangalore to finish up the bits I had to do there, then hopped a night bus to Goa to pick up my cousin and his friend. We then had to get 2 trains (over 28hrs in total!) to reach our final destination of Jaipur. I quite enjoy Indian trains, and as we had AC berths it was comfortable enough.

My travelling partners were going to Jaipur to participate in the inaugural Jaipur Arts Festival, a 5 day event held in a fantastic old palace. Artists from India and all over the world were invited to come and create 2 pieces of work, and there was lots of entertainment laid on. I ended up crashing for a few days, it was loads of fun and very interesting.

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One of my cousin’s pieces – check him out at http://www.thatdave.com/

After a few days chilling at the palace, I left the boys to it, and headed off on my own. First stop was Udaipur.

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CSC_1251Street view in Udaipur – women cover their heads here.

Next stop was Jodhpur, also known as the “Blue City”

DSC_1279Mehranghar Fort, Jodhpur

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Be-turbanned guards at the fort

After Jodhpur, I got on a very crowded bus to Jaisalmer, even further west in the Thar Desert. I’d come here for one main reason – I’d heard you could spend a night in the desert in an open air camp, sleeping under the stars. It meant I had to ride a camel to get there (camels are cool, but they fart an awful lot and are a fairly bumpy ride) but it was worth it. It was just me and a bunch of gap-year students on this trip ( I felt like such an old lady!) but it was loads of fun, and an experience I’ll never forget. The owner of the travel agency also proposed to me….but that’s a story for another day!

DSC_1354Jaisalmer fort – like a giant sandcastle!

CSC_1477Our camel guides

DSC_1466Our beds for the night – proper mattress and duvet to keep out the cold!

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My final stop was Pushkar, a city centred around the sacred Lake Pushkar, believed to have been created by the tears shed by Lord Shiva after the death of his wife. I arrived in the aftermath of Holi Festival (festival of colour) which was brilliant, the streets were pink and purple for days afterwards.

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Holi revellers

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Outside one of the temples

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Shopkeeper in the marketplace

DSC_1487The aftermath!

It was a bit of a whistle stop tour (time was short, so only a day or two in each place), and pretty tiring as the distances between places are huge, but it was a lot of fun. And no, I didn’t accept the proposal from the camel guy…..

Grid 9 Hotel, Kuala Lumpur: Flashpacking in Malaysia

Despite travelling a fair bit over the years, I’d never heard of the term “flashpacking”. Turns out flashpacking is to backpacking what glamping is to camping – a fancier and more comfortable way of doing things, but still at a reasonable price. Suits me!

I haven’t done any hotel reviews on this blog, mostly because I haven’t stayed anywhere really worth writing about, but I was really impressed by the newly opened Grid 9 Hotel in Kuala Lumpur.

Their concept is described on their website as follows: “We built Grid 9 with a vision to create a social experience unlike any other hotel. Inspired by the design of a grid, we want the paths of our guests to intersect, forming a network of globetrotters around the world. More than just a hotel or a flashpacker, we are a hybrid of both. From our pods to our rooms, from our lounge to our gastropub, the Grid 9 experience is what differentiates us from the pack”.

The location is brilliant, slap bang next to the Maharajalela monorail station (2 stops from KL Sentral, where the airport buses alight, and 3 from shopping heaven at Bukit Bintang). They have a variety of rooms, from shared dorms to triple rooms. I stayed here twice when passing through KL, both times in a “Standard” room. I chose this place because it was reasonably priced (about £23/night for a standard room, from £8 for a room in a 6 bed dorm) and had good reviews on TripAdvisor.

Most of the standard rooms don’t have windows – this is clearly mentioned at booking. But here’s the thing – I didn’t even notice until I realised I could hear the rain outside, but not see it. More important to me was the fact that it was spotlessly clean and the bathroom was a decent size with a good shower, proper towels and toiletries. That the bed was really comfortable with premium linens and the best pillows I think I’ve ever slept on (I don’t really get the point of pillows normally, but these made me see the light!). The decor is funky and thoughtful, and they have AC in the rooms, so important in the humidity of Malaysia! Plus, they have free, fast wifi. There’s a decent sized flat screen TV in every room too (less important for me, but a nice touch). These are the things that I think a lot of budget/backpacker places skimp on, but they’re important, and in my opinion worth more than a view. OK, the rooms are a little small, but as I was on my own it was fine for me. There are larger rooms available. There were also criticisms on TripAdvisor re the lack of plug sockets, but it seems they’ve taken this on board and now have an extension thingy in each room.

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Standard room

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Bathroom

They’ve recently opened a gastropub downstairs which I didn’t have time to try, but looks good, and reasonable value. Guests get 10% off the bill.

The staff were great, and I got a nice email back when I wrote thanking them for a great stay. I think it’s really important to support independent hotels who do their thing well, and there needs to be more places like this around the world. I’m sure they will do well. All in all – great value, great room, great location. I’m clearly a committed flashpacker now!

A peek inside an Indian hospital

Yeah, I know I’ve been rubbish at blogging recently. Time seems to be flying by now I’m nearing the end of my trip.

I’ve been mentally composing this post for a while to try to give a feel of what it’s like inside a hospital in India. I think I’ve already become accustomed to many of the peculiarities, so that they don’t seem so strange anymore!

I’m working in a private hospital which is fairly posh by Indian standards, but still fairly basic and dirty by UK standards. The Government hospitals are by all accounts pretty terrible. I’d love to take some proper pictures, but they don’t allow cameras inside so I’ve taken a few low-quality stealth shots on my iPhone (and would like to take more but my phone keeps breaking!). My consultant does only private work, so we do ward rounds in the morning and then see outpatients after that.

One thing that amuses me is the “lift operator” – this guy basically sits in the lift all day pressing the buttons for you.

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There are also lots of rules. For example, this hospital allows only vegetarian food on campus, and there’s a very strict sign warning of hefty fines if anyone is found with meat on the premises (I didn’t get a photo of that sign but will add it if I do). This sign to the left about coconuts also made me laugh, so different to anything you’d ever see in the UK!

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The one striking difference is the complete lack of privacy. That’s fairly common here – privacy just isn’t really a thing, especially where healthcare is concerned. In all the clinics I’ve worked in, it’s common for relatives, sometimes the whole family to be present for a consultation. In the hospital, you must have someone to stay with you in order to look after/wash/feed you (nurses don’t do any of this), and buy your supplies (more on this in a bit). If you don’t have any relatives or friends then you have to bribe one of the cleaners to be your attendant. Your relative(s) sleep on the floor next to your bed. So, we often do ward rounds with not only our patient’s family listening in, but the other patients and their families too! This is a very blurry photo to try to illustrate how close together the beds are (and no curtains, not that they’re soundproof of course!) with everyone eavesdropping. And of course, because it’s still such a patriarchal society, the male of the family (husband or father) will usually be the one addressed, regardless of who the patient is.

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This hospital has a mix of general wards (like the pic above), semi private (two or three to a room) and private (single rooms). Men and women are segregated, and women and children tend to be put together. It has a large intensive care unit (with separate cardiac and neuro ICUs), all general medical specialties, obstetrics and gynaecology and paediatrics. Because it is a private hospital, tests get performed pretty quickly compared to the government hospitals, I’ve been impressed at the turnaround time. The nurses are very shy and deferential, and the (mostly male) doctors get treated like gods!

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As I said before, your relative has to go and buy everything that’s needed for your stay. And I do mean everything – every needle and syringe, every bag of IV fluids, every dressing, every tablet. Nothing is kept in stock by the wards except for extreme emergencies. It’s also quite scary how much the cost builds up, and often we have conversations about withholding or stopping treatment due to financial restraints which is very sad.

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One of the “general wards”.

There’s also a lot of stuff that’s not done in-house (mostly things like CT and MRI scans). If you need a scan, you go to one of the nearby centres recommended by your doctor, and bring the films back for them to see. All the results are on paper (very different from our electronic reporting systems in the UK where everything is ordered and reported in one programme).

For all its’ differences, I’m really enjoying working here – the cases we’ve seen have been fascinating, and I’m learning a lot. Including how to survive a ward round in 39 degree heat when the fans just seem to be blowing hot air around.

I’ll write about the outpatients clinic another day!

Living in Pune and curiosity re the Osho Ashram

After the trip home and all the visa dramas I’m now based in Pune which is in North India, about 3hrs from Mumbai. According to Wikipedia, it is the “cultural capital of Maharashtra and known for its’ high educational facilities and relative prosperity”. It’s a much calmer place than Bangalore (i.e. it doesn’t take me 10 minutes to cross the road due to the INSANE traffic).

In contrast to Bangalore, I’m staying in a very “expat” area here. Partly because it made life a million times easier in terms of being able to get a long term rental for a flat (having an Indian face but a British passport was causing havoc with the estate agents and pushing the prices up!). Plus, a lot of the flats I looked from the Indian equivalent of Gumtree at were horrible – filthy, tiny and most of them would have been sharing rooms and/or beds with others. Anyway, so here I am in my own room in Koregaon Park, north-east of the city centre. It’s meant to be one of the nicest areas in Pune, it’s certainly very spacious and green, with wide-tree lined avenues. Dress code is much more liberal (thank goodness, since it’s 38 degrees here and I’d die in long sleeves and leggings!). There’s a wide variety of restaurants/cafes/bars – completely different to where I was living in Bangalore. Even the tiny local corner shops sell a range of western foods that I had to travel miles in B’lore to be able to find. Bizarrely, it’s not that easy to find Indian food served in restaurants here – they mostly catering for the millions of foreigners that come to the ashram (more on this to come). I live 5 mins walk from the main road which means it’s a lot quieter – a rarity not to hear constant traffic noise outside the window! All this certainly makes life more comfortable, but it’s a bit strange, very different to before and not entirely what I expected from living in India.

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Koregaon Park is the site of the notorious Osho Ashram – now rebranded as the Osho International Meditation Resort. I’ve not visited yet, but I’m curious so I’ve done a bit of research, plus every other foreigner in the area is here for the ashram! The more I read the stranger it gets: who knows what you can believe on the internet! I’ll try to briefly summarise:

Osho was an Indian guru and spiritual teacher who seems to have gathered an enormous international following over the years. He was widely known for controversy – speaking out against institutionalised religion and socialism, and for having an open and liberal attitude to sex and sexuality. He moved to Pune in the 70s and established an ashram that became very popular, particularly with Westerners. Meditation and other therapies were offered, but it was widely rumoured that drug use and free love were the main attractions (most recently here in a book published by his former “right-hand woman”). The government of India became more and more uncomfortable with the situation, and eventually forced him and his commune to leave India in the early 80s. They ended up in Oregon in the US and established a new ashram there, carrying on much as they did in India. At this point there are loads of conflicting articles and I don’t know what to believe. Some say he charged extortionate prices and then encouraged his followers to buy him extravagant gifts – particularly Rolls Royces, apparently he amassed 93 of them over the years. In 1985 it seems that it all went pear shaped – there were allegations of a number of crimes committed by his group including bioterrorism (food contamination with Salmonella typhi); he and his core followers were arrested and deported. Twenty one countries refused to let him enter, and he eventually ended up back here in Pune at his original ashram. His health was bad through the late 80s and he died in 1990 at the age of 54. Cause of death is recorded as heart failure but again, there are many rumours that he died from HIV or AIDS (more on this below).

The OSHO International Meditation Resort that exists today is seriously swanky looking from the outside – all glossy black marble with water features everywhere, and peacocks roaming the immaculate gardens.

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Picture from http://trevsblogg.blogspot.in/2011/02/osho-center.html

It apparently has thousands of visitors per year from over 100 different countries. It offers several different types of meditation and other activities – dancing meditation, gibberish classes, hypnosis, tarot, music, singing, painting, rebirthing therapies…apparently there are swimming pools, tennis courts, archery facilities – you name it. So far, so idyllic. But, there are catches. Firstly, there’s the money issue. Registration is 1150 rupees (around £14) and you then have to pay the same per day for entry. Then, there’s the dress code – no outside clothes allowed. Maroon robes for the day and white robes for the evening – 2 sets of each recommended, 800 rupees per robe. So that’s another £40 in clothing. If you want to swim, you’ll need a maroon swimwear – another 5000 rupees, plus 200 rupees for the pool charge. Tennis? That’s right – special gear for that too. Reading through blog posts of others that have been there, it seems there are plenty of other hidden costs. Courses and classes cost more on top of the entry fee. They sell you special socks, shawls, mats and cushions. Food is meant to be loads more expensive than outside, and they’ll charge you extra if you take a tiny bit more rice than you should. They also run “working holidays” where you stay for 2-3 months, working 6-8hrs per day for 7 days a week but you pay them! 2 months of this would set you back 40,000 rupees (£500) not including food. Seems bizarre, no? OK, the costs of entry etc are not that much compared to the UK, but they’re expensive for India. Plus, the rules are very strict. No cameras, no photos and very little noise. Make any sound (coughing, sneezing, burping and farting included) during a meditation and you’ll immediately be evicted.

There’s also a mandatory HIV test in order to enter, done using a rapid test so you get the results within minutes. Now, I’ve nothing against this – in fact, as an HIV doctor it’s something I encourage, and normalising HIV testing is a big factor in bringing down the rates of late diagnosis. I’m just curious as to why this policy has been established. Apparently the days of wild sex and free love are long gone, but perhaps this isn’t the case, and the management are just being cautious. Some say it’s because Osho himself had HIV, and implementing universal testing following his diagnosis. The official website gives the following suitably vague explanation.

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Certainly, he had some interesting views on the subject – I don’t know what year the quotes in this article were made, but it makes for interesting reading, particularly when he states that “For example, in a country like India, the disease AIDS is not going to happen while India remains monogamous, it is impossible – for the simple reason that people know only their wife, only their husband, their whole life. And they always remain curious about what the neighbor’s wife would feel like. It always remains a tremendous curiosity, but there is no possibility for perversion.” From my experience working with HIV patients here this is very much NOT the case – prevalence of HIV is high here, whereas knowledge and education are low. I’m writing a post and hopefully an article on attitudes to HIV in India so more on that to come.

I’m not really a meditation sort of person, so I’d not really considered going, and the more I read about the types of activity that are offered the more I go off the idea! I can’t see myself dancing and chanting, or alternately laughing and crying in a group of 20 others. I’m all for spirituality if that’s what you want, but does it have to cost so much? I find the whole set-up a bit strange, and very much a money making enterprise. I still don’t fully get why they do HIV testing, and I’m curious as to what they do if someone does test newly positive (I doubt there’s any pre- or post-test counselling available from what I’ve heard) and why they refuse to admit anyone who is known HIV positive. Maybe I’ll go and do some investigating….if I can bring myself to stump up the cash for robes and entry!

Delhi pt 2

After a full on day in Agra, we had a fairly laid back day in Delhi to round off the trip. Thanks to my friend and his hotel points we stayed at the Courtyard Marriott in Gurgaon, so after a good night’s sleep and an amazing breakfast we were ready to hit the sights.

First up, the Qutub Minar complex

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This is the tallest minaret in India at 72.5 metres (?in the world – conflicting sources on the internet), made of marble and red sandstone. It was originally constructed for the calls to prayer to be made, construction started in 1199. Up until 1981 you could climb the tower, but there was a big accident in which several people were killed so it has been closed off since then.

There are other parts to the complex: DSC_1599

 

This is the Iron Pillar, apparently legend has it that anyone who stood with their back to the pillar encircling it with their arms would have their wish granted. It’s fenced off now because of corrosion caused by sweat from all the people wanting wishes!

 

DSC_1604Parakeet and Islamic carvings

 

Next up was Humayun’s tomb

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Built in 1570, it was the first garden tomb to be built on the Indian subcontinent. The architectural style subsequently influenced many other buildings, including the Taj Mahal.

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As often happens when travelling in India, my friend attracted a lot of attention and was much in demand for photos as you can see!

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Next up was the Raj Ghat, a memorial that marks the spot of Mahatma Gandhi’s cremation after he was assassinated in 1948.

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Our final stop was the Imperial Hotel. We’d read that they serve an afternoon tea which is “more British than the British” and were intrigued as to whether it could deliver the goods. The hotel was beautiful and very fancy – lots of glossy marble, and a Chanel outlet in the lobby!

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The afternoon tea was pretty good – a wide selection of teas, cucumber sandwiches, scones with cream and jam and lots of other savories. There was also a good selection of patisserie as well. I can’t remember exactly how much it cost, but it seemed good value, and I didn’t need to eat again for the rest of the day!

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All in all, a lovely weekend!

 

A trip to Delhi and the Taj Mahal part 1

I’m back! Apologies for the radio silence, lots going on here at the moment. And it’s HOT (yep, I realise the UK is stuck in some kind of Ice Age and you’ll all hate me for saying that. Let’s get it out of the way and move on).

Anyway, last weekend whilst you were all stuffing your faces full of hot cross buns and Easter eggs I went to Delhi with a quick side trip to Agra just to see the Taj Mahal. This is because other than the Taj, Agra is a complete hole and you wouldn’t want to spend longer than necessary there. Trust me.

My first experience of Delhi was nearly 10 years ago and I didn’t like it much. This is mostly  because the sneaky Air India staff bumped me off my flight home, accused me of having bird flu and threatened to quarantine me, tried to steal my passport AND confiscated the batteries for my Discman (yep, the pre iPod days). Not really Delhi’s fault, but anyway. And of course it’s had a lot of negative press recently in light of the awful rape case last year. So, I’d mostly decided that I wasn’t going to bother visiting this time, but since my friends from Bangalore had planned a trip I’d figured I’d tag along, mostly as an excuse for one last trip together before they all leave India.

The Taj was first up – we had a taxi driver pick us up and drive us the 4hrs there. The worst thing about visiting any tourist attraction in India is the touts/guides – and there were thousands of them here! There are also loads of drivers who want to take you the 1km from the car park to the gate by various forms of transport (camel/horse cart/bicycle rickshaw) and they’re pretty persistent! We managed to fight them all off and walk up there (not the most pleasant experience since the area around the Taj Mahal is basically an open sewer!).

Buying tickets was interesting – the queues weren’t too bad since we’d come in the late afternoon, but as is usual for any tourist spot in India there’s a two-tier pricing system, whereby Indian nationals pay a nominal entry fee, and “foreigners” pay a lot more (but mostly it’s still reasonable by Western standards). Here, the Indian price is 20 rupees (about 25p!) and the foreign price is 750 rupees (just under £10). Now, I’ve spent the last 4.5 months being told I look Indian (with associated bemused looks when I try to explain my heritage) but I have NEVER been able to get away with paying the Indian price at any tourist attraction. It doesn’t bother me – after all, the price is never extortionate and it’s not about the money – but I like seeing what I can get away with :). Anyway, there are touts who’ll walk up to the ticket window and get your ticket for you – one approached me and asked if I wanted an Indian ticket. I head bobbled without speaking, so as not to betray myself with my very British accent. He asked for 20 rupees and got me the ticket. He’d clearly realised I wasn’t Indian as he then asked where I was from! The guards on the gate didn’t question me at all, and in fact waved me into the “foreigners queue” – aka shorter queue despite the fact that I had the wrong ticket. All very amusing. My friends had paid the foreigners price which apparently bought them shoe covers and a free bottle of water but it was too confusing to work out where to collect those from so they missed out.

Walking in is quite an experience – you can’t actually see the main building properly from the entry point at the West Gate apart from a tiny glimpse through some trees. You then push your way through the crowds and this gateway,

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and boom, there it is in all its’ glory.

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The Taj Mahal is actually a complex of buildings, the most famous one being the marble mausoleum shown above. It was built by the Mughal Emperor Shah Jahan in memory of his third wife Mumtaz Mahal who died in childbirth in 1631. Both their bodies are buried in the mausoleum, but below ground level (the tombs you see on the first floor are replicas). It took 22,000 workers nearly twenty years to build it and apparently cost 32 million rupees. Read more here if you want to.

There’s lots to see – the mosque, the gardens, the interior of the mausoleum itself – I’m not sure we saw everything, but it was crazy busy with huge shoving crowds everywhere so we did the best we could.

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The mosque at sunset

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It may be every Indian tourist cliché personified, it may be stupidly crowded, but it’s the most incredible building. I couldn’t stop looking at it (and taking thousands of pics) and I’m really glad I went. Mumtaz Mahal must have been one hell of a lady to inspire her husband to build her this structure to honour her memory. Best 25p I’ve ever spent!

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More on Delhi in part 2

Attempt at videoblogging: Riding home on a scooter

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I shot this with my iPhone whilst coming home from work the other day. It doesn’t quite capture just how crazy the roads are here (and how noisy, the sound didn’t register properly), but it gives some idea. I’ve almost forgotten what it’s like to cross a road without having to dodge a maverick rickshaw driver/motorcyclist/cow….

Primum non nocere*

*Translation from the Latin: first do no harm. This is one of the first principles taught in medicine, a reminder to consider the possible harm that any medical intervention might cause.

I haven’t blogged much about work yet, partly deliberate as I don’t feel I’ve got my head around it fully. The healthcare system here is a bit bewildering for an outsider, especially as there seems to be no standardisation, and wide variations in practice. There is apparently a huge shortage of doctors here too (one source I found stated 800,000 more doctors were needed!). Some days (well, most days actually) it seems as if the principle of “first do no harm” is incredibly hard to follow!

One of the projects I’m working in is called Snehadaan, it’s a Community Care Centre (CCC) for people with HIV and AIDS, partly run by the government and partly by a Catholic NGO. It’s halfway between a clinic and a hospital – in that patients are admitted for treatment but we don’t have all the facilities of a hospital (for example we can’t do x-rays or any other imaging). We also don’t initiate or change any HIV medication, the patients have to visit the “ART (antiretroviral) treatment centres” for that, and if they need any specialist input (dermatology, ophthalmology etc) we have to send them to a proper hospital. The procedure for this seems random too – the patients must go to the hospital. with an attender (spouse, relative, companion). The problem we have is that a lot of our patients are abandoned by families or spouses due to their HIV status, therefore it takes a long time to arrange someone to come with them, or if nobody volunteers then they just don’t go. Unfortunately we don’t have enough staff to send with patients unless there is absolutely no other option, so we often have patients waiting days, weeks or months for specialist input. It’s frustrating, because they’ll often run out of their HIV medication (a big no-no as they run the risk of developing resistance) or become sicker and sicker whilst they wait. This just seems to be accepted as normal here by staff and patients alike, and no matter how often I nag them, it never seems to change! There is also no guarantee that the patients will a) get seen if they attend the hospital, b) get any treatment, c) not be refused treatment if they are HIV positive or d) get sent back with any information regarding their visit.

Another example is the stock of medicines and equipment at the hospital – having been used to cupboards full of necessities and a well stocked pharmacy it’s hard to be faced almost every week with the reality of running out of something vital. Like oxygen – for some reason, we seem to run short of this frequently. Such a basic necessity, but life-saving in many situations. We have a patient at the moment who desperately needs it, but the person who gets the medical supplies seems to be away and no-one else has been forthcoming to fetch more. We’ve been waiting 2 weeks for a particular medication from an outside pharmacy and still no sign of it.

The management of health conditions is completely different here too – for example, tuberculosis. TB is rife here, so medical facilities are struggling to deal with the burden of patients. This means that very little time is spent on diagnosis – patients are diagnosed on x-ray appearance plus or minus microscope examination of a sputum sample. The gold standard of diagnosing TB is to do the above tests plus to culture (grow) the bacteria from body fluids in order to identify the strain, and to check for drug resistance, which is an important public health problem, and again, common in India. TB culture is very slow, and expensive so is rarely done here. All patients newly diagnosed get started on first line treatment, and are only investigated for drug-resistant disease if they fail to respond to treatment. This is really worrying, patients are not being treated properly and use of drugs that are not effective feeds resistance and makes the epidemic worse. Antibiotics are doled out like sweets here, it seems to be expected for any ailment, often when there is absolutely no indication. Unnecessary use of antibiotics means that bacteria in the environment learn how to mutate, thus subsequent use of that antibiotic becomes ineffective. No new antibiotics have been developed for several years, and we are at risk of running out of treatment options for infections which are easily curable at the moment. This was recently described in the British press as an “apocalyptic threat”. It’s hard to reason with the doctors here, as their practice is so ingrained. I had a disagreement with one doctor last week who was proposing completely unnecessary treatment with several antibiotics to a patient who had none of the signs or symptoms of the condition he was concerned about. “May as well give treatment, no harm in doing so” he told me. “Giving unnecessary antibiotics IS causing harm” I replied, and attempted to have a conversation about antibiotic resistance. It fell on completely deaf ears as he walked off, annoyed that I’d questioned his management and spoken back to him. Thankfully, he didn’t prescribe the antibiotics, but I feel like I’ve got my work cut out for me here!