Day 22 (Saturday, May 24): Cashews

Woke up spontaneously around 3:30am and again at 7:15am to the alarm. I walked to the bathroom to brush my teeth and spied a colony of white and black ants climbing on the wall surrounding the sink. I used my bug spray on them, so now they’re all dead on the wall. Admittedly gross, but better than hundreds of them crawling around. I was imagining the movie, Bugs Life and wondered if the ants could communicate with one another (i.e. letting fellow ants know about my attempt at using bug spray to decimate them).

IMG_5669Outfit of the Day. Haha.

Left for breakfast around 8:35am. Ran into Anna and walked down with her. Breakfast was good, but didn’t have enough time to finish my plate: potato pancakes, omelet, peas and bean curry. Sesen said she refuses to believe that I’ve worked at Hollister and heard not many people like to work there. People were surprised when I said I actually loved it. They asked what I did there. I said operate the cash register, greet people at the front, and fold clothes. The real reason why I probably liked it is because I love folding clothes. Everyone looked at me quizzically and said they hate folding clothes. Only Lindsey admitted she likes folding too.

Dr. Kamath, Dr. Raj, and most of the group waited outside the library. Dr. Kamath wanted to formally present a mini PowerPoint about occupational diseases among cashew factory workers in South India in our regular classroom on the fourth floor. The information was really interesting. Topics included: where cashews are heavily exported and imported (Brazil, India, West Africa, and Vietnam were producing countries), diverse uses of cashews, steps to produce an edible cashew,

1. Clean, Dry
2. Steam, Cool – dangerous3. Separate shell from kernel manually and mechanically – dangerous
4. Peel
5. Grade
6. Pack

IMG_5642the acidity of the shell, demographics of the workers (mostly women, no skills or education required), and common diseases contracted (contact dermatitis- dark brown dead skin from anacardic acid).

  • Tried to introduce glove usage, but it’s inefficient for grip and speed, so most workers choose not to use because they are paid on efficiency and output. Creams (e.g. paraffin, polyethylene, glycol castor oil) are used as a treatment option. Mechanization isn’t a 100% solution. Machines cause unemployment. Eventually the skin renews, but long-term implication = cancer.
  • Other health problems: back, knee, and shoulder pain.
  • Older people cut and separate, while younger people peel and grade (lower pay).
  • 50-100 rupees to ESI health insurance. Injuries covered.

It surprises me that I’ve never really thought about the field of occupational health before – health issues associated with work, so this was a topic I really enjoyed learning more about in India.

Boarded yellow Manipal bus and sat with Taniqua. I initiated a conversation with Dr. Kamath, who sat across from me. I questioned, “do you work at Manipal’s hospital?” K- “Yes.” Me- “What do you do?” K- “Public health (…)” Me- “You’re a doctor too?” K- “Yes. Do you doubt me?” Me- “Noo! It’s just I don’t think you’ve talked much about yourself.” He went to Manipal University for his education. The accent barrier made the conversation more awkward than I would have liked because I found myself leaning in further to put my ear closer to his mouth, so that I could hear better. I told him my plans of attending medical school next year and possibly getting an MPH too, which is what he did. He said he really likes the combination and it helps to explain many maladies. He shared some examples of how he understands more about a person’s problems by looking at the public health side (i.e. occupational). I said I really liked that aspect. He asked me about my background (education). I said I am majoring in Neuroscience and planning to attend medical school. He also asked about my heritage and I said I’m born in Columbus, but my mom is from Vietnam and my dad is from Malaysia. He mentioned Vietnam as a leading producer of cashews and I told him I remember that from his lecture in the morning. He shared he went to Malaysia last week and I said “really?? For work?” He said yes and that it’s a really beautiful country. He asked if I’ve ever visited. No to Vietnam and yes to Malaysia, but the trip was when I was a year old, so I don’t remember anything. He listed all the countries he’s been to – 12 countries mostly for work/conferences. He asked what my parents do. I said my mom is a waitress at a Chinese restaurant and that I am a first-generation college student. He said a lot of Indians here are too.

10544759_10152428759674620_8988784618373036974_oVisited a Rotary Hospital. Talked to Dr. Shetty.

IMG_5645I asked him what Rotary means. He said I made a nice observation. Essentially, it’s a teaching hospital for medical students (MDBS). Typically, students work for one year on an internship.

  • The hospital sees about 100-200 patients/day and performs 2-3 deliveries/day. Send the mothers back on day 4. Perform 25 operations in a month.
  • Other services: cataracts, vaccinations for 8 diseases, cancer screening, OBGYN.
  • Serve rural population.
  • Setup: common wards and private rooms.
  • Affiliated with public health department and focus on community health and preventative medicine.
  • Rotary International founded and built the hospital. The land was donated to Manipal University.
  • 3-H grants to provide accessible care to poor people.
  • Biggest challenge: shortage of medical staff because of rural environment.
  • Netherlands sends interns here for 1 or 2 weeks.

Visited the ophthalmologist in the hospital.

IMG_1326Most common ailments he treats are cataracts and glaucoma. Used to be free with grant, but it’s decreasing. Common beliefs- watching too much television or going outside (sun damage). Myopia is extremely common in school-aged children.

IMG_1328Arrived at the cashew factory and received a tour. Afterwards, we hung out in the owner’s office, while waiting to purchase cashews. Our whole group played word riddles to pass the time. At one point, the phone rang and Dr. Kamath picked it up. It was funny because the owner had previously picked up the phone last time it rang, but since the office was overcrowded with all of us, Dr. Kamath picked this one up. Then, another man ran around the exterior of the office, told Dr. Kamath to open the window, and took the phone outside. Hahah.

IMG_5646I bought two ½ kg bags of cashew. I am planning to give one to my mom and the other to Arif. In line, Adam told me he had a dream with me in it talking about free medicine. Coincidentally, he was in the background of my dream last night too! Taniqua told me I was knocked out asleep on the way back to campus.

We ate lunch in the cafeteria. They had these hush puppy-like balls in curry that was so good. Went with Lauren to the hospital to get her swollen bug bites checked out. Kelsey R and Adam came also. Lauren got some medication to relieve the swelling and itching.

IMG_5649Went back to the hostel afterwards. After tea time, went with Lindsey and Adam to the library to see if the Wi-Fi guy was there, but he wasn’t. I read case studies until dinner at 7:30pm. Taniqua mentioned how it’s crazy we have one week left and a lot of people are longing to head back home, but I shared my wisdom about appreciating every single day no matter how bad it gets because it’s inevitable that we’ll be leaving. The day will come whether we ask for it or not, so why not enjoy every moment you can? I went back to the room after dinner, washed clothes, showered, and tried to finish the case studies that Dr. Raj sent out. But I gravitated over to my bed around 11pm and fell asleep before a Skype date with mom. Oops.

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