Day 15 (Saturday, May 17): Adventures in Mysore + Life Musing

Woke up around 6:45am. Walked down to breakfast around 7:10am. Adam, Drew and Paul were the only ones there when Lindsey and I arrived. I hugged Adam because it’s his birthday! The dining area was immaculate and mostly white in color. Breakfast was buffet style and featured American food! There were an assortment of around 15 dishes, bread, an omelet station, pastries, fruit juice, cereal, milk, coffee and tea. I was craving cereal from yesterday’s noodle dessert that tasted like Frosted Flakes, so I had that along with potatoes, pancake, turkey sausage and a cup of tea.

IMG_0899First stop: Traveled to the top of a mountain to visit the Sri Chamundeshwari Hindu temple.

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Our driver asked if we were all Christian. He told us he’s Muslim. I greeted him with “assalamualaikum” (May peace be upon you) and he responded “Wa ‘Alaikum Assalaam” (May peace be upon you too).

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When we approached the golden temple, little brown blobs were moving around and they turned out to be dozens of monkeys.

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Second stop: Christian church. We explored the congregation area and the basement.

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IMG_1316Third stop: Silk scarf store. I believe the scarves were around 1000 rupees. I didn’t buy any, but quite a few people did.

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While driving, saw an area where a plethora of white sheets were hanging. I don’t remember who told us this, but this is their method to wash and dry hospital sheets.

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Fourth stop: Women’s Health Research Institute.

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After a brief introduction by three ladies, we received a tour of the facility. Most of us quickly realized that mostly women worked here, so someone asked if any men do. They said “yes”. The three guys work as the driver and food coordinators.

We met an intern from the US that’s studying TB at the institute. There is a $500 administration fee to ensure the interns are serious and not just here for vacation. We toured the kitchen for the interns. Before leaving, a group of us talked to the US intern. He’s from California and took a year off after graduating from UC Berkeley with a public health major. He will be attending Yale Medical School in the Fall. He was here for 6 months. Fun fact: he learned to drive a vespa here.

Interns in lab study various topics such as:
– Malaria and helminthes infections in pregnant women
– Joint Indo-US study of lactobacillus and its phages in bacterial vaginosis
– UTI
– Vit D deficiency in women with BV
– Dengue virus IgG ELISA

Research:

Lab
– Molecular epidemiology of bacterial vaginosis. Amsel’s criteria for diagnosing bacterial vaginosis (must meet 3 of 4):

1. Thin homogenous vaginal discharge.
2. Vaginal pH higher than 4.5.
3. Postive whiff test for amine with KOH prep.
4. Clue cells on saline wet prep

Lactobacillus research funded by NHI. Lactobacillus in vagina and urine testing. Post-test counseling and post-natal care (PNC).

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– Evaluation of rapid diagnostic tests
– Antibiotic resistance
– Community acquired resistant UTI
– STI

Community
– Maternal child health projects
– Women’s reproductive health
– Cancer prevention
– Immunization and children health camp

Clinic
– Longitudinal cohort studies on bacterial vaginosis, reproductive tract infections, cervical cancer screening, STI/HIV prevention.
– Obtain HIV blood from mother. Identify positive or negative. Counseling available.

How they build more awareness about their services to the community:
Collect list of pregnant woman from Anganwadi teacher. Go door-to-door (service at their doorstep). This makes it easier to motivate people to come to the mobile clinic in the subsequent days.

2nd day- Education for general public. Awareness program for blood pressure, diabetes, cancer, HIV. Pregnant women. Immunizations. Birth. Flip chart pictures and power points. Family planning.

3rd– Medical camp. Self-help group. Bring women to clinic. HIV stigma very high. ASHA linked to village. Mobile clinic. Given a place to set up like a school. General check-up. Consent. Antenatal exam. Blood draw, serum separation, blood grouping.

– They do not provide treatment, but focus on education, research, detection and counseling.

– The institute is linked to the government.

– Post-natal care follow-ups last up to one year.

– Serve rural areas. Have capacity to serve 144 villages, but currently it’s 82 villages.

– HIV in pregnant woman is decreasing.

– Highest cancer rate in India is cervical.

PAP smear requires a lot of trained workers and is typically administered by private doctors. The rural population needs sustainable tests -> VIA (Mysore is pioneering this) – visual inspection. Treated by cryotherapy and LEEP.

I asked the question “for young girls, is it common to provide preventative vaccinations for cervical cancer like Gardasil?” They talked about how expensive it is – $6000-7000, which is a challenge. Currently, it is not on the required immunization chart. Targets ages 9-30 years old. Research is currently working on a cost-effective approach to preventing cervical cancer. This is also a public policy issue. They need large interest groups to support the vaccinations.

Parliamentary is mostly men. Advocating for women is a constant struggle.

Saving Children Improving Lives (SCIL) is a successful strategy for increasing uptake of HIV/PMTCT services among rural pregnant women. Provision of conditional cash transfers to women’s microeconomic self-help group members to refer pregnant women for antenatal care and HIV testing.

Prerana women’s health initiative. Objectives: provide sexual and reproductive healthcare; physical, mental and family health; conduct research to provide evidence-based care and treatment.

Project Chaitanya: increase awareness and education around the prevention of cervical cancer.

Primary prevention: 1) Creating a peer educator model in rural villages by giving training and awareness about HPV, cervical cancer and vaccination.
2) HPV- Vaccine acceptability study by parents

Secondary prevention: collaboration with prevention international: No cervical cancer (PINCC) from the US –increase screening capacity of developing countries to screen women for precancerous lesions using simple methods

Train health providers in performing simple procedure like cryotherapy and LEEP on detection of precancerous condition.

Current cervical cancer screening program is on Friday (special clinic day only for VIA screening). IMG_0970The ladies were so hospitable in that they provided us delicious snacks during their presentation: samosa, chex-mix like dish, pretzel-shaped dessert and mango juice (I apologize for not knowing some of the technical names for the food).

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Fifth stop: Mysore palace tour. A headphone-guided version was available, but we just did a walk-through. We followed masses of people in the maze-like tour through rooms filled with replicas, paintings, photographs, memorabilia, trinkets and statues. Cameras were not allowed inside. Not sure how exactly long it took, but I would guess around 30 minutes.

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Sixth stop: Café Aramane for lunch. Our group opted to sit in the air-conditioned room because the restaurant environment was smoky and humid. I sat with Nikki and Xhonela, and we shared two platters (one North Indian and the other South Indian).

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Seventh stop: A quaint art gallery with a lot of ancient paintings. Dr. Raj informed us that a lot of the paintings correlate with stories in the Hindu religion. A couple of us observed that exposed breasts were a theme in many of the artworks, and I think Taniqua bravely asked Dr. Raj what that was all about. He informed us that sari’s back then did not include a blouse because blouses are a western invention.

Eighth stop: Pantaloon store at the mall. The department store was so large that we didn’t have time to peruse the other stores in the mall. I was looking for some Indian-styled shirts/blouses, but didn’t come across any that was a good fit. I found a light blue and white patterned scarf for 249 rupees though!

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Headed back to hotel for an hour. Lindsey and I decided to chill in the lobby and asked for the hotel’s wifi password. My phone was extremely slow, so I eventually gave up on accessing the internet.

Ninth stop: Returned to the Mysore Palace to watch the light show. There was a story line behind the light show, but we could only guess what was happening because we didn’t know the local language, Kannada. A few minutes before the show ended, it started raining. Fortunately, as we were walking back to the entrance, we had the opportunity to see the palace all lit up in golden lights. Such a majestic sight.

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We walked about 10 minutes back to the hotel, which was quite an adventure. Imagine a group of 20 students crossing a wide and busy Indian-style intersection at night. Not to worry – we all survived! Haha. I got an adrenaline rush from the experience.

We had some time to kill before dinner, so several of us played “Would you Rather?” in the lobby using a question bank from the internet. The one question that struck a cord with me was “would you rather have a bell ring every time you are aroused? or feel a sharp pain in your side whenever someone says your name?” I was surprised that everyone agreed on the sharp pain, but I would choose otherwise (I didn’t get to voice my thoughts at the time). I’m going on a tangent/a little TMI, but life’s too short to live dishonestly with oneself or to be afraid to tell someone how you feel. I read this relevant quote a couple weeks ago:

IMG_5926I think this message can go beyond a romantic context (I know. I know. The question above used the word “aroused” but forget about that for a second). You can let your family and friends know that you love and care about them. We often take for granted the people we see frequently, so it’s never foolish to remind them of their value in your life. In the case of romantic relationships, if the love isn’t reciprocated, at least you tried and won’t have any regrets. Living with honesty and openness and welcoming candid conversations is extremely liberating. This is what it feels like to be human. I am working on this myself. #gettingoffthesoapbox

Multi-cuisine dinner buffet. We all sang for Adam’s birthday.

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For dessert, I was tempted to try some fruit because I was missing it in my diet, so I ate five small pieces of the assorted pineapple, watermelon and papaya. Ice cream is my weakness, so of course I had some for dessert also. The flavors were vanilla, mango and chocolate. I even went up for seconds.

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The concierge encouraged us to go to the discotech club right outside the hotel.

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As a collective group, we decided to check it out. We only had to walk one minute to see a couple men dressed in black shirts stamping people’s hands with the words “the room” in purple ink. We walked down the stairs to approach a coconut door.

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On the other side of the door was a neon green lit up path that led to the dance floor equipped with a disco ball and everything.

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There were “no smoking” signs plastered on the walls, which was nice. Techno music permeated the room. We stood relishing the sights and sounds for about ten minutes. We went back to our rooms in the hotel. Coincidentally, our room was one of the closest to the club, so Lindsey and I could hear the pulsating beats of the music well into the night, but it didn’t bother me. I showered, packed and went to bed. Stomach wasn’t feeling too well during the night. Suspected it was the fruit. I’m not sure if I mentioned why we shouldn’t eat raw vegetables and fruits here, but it’s because of the water and the different bacteria in it that our stomach might not be used to if we didn’t grow up in the country.

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