So this is the second day in Trivandrum, and the first day of the actual course. We're off for today, having had dinner, and I am, after taking a shower, holed up in my room under the ceiling fan, writing this. It seems to be the only place you can stay at to avoid getting all sweaty in a couple of minutes.

It was good to come to Kerala. The air is cleaner, and the landscape is lush like anything I've seen. They call this state God's Own Country. It's also a fair bit more humid than Bombay, and even though it's getting to be annoying to sweat at all times, I'd be lying if I said the tropical climate didn't appeal to me. Really, this place has a very jungle-y feel to it. Trivandrum looks like it's been dropped at random in the middle of all this vegetation, and where the buildings end, there are palmtrees as far as you can see.

As for today and the course, 7-8 hours of sleep last night had me feeling a lot more up to speed. This day held a visit to a Primary Health Centre in the countryside - these are small operations run by a staff of 10-15 people, and healthcare and medicine are provided for free. Unless you happen to be rich (a claim not possible to make by a very large part of the population), one of the PHC:s is the first place you go to when ill.
At first glance, the place seemed seriously undermanned. There's a crowd of 80 or so people waiting to get in, with a single doctor to see all of them. We get out of the car, and the difference in temperature from its air conditioner-cooled interior to the pounding heat outside makes my glasses fog up.
We all stand there looking around a bit nervously, while the crowd goes silent and all eyes turn to us. I knew this would happen, but it comes over me like a cold shower how alienated and distant I feel from everything and everyone I came here to learn how to improve and help.

As we stand there looking lost, probably a stretch of time that felt a lot longer than it actually was, my thoughts drift back to the trip here. Aeroplanes. For trips like this they are like teleporters or time machines. You get into one, and a few hours later you step out, a bit lagged, into another world.
From somewhere, I've heard a story of how certain American Indians believe that when you travel somewhere, your soul attempts to go along with your body - but while the body can be moved at great speed, the soul can only travel as fast as you would walk. So whenever you go by plane, your soul will be left trudging along way behind you, and it might be a good while before it catches up. So I stand there and think maybe that's why I'm moving so slow, why I look at things without being able to feel like I really see them.
But, what was I expecting. You have this idea of yourself boldly going where no white man has gone before, getting on the scene and sorting things out Lee Iacocca style. You know, you've been in the room for five minutes and already you're in charge. Wake-up call.

Slowly, we make our way through the crowd. Some are coughing, some have trouble standing, and a good deal of them have young children or babies with them. They part to let us through, and I try to remind myself that though I certainly feel like one, this time I'm not just a rich white kid getting whatever he points at. I'm here to learn. I'm here to help. I'm a Man with a Quest.
The doctor, a woman in her thirties (or so) with a friendly smile steps out to greet us and show us around the place while explaining how it works. It's not very big. One room to see, examine and diagnose the patients, one for administering immunizations, one working as a pharmacy, for sorting and distributing drugs, and one room to store journals and records, and for the staff to take breaks in.

After this, with presumably all of us feeling guilty for them having been kept waiting this long on our account, the patients started dropping in, one by one. There was a cloth-screen put up by the entrance as to give a certain measure of privacy, as the entrance hall and the examination room were virtually the same locale. With so many people starting to crowd in though, there wasn't much privacy to be had. The eight of us were sharing a table with the doctor, at the end of which a chair was placed for the patients to sit on and speak of their ailments.
Now, you probably aren't a medical student, but if you are, forget all you know about "starting openly" or "the patient-centered discussion". Here there was a rapid examination done, with the stethoscope barely resting on the chests and backs of the patients long enough for a heartbeat or intake of breath to be heard. After this a diagnosis was produced and subsequently explained to the patient even faster. On average our doctor didn't spend much more than two minutes per patient.

But, I think from my bed, as the cotton lets go of my mind and my eyes finally seem to clear up, this was my first time face-to-face with patients in poverty, and it proved impossible not to be moved by it. How could you not care for the old woman, blind and partly disabled, with irises all white and swirly like milk from the cataracts, wailing and begging repeatedly for the mercy of death. How could you not feel the urge to hold her, help her and do what you can for her, telling her everything will be all right in the end.
There were so many patients passing by so fast, but with most of them looking so humble, so grateful for whatever help or medicine they could get during those two minutes, even after standing in line for three hours of 35°C, blazing sun and extreme humidity, in many cases with a fever already... how could one not want to help out after seeing this, I wonder.

Well. Time stretches out here in India, it seems, but even so it's getting late, and tomorrow holds a day of visiting families in the countryside. We are to examine differences in income and living standards, and then proceed to give a presentation of our findings. For me, right now, that spells sleep.

Goodnight.