Jaipur Foot

This is yet another heartwarming story.  Mr. Mehta started this nonprofit to provide artificial limbs and other rehabilitation aids to physically challenged people who live in poverty.  

Mr.Mehta met us at the door, and walked us through the limb making factory showing us the production method and demonstrating the use of the limbs. Some of the men working in the factory were beneficiaries.  One man in particular stole our hearts.  Both his legs were artificial.  One cannot tell this just by looking at him walk about.  He can run a mile in 4 minutes and 20 sec.  One of the women (a triathlon runner) in our travel group raced with him and the man won.  

The limbs are fitted and the patients are provided rehabilitation therapy before they are sent home.  There is no cost to the patients.  They come from all over India.  The patients and often their family or support person who accompany them to the hospital are provided lodging and food during the treatment.  No one is turned away unless the doctors think they cannot be fitted with limbs (this happens very rarely).  On average it takes 1-2 days to make and fit the limbs.

It costs Jaipur Foot US $ 45 to make one limb (compared to $8000 in the west).  They produce about 400 limbs a day.  In the 35 years they have been in operation they have benefited 1.2 million people (some limbs have to be refitted after a few years).  Their operating budget is US $ 3.5 million and 4% of their budget covers admin cost.  They run this operation with 65% donated funds, 25% grants, and 10% earned income.

 

One of my travel fellows asked Mr. Mehta why they won’t charge the patients a small fee to generate more earned income. By then the meeting was continuing on the grounds surrounding the premises- after we came out for the race-and needless to say we had a huge audience (those who had come to the clinic that day). Without a word Mr. Mehta turned around and went to one of the patients sitting under a tree waiting for treatment and asked him to show us what he had in his pocket (did he have any money?).  The man turned his pocket inside out to show he had none. 

It seems Jaipur Foot’s formula for running this operation was science, technology, and a good measure of compassion. 

Not just a piece of cloth

 Goonj, Delhi (Warning: Some description of facts you are about to read may make you uncomfortable)

Goonj is not a place in Delhi. The name means echo of voices.   It is a social enterprise that aspires to eliminate cloths poverty. Cloths poverty manifests in many ways. The only kind of clothing need that gets addressed by relief organizations around the world is when a natural disaster occurs.  The more common killer of life and dignity has to do with lack of warm cloths. The man who started Goonj has an incredibly moving story.   

There is another kind of cloths poverty that is completely off the radar of any and all well- meaning social organizations that Goonj recognizes and addresses. It is to make sanitary napkins available to women in the slums. Because women in need are ashamed to talk about it this need never gets addressed.  Some families are so poor that they have only one piece of cloth that several women in the family share.  In some cases they also share it with the neighbors. The piece of cloth is often the mark of the level of poverty of a household.  

The issues for these women go beyond the availability of the piece of cloth.  Even when they have the cloth there is no privacy for them to wash and dry.  They wash them when no one is at the pump or well (water access is in public spaces) and dry them at night.  By sunrise they take them down from the clothsline to hide it from others seeing it.  Often they are damp and dusty when worn again.  The consequences are infections and in some cases death.

Goonj attempts to solve this problem through their recycling program.  They make sanitary napkins from donated garments, recycle cloths, and create local employment.  The cloths are distributed to families as reward for work and not as donations.  Some examples of cloth for work programs included digging wells or building a bridges, improving school attendance, clearing rocks from land to plant crop /save top soil erosion, etc.   

A common misconception we have about clothing need relates to circumstances.  After a natural disaster we often see tons of clothing donated to affected areas. The relief agencies often have to deal with the sorting challenges that we cannot see.  Often a significant amount of cloths (30%) are not appropriate – warm caps given to people in warm climates, pants and shirts are sent to women who wear sarees, over size clothing, etc.   The other challenge is the excess inventory. What people lose in a disaster is storage space.  The second set of cloths to them at that point is therefore not useful.  Goonj addresses all these challenges by sorting, recycling, and timely and distribution. 

    

Something that the founder of Goonj said that will always stay with me.  We who give away cloths don’t donate (we say we do), we discard them.  Our discarded cloths become a resource and source of dignity to others only when given at the right time form and manner.  And they dignify our discarded cloths and save resources by extending its life. 

Visiting and talking to the folks who run this organization was a very moving experience…

God's Own Country

I see why Kerala is called that: diversity and beauty of the flora and fauna, the backwaters, and the lush green outdoors.  (The downside is the mosquitoes.) Kerala stands out in many other ways besides being beautiful. Imagine this.  There is a Hindu temple at every street corner and a gazillion churches in a state that is ruled consistently by the communist party.  There are no panhandlers, and ALL men wear mustache.

The people are gracious.  I got to chat with a retired civil servant about Arundhati Roy’s work. As in the west, here too there is mixed sentiment for her work.  He did not think that Roy had anything valuable to say and that she is an eccentric.  With a knowing smile he added that he is of course biased.  Although a fiction why the locals may not particularly like Roy’s portrayal of Kerala in “God of Small Things” is understandable.  Keralans are known to be liberal, progressive, and literate (the state is 91% literate).  My massage therapist said she does not always understand Roy’s writings.

I am thoroughly enjoying the homestay. In addition to doing the things that tourists typically do, I am being a local unlike I was in other states.  I went to see a Malayalam movie in the theatre (lots of families brought their babies along who were nice and quiet); I went to a family gathering of my hosts’ relatives and ate local food on banana leaf- traditional style; and in the evenings I am watching local sitcoms with my host family. Language?  Not a problem.  There are many similar words in Tamil & Malayalam- I make up the rest.

Arvind Eye Care in Madurai (now in many other states in India and Africa)

What is special about the Arvind Eye Hospital is that while providing free or pay as you please eye care (yes, exactly), they are preventing blindness in India in significant numbers, AND making it financially. Go figure!

I read about Arvind eye hospital in C.K. Prahald’s “Bottom of the Pyramid.”  Seeing the facility in Madurai was an experience to remember.  I spent half a day there first attending a presentation of the eye care system followed by a tour of all their clinical facilities. 

Statistics: Twenty five percent of the world’s 3.5 million blind people live in India. Seventy five percent of the blindness here are avoidable. Arvind hospital’s mission is to prevent blindness at no cost or at affordable cost to the patients. Their pricing system puts the sophisticated economic pricing models (& assumptions) to shame.  The concept is simple: provide the services to everyone who needs it.  If they can afford to pay for the services they will. And they do.

When patients come to the clinic they are asked to choose the price they can afford to pay.  For example, they may choose to pay Rs.100, 50, 25, or none if they cannot afford to pay at all. The patients are not required to show proof of income or any other documents to qualify for the free service. In fact I could have walked into the clinic and received eye care at no cost, no questions asked (other than my name of course).

In the year just ended their ratio of paying to non-paying outpatients is 3:1 and for cataract surgeries it is about 1:1. (When they started 20+ years ago all patients were treated for free.)  On average every paying patient covers the cost of two non-paying patients. All clinical staff, fellows, and volunteers have to work in all areas: paying and non-paying hospitals and outpatient clinics.  The quality of clinical care received by all patients is the same.  Paying inpatients get single rooms (with attached bathroom) with extra bed for health attendant, or shared rooms if they pay a lower price. Non-paying inpatients get shared room with cots or floor mats of their choice.   

About 3000 patients go through their outpatient clinic in Madurai each day.  They use telemedicine to reach out to rural patients-  roaming vans equipped with satellite communication devices are used to reach out to people in rural areas.  They also now have primary care centers in villages. 

There is something else they seem to have figured out well- the “system” that uses limited resources in the most efficient way.  Their cataract surgeries use production line like organization to make best use of the surgeon’s time.  About 350 cataract surgeries happen each day in the Madurai hospital alone. They do eye transplants as well (smaller number).  

 The day I was there, I saw high school age children attending an exhibition on eye health.  Preventative care through education is a huge priority for this hospital. 

I was told by the way that MBA students from Wharton School of Business were currently on their campus studying strategic growth.  

Traveling Alone

The most interesting thing about traveling alone is the meeting of people. I continued to see these two young women at the Trichi hotel at meal times and imagined contemporary India.  I could tell they were not on a vacation.  They eyed me too, and even gave me warm smiles occasionally. I am sure they speculated about who I was and what I was doing here just as I did them.
 

Funny thing is that to Indians I do look local but I act like a foreigner- at least in this part of the country (south) I can speak the language, but in the north I did not fit in other than in looks (must admit even there I could not compete with the beautiful Indian women).  So finally I decided to say hello to them.  Since then we had breakfast and dinner together, talked and laughed every day until we parted. The Tamil Nadu Government has hired them to train teachers to teach English effectively in schools.  The problem appears to be the reluctance of Tamilians to learn a second language- they are adamantly opposed to learning Hindi- so English is a compromise it seems…

The night before my young friends left they  joked with me as I eyed another lone person dining there- that she was my potential chat buddy the next day.  It turned out at breakfast the next morning another woman asked to join me at my table.  She was attending the non-linear systems and dynamics conference in Trichi. She is a physicist who works in Hydrabad as a researcher.   We had a good conversion about heath care systems here and in the States (she had been an accidental patient there having been diagnosed with breast cancer in California while on a conference trip!!). Shame on me for feeling sorry for myself for being alone when I was down with a cold!  

It is about dinner time now.  And off I go to meet (or not) another new person... 

New Life, Trichi

The reason I am stationed in Trichi in South India is New Life-  A non-profit that provides a home for the homeless children, educates them and advocates for abused and neglected children.  They run several hostels for abandoned and orphaned children  including those rescued from sweat shops.  Although there is law against child labor in India, by the definition of the law, only “industries” are prohibited from using child labor.  Unscrupulous entrepreneurs make children work in make shift house-like premises to circumvent the word of the law. This group (New Life) uses local networks as informants to rescue these children.  The children I saw today are between the ages of 3 and 13. (They run a vocational training center for those over the age of 14.)

They so eagerly recited poems, sang and danced, and told me all about what they were learning.  They told me where they are from and under what circumstances they came to New Life. Education for these kids is not just for learning to read and write.  The girls are taught to survive the cruel world out there, how to say no.  Two girls recited a poem in a call and response fashion.--one offers the other candies, ice cream & toys to entice her to go with her, and the other responses with a "no" to each offer saying “you can keep your goodies and gifts yourself, I will not go with you, I want to go to school to study.”

 

While we were at the hostel (located in a village about 30 km from Trichi) a man brought his 8-year old son to be admitted to the hostel- he sees no other way to give his son an education. On further inquiry it turns out that he also has a girl child 10- years of age but she has to stay with the father because she is needed to cook for him (his wife has passed away- that is his story).  Beatrice, my host and the CEO of New Life is adamant that the girl must come too if the boy is to be admitted to the hostel, and the father must learn to cook for himself.  The boy is almost in tears, hope this goes well for both children.

I am going to spend a couple of days with the staff in the office- they think I can be of value in some way---  I think I am the one who is changing with this experience.  Then I get to meet the Italian and French volunteer workers as well.  Beatrice tells me that all the foreign volunteers are more interested in the microfinancing part of their operation only. The woman who is heading their microfinancing division has an incredible story.  On Monday she is taking me to a microfinance federation (of women entrepreneurs) to show me how that system works. 

The Tabla Player

On my flight from Dubai to Kolkata I befriended this vivacious  young Indian man who helped me put my bag up in the bin (“can I help you with your bag, mam?”) making me feel my age.  Turned out he is a tabla player who travels and performs around the world and was just returning after preforming in London.  He told me that he had performed in almost all the major cities in the USA and Canada.  He invited me and my travel partner to a performance the next day in Kolkata. He reminded me of my tabla playing nephew.  I was not  going to miss this-in any case we weren’t going to be sightseeing in the evening- so we exchanged cell numbers before parting ways. He was going to call me regarding the venue but the next day came and went without a word from him.  He was not real, I figured…   It turned out I was wrong, my travel partner’s phone was turned off when he tried to call (I had not acquired a cell phone by then).  He sent me a utube clip of the performance we missed. In this performance he (Aniruddha) is accompanying Sumitra Guha.

http://www.youtube.com/watch?v=KXyrkvHga6s