Small Things; Great Love

There are unique practical challenges to doing legal work in the developing world. 

Two rats sometimes frequent our office.  One indomitable animal-lover named them Harold and Gerald.  For context, this is the same intern who befriends the dogs outside our office that have been nicknamed “Virus” and “Train Wreck”, respectively. 

A reporter who failed to appear at our office for an appointment called to say that she “was not accustomed to working in such areas as these.”

There is a small goat pen neighbouring the office, and every afternoon, about 30 of them scamper across the street.  They jockey to plunge their snouts into feed buckets, ram each other in the head, and cause general havoc for the autos trying to navigate down the lane. Every week or so, a new set of animals hops off the back of a truck and trots merrily into their pens, where they unknowingly await their demise.  You see, this happy little goat kingdom is actually a slaughter house. 

Our third day leaving work, Mark froze mid step and turned me in horror.

“What is that?”

We had just passed the building, which was gated at the end of the day.

“The goats.”

“No,” he said, shaking his head, “that cannot be a goat.  That is a person.  Just listen.”

A tortured wail warbled through the air.  It was uncannily human, like something out of a horror movie.

“Trust me—I hear them from my window all day long; that is a goat.  At least, it was a goat. But,” I started, my gaze traveling up the concrete building to a small, barred window, “if there were a person inside, no one would ever know.”

  

The most disturbing thing is that a few short weeks later, I had tuned out the noise completely.

There are, leaks, faulty electrical circuits, cramped spaces, and makeshift desks so small that you need a system in order to read and take notes at the same time.  These are humble surroundings, to say the least.  Yet, almost every one of my colleagues travels 1.5 to 2 hours each way, every day, to do this work.  They spend up to 4 hours a day in sweaty, stinking buses and trains so packed that people who faint from the heat have no room to fall.

These people are my heroes.  The work done through them, from this little office, is amazing.  During our short time here, we have had 2 convictions in cases that we were told would be impossible to win. We have seen a notorious trafficker who is responsible for countless girls’ captivity, arrested.  We have seen two sets of girls come out from years trapped in darkness and begin living in freedom.  Daily, doors have opened in such ways that can only be described as miracles. 

Click here for but one example and here for another.

This is life doing small things with great love.  Ride a train at rush hour, and you will start to understand.

Small things.  Great love.

Encounters With Indian Healthcare

A couple weeks ago I contracted some sort of skin infection. At first I thought nothing of it. But within a week the large, painful, red, bulges in my underarms could no longer be ignored. Initially, I was overwhelmed at the prospect of seeking medical attention in this foreign and intimidating country. Should I go to the hospital? How do I get into an Indian hospital? How will I find a reputable doctor, and not a quack that uses unsterilized needles? How will I pay for it? Do I call my travel insurance company? 

After a few minutes of panicked deliberation, a thought came into my head: isn’t there a doctor on the ground-level of my apartment, just a few feet away?

After a quick consult with Lauren, we agreed that I would go, but I would bolt at the first sign of a scalpel or needle. I set off downstairs to see the doc.

This is the sign that greeted me:

I was not comforted by the claim of “surgeon.” Ah yes, I know the cure for a skin infection, SURGERY. 

The pain was quite bad, so I told myself it was worth a try. Bizarrely, less than ten minutes after stepping into the office, I was back in my apartment having been examined, diagnosed, and provided with a full antibiotic regime. The price tag: 200 rupees, or about 4 dollars. So much for insurance, I thought. You would have to have open heart-surgery just to make the deductible worthwhile.

After some skeptical googling of the diagnosis and drugs, and a skype consult with Dr. Dad, I conceded that the doctor had probably nailed the diagnosis and prescription.    

But the story does not end here. After making initial improvements on the antibiotics, about three days into my course, the infection rebounded. What!? Apparently, Indian health-care professionals go a little light on the antibiotics. 

I decided I needed to up my dose, however, Doctor Downstairs was adamant that twice a day was sufficient. C'mon, the Internet and my Dad say three times a day. What more do you want?  I decided to undermine the doctor’s medical opinion and headed off to the pharmacy in search of more antibiotics. I was worried they would want a prescription, but nobody even raised an eyebrow. I probably could have loaded up with Oxytocin. 

I again made progress on the upped dose, but when new boils were still popping up ten days into my antibiotic course, I started to get worried again. Maybe the bug wasn’t sensitive to these antibiotics? Maybe I had contracted an Indian super-bug?

I asked fellow interns what to do. One guy gave me the info for a dermatologist he’d seen. 

“So, I go back to the family doctor and get a referral to get on the dermatologist’s waitlist,” I asked, thinking I might not even get in before we left India.

“Um, no. You just call her.”

So we called up the skin specialist, and she was able to see both me and Lauren (who had other skin stuff) that night. I don’t even want to know how long it would take to see a dermatologist in Canada. 

And so begins our encounter with Dr. Pramila, our neighborhood dermatologist. 

Dr. Pramila turned out to be rather amazing. Very professional, great bed-side manner, perfect English, and very thorough. We both left with multiple-step regimes for curing our ailments, and prescriptions for a whole wack of ointments and creams (that ran us about $25 combined). Lauren, who has bad allergies, and has struggled to find quality, accessible, skin-care in Canada, contemplated setting up a standing weekly appointment to take full advantage of this find.

The funniest part, however, was when Dr. Pramila told me that I was on the ‘right’ drug, but the wrong ‘brand.’

“Oh, yes, this drug will work, but I would recommend the one made by GlaxoSmithKline. The brand you have doesn’t really work.”

Apparently, I was taking a generic. And there is no guarantee that generic drugs will actually work here. About the efficacy of a tic-tac, in many cases. It’s not that they’re fake – they’re just not manufactured properly. Fake drugs are a whole different problem. An enormous and highly disconcerting problem. Some studies that tested drugs in Indian pharmacies found as many as 20% to be completely fake. But I digress.

So, in the end, I am happy to report that I am now infection free. My encounter with Indian healthcare was, on the whole, not all that bad. Some interns seem to have fared much worse. But for me, despite much trepidation, it did the trick.


-Mark