Daulati’s Tuberculosis of the Spine…

…I spent the entire day today at the hospital with this beautiful, angelic, and incredibly unfortunate young girl named Daulati. Even among the slum’s residents, Daulati’s family is one of the most destitute of all. To make matters worse, she has half a dozen siblings, is severely malnourished, and can now hardly walk due to an infection that has contorted and crippled her spine.

_Daulati on X-Ray Table
–Daulati today on the x-ray table–

I never met or even knew about Daulati when I was here last year. However, I became aware of her painful and debilitating condition nearly one month after my departure. She and her family had heard about our work treating other children and approached Mithlesh for help. Mithlesh sent me the following photo with a short description of her severe pain and evident need for immediate treatment:

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–Daulati on June 21, 2012–

Not knowing at the time what this condition was, I asked Mithlesh to take her to the hospital as quickly as possible. Amazingly, Daulati’s family had never sought treatment before. Mithlesh and Mamta both generously agreed and took Daulati with another of our patients to New Delhi on multiple occasions. The physicians there drained her abscess and referred Daulati to the All India Institute of Medical Sciences (AIIMS), India’s largest government research hospital, for further care and radiology.

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At AIIMS, Daulati was diagnosed with “Tuberculosis of the Spine,” also known as Pott Disease.

According to the NIH, India has one of the largest concentrations of patients with TB anywhere in the world with more than 6 million radiologically proven cases. I can only imagine there are at least twice or three times as many people who actually have it but never seek care. Worldwide, approximately 30 million people suffer from TB and nearly 3 million people die annually from the disease. Among all cases of TB, approximately 1-2% of patients develop skeletal tuberculosis, approximately half of which are reported to result in spinal tuberculosis.

_Pig in Ruins
–Conditions ripe for disease…notice the pig in the center room–

Patients with TB are often poor, illiterate, uneducated, and/or live in highly dense and unsanitary conditions. Multi-drug resistant tuberculosis (MDR-TB) is a growing problem in India, mainly due to a lack of proper patient education. Illiterate and impoverished patients start taking their antibiotics, improve, and then stop taking all medications because they feel better and don’t want to waste their time or money taking pills. Strict adherence to medication protocol over as many as 9 months is vital for curing a patient’s TB. However, these patients live day-to-day and lack the awareness of the harm they do to themselves and others. As a result of their failure to adhere to instructions, they occasionally develop MDR-TB that creates entirely new and severe public health concerns.

_Daulati and Sister

People here fear TB, as they should. Mithlesh expressed his concern of being infected. I could not ask people to take on a risk that I could not evaluate or take first. Instead, I attempted to have Daulati’s family take care of her on their own. However, they refused/were unable to go on their own. They live in the same room as her and breathe the same air all day every day.

_Daulati on Bed
–Daulati just a few days ago–

Even though Mithlesh and Mamta had shown Daulati and her family what to do and where to go, they would not go alone. For the past six months, Daulati’s condition has continued to deteriorate. My first sight of her broke my heart. She is like a pile of mangled bones shrink wrapped in dark weathered skin. She walks bent over at a 90 degree angle with her arms assisting her every move like a primate. Watching her climb in and out of chairs or vehicles is heart-wrenching. How could her parents stand by and watch her suffer so miserably?

I never cease to be amazed by the extent of suffering people will endure here. Daulati’s condition has been worsening now for nearly two years. She has had severe kyphosis (hunchback) for over a year and yet her family never took her to a doctor. As shown in the photo above, Daulati spends her days laying in a mesh bed outside of her family’s little shanty in the slum.

_Daulati's Father and Home
–Daulati and her father outside their makeshift home–

The longer I stay here, the more I realize that healthcare among the poor in India is a complete mess. After experiencing the deaths of Kishan, Santosh, and numerous other precious little children who died from easily-treatable illnesses, I have realized that many of the problems are fairly simple. Rapid, early treatment could have saved faces and lives in many cases.

_Manish Portrait with Dolly
-Manish’s venous malformation should have been removed when it was the size of a pea–

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–Kishan should have received treatment for pneumonia before it killed him–

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–Santosh needed an IV for his diarrhea. Instead, his simple illness was fatal–

Today, however, Daulati’s world took a new turn. I suited up in a mask and gloves, placed masks on Daulati and her father, and then set out with them in an auto rickshaw to one of the best private hospitals in town for appointments I had made. Within 4.5 hours, we had visited multiple senior orthopedic and plastic surgeons and obtained T-and-L-spine MRIs, chest x-rays, and blood tests. She was an ideal patient and never once complained, even when her noisy, claustrophobic MRI took nearly 90 minutes.

_Daulati in Wheelchair
–Samosas and ice cream as a treat for being such a good patient–

The physicians today were not too concerned of active pulmonary TB, which is good news for her family and me. However, I will continue to take the best precautions I can.

We will return for her results and follow up on Thursday morning, when the surgeons will drain her abscess, treat her tuberculosis of the spine, and plan an operation to repair her kyphosis that would otherwise remain chronic.

How far would Daulati’s family had let her health deteriorate without seeking help? After my experience alone with her father today, I fear she would have almost certainly died.

Many thanks to the donors of Healing the Hidden who made Daulati’s MRI, x-rays, blood tests, transportation, and consultations possible today. Our combined efforts may very well save her life.

(Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3075833/)

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Top Shots: Slum at Dusk…

…In the movie The Best Exotic Marigold Hotel, which takes place in India, Penelope Wilton’s character asks Tom Wilkinson’s, “How can you bear this country? What do you see that I don’t?” He responds, “The lights, colors, smiles; they teach me something.”

I think these photos capture a bit of what he means. Click on them for the full resolution sights!

_Man on Roof at Sunset

_Tree in Center

_Up and Down Rooftops

_Deceased Dog Vertical

_Bull in Center

_Dog in Canal Looking

_Tree on Left

_Smoke Stack at Sunset

_Ring of Fire

_Geese at Wedding

_Slum at Dusk

_Big Tree in Center

_Slum at Night

Choosing the Lucky 15…

…In India, about 72,000 children are born every day (approximately 1 birth every 1.2 seconds)! Nearly half of those children will not have access to adequate nutrition, let alone be able to receive a proper education.

Last Sunday, we underwent what is to me the most difficult job of Squalor to Scholar, selecting new students. For each student we eventually admit, there are dozens of deserving children their age and gender nearby that we must refuse. I know that, without our presence, none of these children would likely ever attend a school capable of giving them a meaningful education. Although we help as many children as we can, there will always be more waiting.

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On Saturday evening, after most adults have usually returned home from their factories, construction sites, and rickshaw pulling, we tried something that we had never tried before. I had Mithlesh, the slum’s only English-speaking resident, walk through the entire slum to announce a meeting that would occur at 11am the next morning. For three hours, he walked from one end of the slum to the other informing residents that we would like all 3.5-4.5-year-old females and their families to be present at our important meeting for further information about being enrolled in the most prestigious school around.

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_Meeting with Mamta

When we arrived for the meeting at 11am the next morning, 31 little girls and their families were waiting for us. Having learned from our selection process last year, we verified the documentation and eligibility of each child and photographed them with their names and birthdays so we could identify them later. We then informed the families of the significance and responsibility associated with this wonderful opportunity. We also answered several questions and ensured the long-term commitment of each family should they be selected.

These are just a few of the precious children we had the fortune of meeting:

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_Selection Meeting

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We then asked all parents and family members to leave the room for 90 minutes while we evaluated each of the children further. They stepped outside and stood right next to the door. For many of the little children, it was their first moment away from their mother or father. About half cried bloody murder while the other half just stared at them baffled by the whole situation.

As you might remember, I was first informed in October of the plans to admit fifteen 3.5-4.5-year-old girls to the Carmel Convent School this admissions cycle. Since I was back in the United States at that time, Mamta performed an initial evaluation of students meeting the necessary criteria and has been teaching many of these students since to prepare them for the final selection process. Her specific knowledge about and experience with each of the children and their families has proven invaluable in the selection process. Thanks to Mamta’s dedicated work, many of the students now know how to count, write their ABC’s, and sing multiple songs. Thank you Mamta! We could not do this without you.

_Line Up of Test Takers

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–Manish even accompanied his older sister to the meeting–

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In addition to Mamta’s evaluations of each child, we further tested their levels of writing and speaking, as well as their general attitude toward learning. These children are approximately half the age of the students we took last year, thus requiring a much different mentality when determining how to evaluate “talent.”

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In the end, we whittled down the original 31 children to 19. The sisters have also selected some of their own children and they will be added to our final list.

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–The finalists–

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–Mamta instructing families about the next step in the process–

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–A mother waiting for her daughter and our decisions that will impact their futures–

One more step remains: to introduce our top children to the sisters and have them select the final 15 students for registration. I’ll be back soon to bring you with us and introduce the Squalor to Scholar Class of 2027.

Finding the Class of 2027…

…Although I initially thought we would have more than one month to select children for this year’s admission to the Carmel Convent School, our timeline has been shortened dramatically. Over the next few days, we will search for, gather, examine, select, register, enroll, and begin preparing fifteen 3.5 to 4.5-year-old girls for the first day of school in their family’s histories.

_Canal Looking Down the Slum
–The Patel Nagar slum, home to 25,000 people–

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Last year, we scoured this slum of 25,000 residents for the most talented and deserving children we could find without much regard for their age. Although our first class of students is thriving in and out of the classroom, it has taken a tremendous amount of work on their part and ours to get them caught up with their classmates. When our students began first standard classes 10 months ago, they were already nearly 3 years behind other students. The wide age range of our students has also turned out to be an issue with accreditation and overseeing agencies, thus necessitating a new approach this year.

_Rani Portrait
–Rani, who has been studying at the Carmel Convent School for the past 10 months–

_Cover Photo of Child
–A young girl waiting in the slums for help–

This year, the sisters have generously decided to provide us with 15 seats in Lower Kindergarten (LKG), the youngest class. This way, our students will receive the same education as other students from day one. As I have mentioned numerous times in previous posts, female infanticide and male favoritism are still realized as substantial problems in Indian culture. This year’s theme of the Carmel Convent School is “Save the Girl Child.” To balance the ratio of males to females in their school and make a poignant statement about the importance of saving and educating female children, the sisters have decided that this class of 15 will be comprised solely of females. These girls must be of impoverished backgrounds and have birth certificates, caste certificates, and government-issued ration cards, among many other forms of documentation. They must also be between the ages of 3.5 and 4.5, thus narrowing our selection criteria dramatically.

_Amy Walking Hand-in-Hand
–Volunteer Amy Bergam walking with current students Poornima, Pooja, and Neha–

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–Volunteers Amy Bergam and Caitlin Rulien with Neha and Gudiya, respectively–

Every day, generous and caring volunteers from around the world join me on my journey into the slums in support of our current students and search for new ones. The process is incredibly emotional, especially to the volunteers who have not been involved in such life-changing work before. However, I can certainly sense my own maturation over the past year. I feel very much at home in the slums now. Nearly everyone knows me or at least has an idea who I am. Although I will never be comfortable with the poverty and squalor, I am now accustomed to it and am rarely surprised by the powerful sights or pungent odors.

_Dirty Park

_Madhu Hugging Mom
–Madhu hugging her mother after school–

Last year, I had to convince families in the slum why they should send their kids to one of the best schools in town. Madhu, shown above, would never have attended a day of school in her life had we not spent many hours with her family discussing why Madhu should take advantage of our unique offer. Her mother originally denied our support but changed her mind at the very last moment. Their expressions in this photo are indicative of their opinions now.

_Lata
–Lata’s family refused our support–

_Rahul
–Rahul’s parents also denied us the ability to help him–

Both Lata and Rahul were selected to join Squalor to Scholar last year. They are both highly intelligent and driven. Although I tried many times to convey the importance of education to their families, both families turned down these opportunities of a lifetime. This week, I went back to the place I had met Lata and Rahul last year. They were still there, trudging through life in the slums. These two wonderfully talented and handsome individuals will never attend a formal day of school. They will likely live in slums and in poverty for the rest of their lives.

This is a prime example of the types of challenges we must overcome here. Nearly all of this slum’s residents have migrated here from Bihar, a state generally believed to be the poorest, most corrupt, and most educationally backward state in India. They are also members of the lowest castes and are used to people treating them as such. Therefore, the adults here have developed a rather strong distrust of others.

However, the success of Squalor to Scholar and our continued presence here over the past year has earned the trust and respect of many families. Everyone in the slum knows about our students and sees them walking to and from school every day. With their bright, immaculate uniforms, they are still beacons of hope and opportunity to everyone around them. I am still stunned, however, by the lack of jealousy toward our students.

After the selection and enrollment of these new students, I will return to the families of Lata and Rahul to offer them one more chance.

_John and Ankit
–Ankit is, like Ajeet, now one of the top students in his class–

_John on Rani's Roof
–Enjoying being reunited–

_John on Rooftop
–Checking on our students/families and searching for new ones–

_John with Rani
–Maintaining the Squalor to Scholar “family”–

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–Verifying documentation and eligibility of candidates with Mithlesh–

_John at Selections
–Meeting and teaching potential students–

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–Tracking students and organizing further evaluation–

_Working in the Slums
–Discussing expansion with local officials and social workers–

_Picture of a Picture PS
–Working to bring you with us–

I have certainly hit the ground sprinting here in India. In only two weeks, we will have accomplished what took nearly two months last year. As I continue to learn from our mistakes and challenges, my goal is to streamline our work so that it is scalable and replicable far beyond the borders of New Delhi or even India.

_Chandani Looking Out Window

There is tremendous potential ahead. I’m not sure what the future holds, but I have a good feeling about our rapid progress. What an amazing year this has been. This time last year, I had still not even met the sisters or known anything about their renowned Carmel Convent School.

Top Shots of Week One…

…I have never been anywhere else in the world where the people are so universally photogenic and surroundings so bright, colorful, and unique. The striking residents here do not beg for money or possessions, but just that I take their photos. It is as if they want me to see them again and remember them forever. Over the past week, I have taken 1,661 photographs, mostly of people. Although I wish I could, there is no way for me to blog about or explain all of them. Therefore, I am occasionally going to upload a “Top Shots” post like this to give you a taste of general life as a foreigner working in the slums of India. Here is my small selection from week one:

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_Rani's Sister and Friend
–Rani’s sister Rupa and her friend Dolly–

_Cow and Cow Pies
–A cow and cow pies–

_Roshan Mother and Sister
–Roshan’s Mother and Sister–

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–Hitching a ride home on a tractor–

Lonely Child

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–The shutters are often firing in both directions–

Well Worn and Happy Man

Manisha's Brothers
–Manisha’s brother, Akash, with a local toddler–

_Gambling in the Slum
–Gambling on the edge of the slum–

_Grazing Cattle
–Grazing cattle…perhaps there are alternative reasons why nobody eats beef here–

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–Gudiya running home from school–

_Torn Up Alley

_Auto from the Back Seat
–Riding in an auto-rickshaw–

_Burning Door

Female Portrait

_Slum Goat

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Leading Two Lives…

…The day after I arrived, our students suited up in their new winter uniforms and set out for their special class while regular school is still out of session for winter break. For the winter season, we purchase our students new uniforms, including sweaters, sweater vests, blazers, and long pants or skirts to stay warm. They look terrifically handsome and beautiful yet striking against the background of their foggy homes and surroundings.

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–Sonu and Pritesh–

Our students rarely go anywhere alone. As I expected, they have become best friends over the past few months. Hand-holding even among men is common in India and our students walk everywhere hand-in-hand.

Poornima and Anita Walking to School 2
–Poornima and Anita–

Roshan and Mother
–Roshan and his mother–

First View of All in Winter Uniforms

For those of you just joining us, these students you are looking at live in a slum and are members of the lowest castes in Indian society. No one has believed in them enough before to give them the opportunity of a world-class education, or any education for that matter. Even now, many people here are skeptical about their abilities to succeed.

We, however, do believe in them. Over the next few months, I’m going to prove to you why. These students first started school 10 months ago. At that time, they knew only the English alphabet and how to count from 1-100. They could not read, write, or speak to any greater extent. Even in Hindi, their native language, the could only recite the alphabet.

For the past 10 months, they have been studying 7.5 hours a day (2.5 hours longer than regular students) and six days per week at the Carmel Convent School, a well-renowned English-medium private school near their slum. Before I left, our students and I could hardly communicate at all beyond body language. Now, they understand much of what I am saying and can even translate for me when people approach us on the street to ask me questions.

When we walk places, they call out and spell the names of everything they see. They will point at, for instance, a picture of a elephant and yell, “Elephant…e-l-e-p-h-a-n-t!!!!” or see a rickshaw passing by and yell, “Rickshaw…r-i-c-k-s-h-a-w!!!”

Goofing Around in Winter Uniforms Cropped

They also happen to have spectacular senses of humor. They have always made me laugh with their actions but they do so now with their words as well. When passing a field where many people go to dispose of their human and material waste, the children point and yell, “Park…Dirty park!…Very dirty park!!” as they wiggle and rotate their hands back and forth to signify ‘do not enter.’

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–The “very dirty park”–

In the Classroom Winter Uniforms

The vast majority of our students can now read entire pages of books out loud and without any hesitation, even material they have never seen before. I brought “The Cat in the Hat” along and we were able to read it together for the first time.

Sky View of the Classroom

They also understand that they’re all in this together. They help one another when they are struggling and congratulate those who receive high marks on tests or homework. They are like a large 21-person family.

Roshan and Ahshansh in Winter Uniforms

Gudiya Ready for Prayer

Every class begins and ends with a prayer thanking God for the ability and opportunity to study. It is a precious sight to behold.

Walking Through the Slum
–Walking home from school–

Mansiha Showing Home
–Manisha returning home to begin cooking–

When school ends, the children return to their dwellings in the slums and change back into their tattered clothing. Many of them return to bare feet and quickly become indistinguishable from the other children in the slum. They begin their chores and often perform most of the work to maintain their homes. At about 8pm, most of the students begin their homework and study for 1-2 hours before going to bed.

These kids are among the most fascinating and inspiring I have ever met. They lead two completely different lifestyles now and yet fit into both of them remarkably well given their circumstances. I am proud of them and hope you are too.

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–Madhu cooking with her mother–

My Return to the Slum…

…It has been seven months since I departed India and yet I feel in many ways as though I never left. The constant din of automobile horns, pounding of factory machines, chants of salesmen in the streets, and clanking of billowing tuk-tuk engines create a unique atmosphere that cannot be forgotten. The air is thick with pollution and inhaling occasionally takes noticeable effort. It is very cold at night, to the point of needing fleece and a wool hat inside my sleeping bag.

I arrived in Delhi at 11:00am on January 10. After 28 hours of flights and airports, an hour of customs and immigration lines, and a 90 minute taxi ride from the Delhi airport, I finally arrived at Mamta and Shri’s home. Their daughters, Naysa and Nayma, were standing in the middle of the street with flowers in hand. I stepped out of the car to kneel down and hug them when they extended their flowers and harmoniously sang “Welcome to India, John Bhaiya!”

I unpacked and organized my belongings, set everything up as I had it before, and then joined two new volunteers, Amy and Bethany, for Mamta’s great cooking.

Back Home
–Amy (left) from California and Bethany (right) from Australia–

Then, off to the slum we went. I was immediately recognized by hundreds of children and adults in the slum. Many of the adults even came forward to shake my hand and welcome me back.

First Sight
–Greeting my old friends and making new ones–

I had wondered many times what the reaction would be to my return. However, I did not predict or even consider the reaction I actually received. Everyone I had interacted with before in the slum knew that I was coming and the day that I was supposed to arrive. No one, therefore, was surprised by my arrival.

Madhu and Manisha Surprise

Interestingly, many of our students seemed initially hesitant to approach me. They would peek their heads around a corner, see me notice them, and run away with big smiles on their faces. It was as if many of them were playing a game of hide-and-seek.

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–Manisha hiding from me–

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—Madhu waving hello–

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Only then would they come closer. They ran up to me and stopped just in front of my feet. They made no attempt to touch me but looked directly up into my eyes with massive smiles and said “Hello, John Bhaiya!”

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–Ankit, Ajeet, and Sonu–

Sindu First View
–Sindu at first glance–

Girls at Anita's Home
–However, they still do not smile for photos–

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–Neha holding my family’s photo in plastic–

Neha ran to get something to show me. Before I left last May, I had given a picture of my family and me to each of the students. Neha’s family framed the photo and keeps it in plastic covering on the wall of their tiny dwelling. She was so proud to show me she still had it.

Greeting

Manish and his mother Dolly were out in public prominently sitting along the main route through the slum. Manish has continued to receive treatment during my absence. His venous malformation does not appear to have grown, which is cause for celebration. I wish that we could do more but at this time surgery is still not an option here. I will take him to a physician soon for closer follow-up.

Dolly and Manish
–Dolly and Manish–

Mithlesh and Parents
–Mithlesh (left) and his family–

Mithlesh and his family have had a very tough time since I left. His father Narayan (center) was diagnosed in September with Grade IV Glioblastoma Multiforme, a very aggressive malignant brain tumor. He has undergone surgery and many rounds of radiation treatment at government hospitals. He remembered who I was and thanked me extensively for coming back. However, he can no longer remember the names of even his own family. His family, consisting of about 40 individuals, has pooled their money to support the tremendous expense of his medical care. They have spent all of their meager savings fighting for his life.

Rani First View
–Rani says “Hi, Merril-didi!”–

All of the students ask me if my friends Heather, Natalie, Crystal, Rehan, Dina, Jess, Yeonui, Merril, Win, or others are coming too. They ask for each of you by name and still have many of the gifts you left them. I tell them that you will not be back this year but perhaps in the future. Then they wobble their heads, smile, and continue on.

Ajeet with Prizes and Certificate
–Ajeet with his awards–

Ajeet was very excited to see me and anxious to tell me about multiple awards he has received at school. I asked him more about them and he sprinted away. He returned a few minutes later with his “Certificate of Honor” for a listening skills test and two gift-wrapped pencil boxes as prizes, both of which he placed back in the wrapping paper after showing me.

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–Anita–

Manisha at Anita's Home

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–Suman (not attending the Carmel Convent School) and Poornima (who is)–

School is still out for winter break and will resume on January 16. Our students do, however, have a special class every morning during the break. Their class had already ended on this day so our students had returned home and removed their uniforms. Without their school attire, they are largely indistinguishable from other children in the slum (other than the girls’ red headbands, which they seem to wear all of the time and help me spot them from hundreds of feet away). Somewhat to my amazement, our children are fitting in with their peers in the slum with hardly any problems.

In the next post, we will join our students in their winter uniforms to their special class. Our children have learned a truly incredible amount in the last year and I cannot wait to share their success with you.

Slum Looking East
–This is just the beginning; there is a lot of work ahead–

Fighting Destiny…

…The realities of life in India have hit me like a freight train. Today, I walked to a distant part of the slum to see Santosh for the first time since his operation that we organized for him last year.

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This is a picture from my first encounter with Santosh on April 3, 2012, when his mother brought him to us because she had heard there were foreigners taking children to receive medical care.

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–Santosh smiling en route to the hospital on April 9, 2012–

Over the next month, I spent many days with Santosh and his mother, Sugo Devi. We made multiple trips to hospitals in Delhi to see pediatricians and surgeons for consultations, lab work, and surgical preparation.

Most children with cleft lips and cleft palates can have their first surgeries when they are as young as three months old here. However, due to his malnutrition, Santosh had to grow much longer before he could safely undergo an operation.

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–Santosh just before surgery on August 30, 2012–

Santosh grew to the necessary size and on August 30, 2012, was admitted to a hospital in New Delhi to have his surgery.

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–Santosh in recovery–

Santosh’s operation went according to plan and the physicians who cared for him were very happy with the results of his bilateral cleft lip surgery. Due to Santosh’s high risk of infection living in the slums and our inability to ensure proper post-op care, Santosh was kept in the hospital for 12 days. His mother stayed by his side the entire time.

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–Santosh on September 11,2012–

Santosh was finally discharged on September 11, 2012. This is the last photo I have of Santosh, which was taken that very day.

As you can imagine, I was very excited to see Santosh today. I knew that his scars would have healed by now and that his smile would be even more beautiful than ever. I had a big camera in hand to capture his progress.

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Ajeet and Mithlesh led the way past thousands of slum residents, fields of trash and feces, and legions of children who will never attend a day of school in their lives. We arrived at Santosh’s home but neither he nor his family was present. We waited while neighbors searched for their whereabouts and crowds amassed to gawk at the foreigner.

Waiting for Santosh

Santosh and his family were nowhere to be found and we walked back from where we had come. I carried on with my day and visited other patients, students, and families.

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–Ajeet leading the way back–

This evening, I received the tragic news. Mamta answered a call from Mithlesh after dark and, while still on the phone, turned to me and said, “John…Santosh is gone.” I asked, “Where did he go?” She was listening intently to the phone and simply pointed to the ceiling.

Earlier today, on the very day that I returned to see him, Santosh left our world. The cause of his death is still uncertain and I expect that it will never be known. His father reports that Santosh became noticeably ill about 4-5 days ago. That is all I know at this time.

This is obviously not the way I envisioned my journey beginning. However, this is the burden we have chosen to bear. Mamta, Mithlesh, numerous physicians, and I spent many days of our lives fighting to improve Santosh’s life. We thought that his biggest hurdle would be overcoming a deformity. The thought of him dying never crossed my mind.

Life here in the slums is grim. I do not always convey the extent of the suffering and poverty because you would probably stop reading. After a while, it is natural just to look away. We are fighting destiny, there is no doubt about it.

Although we will certainly cherish the many victories of our work, we must also be prepared for, understand, and learn from the failures. These are human lives at stake; no matter how difficult this work can seem we must never lose sight of its importance.

I predicted that my return to India would come with many challenges. Santosh’s death today has made this poignantly apparent. However, we also have much to celebrate and those posts will come at a more appropriate time. For now, let us remember Santosh and his smile. May we learn, through his death, to sustain and improve the lives of those still with us.

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Internet Coming Soon…

…After more than 9,500 miles and 31 hours of travel time door-to-door, I have arrived safely in Faridabad!

Of course, it wouldn’t be India without some initial setbacks right out of the gate! Due to new Indian national security laws, my previous mobile sim cards were cancelled and new ones take 48 hours to activate. Therefore, I haven’t been able to get a good enough internet connection to blog. I should have one soon. Sorry to keep you in suspense, but here are two photos of our precious kids that should put a smile on your face and give you a sense of how they’re doing:

Ajeet with Prizes and Certificate

Goofing Around in Winter Uniforms Cropped

Much more to come soon! I’ve already taken hundreds of photos.

5283 miles down…4,175 to go…

…I just arrived safely and comfortably in London after a 10-hour overnight flight from Phoenix. We were just served breakfast on the plane before we landed and yet the sun is already setting as I await my next overnight flight direct to Delhi. When the sun rises in the morning, I’ll be over Afghanistan.

My last supper before boarding the plane yesterday was a delicious, juicy hamburger with a side of Caesar salad from Houston’s. I will not see beef, salad, or ice water again for the next three months.

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Mom and Dad then took me to the airport to send me off, just like before. Their love is unwavering and I am so blessed to have them. As a 25-year-old man living at home, I should probably love saying goodbye. However, we are certainly not like most families and I will miss them dearly.

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This is the exact same route I took 422 days ago. However, this time, the emotions are quite different. When I boarded this flight before, I felt like I was travelling to the edge of the Earth. I was full of uncertainty, doubt, and questions. Today, I feel like I am headed to another home, to another family, and to hundreds of people who are almost as excited to see me as I am excited to see them.

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London to Delhi Halfway

I’m writing here watching the sun set. I’m about to have a glorious last latte from Starbucks as I watch the planes line up for landing in the distance while I listen to their pilots talk to air traffic control on my iPhone.

In 2012, people visited this blog from 106 countries! I’m glad to have you all along with me in 2013.

January 2013 Blog Map

Look out New Delhi, here we come!

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