Rolling Out the Red Carpet…

…What a weekend! On Friday afternoon, I finished my Pulmonology final exam at Mayo Medical School, ate dinner with my parents who had come to visit from Arizona, and went to bed at midnight after scrambling to pack some last minute items.

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At 4:15am, I got up to start the 8,500 mile journey to Faridabad. It started with a light 5 hour drive to Chicago. Next was an 8,000 mile, 15 hour flight on Air India direct to New Delhi. Having squeezed in a total of 6 hours of sleep in the previous 48 hours, I slept from Quebec to Afghanistan.

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Shri surprised me with open arms at the airport by picking me up himself (I was expecting a driver) and we set out for the Formula 1 inspired 90 minute land adventure to the opposite side of the city. At one point, we were going the wrong way down the center of a road that would have been about 7 lanes wide if it had had lanes.

At another point, some locals trying to make a point about something had barricaded a busy intersection. I just laughed the entire time as utter chaos ensued with hundreds of cars honking at one another and trying to turn around at the same time even as traffic backed up as far as I could see. It took us 20 minutes just to move 100 feet. Ahhh…I missed you India.

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The welcoming party in Faridabad was waiting in full force. My friend Lauren (who has her own blog going at laurennippoldt.com, definitely check it out) was waiting at home. She is currently 2 months into a 6 month stay here and doing indispensable and tireless work for our students and their families. She, Mamta, and the schools have set up an entire week of events, surprises, conferences, talent shows, and meetings.

I set down my bags and Lauren and I set off on foot to the slums. Kids riding by on bikes and from the rooftops yelled, “Hi John Bhaiya!” as if I had never left.

Within about 60 seconds of seeing our first students in the slum, a chain reaction commenced and dozens of kids started running toward and away from us in every direction. Ajeet pointed out that some kids were being dispatched to alert the others, even those who had moved to more distant parts of the slum. I was so busy saying hi and hugging everyone that I couldn’t take pictures. Thank you Lauren for capturing all of these!

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Neha and Gudiya’s father, covered in water and wearing only his underwear because he was bathing along the canal as we approached, directed me into their home. Gudiya disappeared and returned minutes later with a huge bottle of orange soda for Lauren and me. Their mother dusted off the only small stool in their home.

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With hardly 4 hours on the ground, we’d already visited with hundreds of the kids and their families. As dusk set in, we returned home to Mamta waiting for me with a beautiful smile and one of my favorite paneer dishes for dinner. My friend Allison (who works here in New Delhi and has helped us with lots of great work over the past two years) also surprised me by coming to visit for the evening.

I feel like a prince coming home for some long-awaited royal event. It is truly surreal to travel all that distance to a remote corner of the world and have so many loving, inspiring, wonderful people here waiting to welcome me back. My bucket shower before bed was the best bucket shower ever!

It’s great to be back! #‎squalortoscholar‬

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In the Mayo Clinic Spotlight…

…It was an incredible honor today to have Squalor to Scholar featured front and center in the Mayo Clinic newsletter. For those readers unfamiliar with me personally, I joined the M.D. Class of 2017 here at Mayo Medical School in July 2013. Since then, I have overseen Squalor to Scholar from Rochester, Minnesota, and feel blessed to have tremendously supportive and compassionate people supporting me at Mayo Clinic, back home, around the world, and especially in India. Read the full article here: http://intheloop.mayoclinic.org/discussion/from-squalor-to-scholar.

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Top Shots: Day-to-Day Life…

…Over the past three weeks, we’ve registered and vetted more than 150 children and their families, visited and evaluated 13 local schools, conducted a half dozen women empowerment seminars, organized and enabled an upcoming surgery for Prianka, prepared our students for their first final exams, and tried to win a $5,000 voting competition at http://www.volunteerhq.org/john-schupbach.html (which we are unfortunately currently losing by about 400 votes…please help!).

Here are some of my favorite photographs from the past few days:

_Salutes at Government School–Students at a government school salute me upon entry to their classroom

_Sister Jaya Mary in Hallway–Sister Jaya Mary gives me a tour of St. Joseph’s Convent School’s new wing for 11th and 12th standards

_In line for KG–Kindergarten students at the Carmel Convent School line up for morning assembly

JCS_8410–A little boy shows us his ability to write the alphabet and numbers 1-10

JCS_8253–Mira, Bethea, and Faith register, evaluate, and photograph applicants

JCS_8181–Smoke from constantly burning rubbish engulfs the slum (It’s good for the lungs!)

_Ankit in Ajeets Home–Ankit ensures that I take a moment of rest and enjoy a cold soda that Ajeet’s family bought me

_Chalk Flying–Instructions are written in Hindi with chalk on a wooden door in the slum. We rely on scattered literate parents to convey these messages by word of mouth. We can reach about 60% of the slum’s residents in 24 hours this way.

_Mother Reading List–A mother looks for her son’s name on a newly posted list of accepted students. He wasn’t on the list.

_Annoucing List–A local social worker, Ranjan, reads a list of selected children to a group of illiterate mothers and grandmothers.

_Able Charity School Reading List–A slum school teacher announces the same list

_Priti–Priti unfortunately had to be left behind

_Kanchan with Mom–Kanchan’s mother has had trouble sleeping all week waiting for our final decisions. Fortunately for her, Kanchan was accepted!

_Mom with Polio–Himanshu entering the Carmel Convent School for the first time with his mother, Sunita, who suffers from the effects of polio

_Mothers Waiting–Mothers and their children listen intently to instructions from Mamta and the Sisters

_Arti Evaluated by Sister Pushpa–Arti, who now has a glass eye after suffering from eye cancer, is evaluated by Sister Pushpa

_Announcing Plans–Mothers and children listen to plans and expectations

_Tailoring–Tailors measuring the last of our 86 Carmel Convent School students

_Sindu Cooking–Sindu, age 9, cooking a meal for her family

_Sindu Close Up–Sindu on her way home after a final exam

_Bucket Shower–A boy bathing under cold water from a bucket

_Ajeet Cricket–Ajeet has never taken cricket lessons…but look at his eye-hand coordination!

_Girls Graduation–Girls attend their “Farewell,” the equivalent of our graduation, at a large government school

_Microphone–A microphone and hundreds of young women await one of my speeches about the importance of higher and vocational education

_Frog Race–Students take part in a frog race on a school holiday

_Akanksha–Akanksha, our student being promoted to upper kindergarten this year, enjoying a game with her friends

photo (11)–Prianka had a large abscess drained from her face this week. She is being treated with antibiotics. She will go home while her treatment continues and return to Delhi in 4 weeks for another surgery to remove residual tumor shown on a recent CT scan. Thanks Mom and Dad for funding Prianka’s care!

_John with Sisters–Me with Sisters Jennifer and Jaya Mary

We’re working hard here…very hard. Please don’t forget to vote at http://www.volunteerhq.org/john-schupbach.html and have your friends and family vote too. If each person reading this blog voted, we would win!

More good news: If your fingers are tired like mine from typing johnschupbach.wordpress.com, worry no more. This blog can now be accessed by simply visiting http://johnschupbach.org!

$5000 On The Line…

…I make it a point to rarely ask for donations, to avoid spamming you with requests, and to never exaggerate our level of need. However, a truly unique opportunity is upon us. Our work over the past year here in India has resulted in my nomination and selection as a finalist for the IVHQ Volunteer of the Year Award.

Although I am very honored to be considered for the award, I am most interested in the $5,000 Squalor to Scholar will receive if I win. This $5,000 will put as many as 20 new students through school for their entire first year. Sponsors will then fund their continued education through college and into their professional careers thereafter.

Please take 10 seconds to visit http://www.volunteerhq.org/john-schupbach.html and vote for me. Even if we get 5,000 votes, your 10 seconds will be worth a dollar! That’s an entire day worth of work to many of the people here!

_Indu Praying

Don’t do it for me, do it for Indu…

_Prianka Praying

…and Prianka…

_Sonu

…and Sonu…

_Komal Praying

…and Komal

JCS_7759…and the thousands of children still awaiting our help!

You can vote once every 7 days until 7am New York time on March 15. Please vote as many times as possible and share the link with your friends, family, and colleagues. The competition is already proving tough. However, if our students can climb from the slums to the top of their elite classes in a year, we can win an online voting competition. Put your thinking caps on and let the games begin!

On behalf of the 20 children who might just get the chance to go to school because of your votes, THANK YOU. Here’s the link again: http://www.volunteerhq.org/volunteer-of-the-year.html

116 Slum Superheroes…

…Without giving away too much too soon, Squalor to Scholar will soon be surpassing a momentous milestone. Plans are well underway with multiple schools that will allow us to surpass the century mark and bring the total number of our students to 116! As you know, these children are viewed as inferior, less capable, and sometimes even unworthy of a world-class education. It is our intention, however, to prove otherwise. In less than a year, our 21 original students have proven to themselves and the world that, indeed, they are worth it.

JCS_7558–Three of our newest students: Simran, Roshani, and Seeta–

Approximately 200 million people in India are of the Scheduled (aka Untouchable, Dalit, or Shudra) caste that I mentioned in the previous post. We will soon be supporting 0.00005% of this often ignored population! Sure, that’s a small percentage but it is an undertaking that is sustainable, effective, and inspirational. As my father would say, the camel’s nose is in the tent. We will spring from here to tackle the educational and public health challenges of India on a much more macro level while remaining fully aware of the needs and issues of the people our work will target.

Our pursuit here, however, has been and will be focused on quality, not quantity. These children are more than numbers or statistics; they are breathing, vivacious human beings who not only yearn for knowledge but have the potential to teach us about ourselves.

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All in all, the 116 children who will soon be under our care will receive every resource necessary to excel in their top-tier schools, graduate from 12th standard (the equivalent of high school), and attend college or vocational school. Over the next 12-14 years of their primary and secondary educations, our students will, combined, rack up nearly 2,500,000 hours of classroom learning! That’s the equivalent of more than 285 years!

_Laughing Hard

I was walking and laughing with our current students the other day when the boys started energetically impersonating superheroes. They acted like they were shooting webs from their wrists, simulating roundhouse kicks, and flying as fast as possible down the street. I joined in as Ironman and pretended to fire up the rocket engines in my boots and gloves. Ajeet ran over to me and, quite seriously, said, “John Bhaiya…you…are…superhero!” I asked, “Which one? Spiderman? Superman? Batman? Ironman?…” He stopped walking and contemplated with his hand on his chin and eyes looking toward the sky. He then responded with a big smile on his face, “No…you…are…Johnman!”

_Superhero AjeetThe true heroes here, however, are our talented students, their perseverant families, and, of course, the generous sponsors and donors who make all of this possible! Just think…this time last year, we still did not have a single student enrolled in school. Within the next couple of weeks, we will surpass 100!

_Goat in Dirty Park

Last night, a close friend of mine from home was on CNBC providing market analysis after the closing bell. I watched the video of it tonight online. There he was in a suit and tie, looking great at age 25, making his predictions as a burgeoning expert in the field. I told my fellow volunteers who jokingly noted, “And look at you, sitting inside a mosquito net next to a slum wearing a ski hat to stay warm!”

I laughed at the irony. However, there is nowhere I would rather be (ok…I lied…a hot shower at home and some of Mom’s lasagne would be pretty stellar right now). However, from this mosquito net, I can trade stocks, follow world news, promote human rights, and conduct research on local and international levels. I can bring thousands of people around the world together and shine light on problems that are overlooked even by those who live right next to them. Welcome to the 21st century!

_Aarti

One of the first questions I am often asked about Squalor to Scholar is, “How do you choose the students?” To me, this is the hardest part of our job. Not a day goes by when a mother or child does not beg me for admission into a school. Many criteria go into each selection and it is difficult to convey why we can help some people and not others. It’s one thing to deny someone money or food here because that individual will, sooner or later, likely obtain what they need. That’s an instinct of survival. However, education is not an immediate necessity. Among the “to-do list” of the poor in India, education usually ranks pretty low, somewhere near long term personal health.

Over the past year here, however, we have brought the topic of education to the forefront of every parent’s mind. That, in and of itself, is a victory.

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Three days ago, we printed out formal applications containing our important criteria and sat down unannounced in the slum at 9:30am. We planned on registering just a few children. The news spread like wildfire. Members of our team filled out applications continuously for the next 11 hours!

Due to such an overwhelming response from the community, we’ve begun creating a database of all eligible slum children ages 2-10 so that we have a permanent record of their biographic and family information. In three days, we’ve processed more than 200 applications. Each application takes considerable time and effort, as nearly every parent in the slums is illiterate and a member of our team must fill out the entire form.

JCS_7805–Volunteer Mira Patel speaking to a parent who has come for registration–

Luckily for us, volunteer Mira Patel speaks Hindi! She has been an incredible addition to our team and has certainly boosted productivity. Mira, Mamta, and Mithlesh do all of the speaking and documenting to assist families.

JCS_7746–Volunteer Bethea Robertson evaluating one of the applicants–

Bethea then evaluates the students individually and attempts to determine their basic knowledge, interactivity, estimated potential, current abilities, and degree of family support. Faith and I then obtain their photographs for our ability to recall, find, and identify the children later.

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_Testing

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_Lucky

Lucky might just turn out to have the perfect name! We’ll let you know in a couple of weeks where he ends up.

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Our 15 newest students are thriving in the classroom and impressing even the sisters. These are some recent photos of them leaving school this week. Their pristine new uniforms are currently being made.

_Roshni Looking Up and Smiling

–Roshni (above)–

_Chandani Holding Moms Hand

–Chandani–

_Angali and 3 Others on Bicycle

–Anjali (the third one on the bicycle)–

_Sadna and Raj Nandani in Cart

–Sadna and Raj Nandani in the back of a cycle wagon–

_Ajeet Neha and Gudiya Walking Home 2–Neha, Ajeet, and Gudiya walking back to their homes after walking me home–

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Last night, Prianka returned from Bihar to re-visit her surgeon in Delhi. She had a smile on her face and tears in her eyes when she saw me. Her benign tumor has continued to grow despite her previous surgery. She was admitted to the hospital today and will have another highly invasive surgery tomorrow morning. She’s my superhero tonight. Her surgeon will be her superhero tomorrow. Please keep her and her loving father in your thoughts and prayers.

To all those who have supported us this year and made the educations of 116 children and surgeries like Prianka’s possible, thank you!

Tangible Untouchables…

…It’s a rainy, gloomy day here in Faridabad. The streets are flooded and the slum is a sea of thick mud and cow dung. For the first time in more than a month, I am the only foreigner living in Mamta’s home. It is eerily peaceful for India. The ever-present sounds of chanting salesmen, children shouting, impatient drivers honking, and sputtering engines billowing clouds of smoke are nothing but memories of sunnier days. All that I hear are the patter of rain, the distant pounding of nearby metal factories, and the faint call to prayer from a faraway minaret. The air, for once, is fresh. The usual airborne industrial debris seems to have vanished. The smoke has cleared. The dust has been beaten to the ground by drops of water. Taking deep breaths and being able to listen to my own thoughts have never seemed like the luxuries they are now.

_Machine Shop
–Women working in a dimly lit unventilated machine shop–

Life among the slums here is tiring. Trying to make a difference is exhausting. Throw in a little ‘Delhi Belly,’ a common cold, and some water scarcity and it would be tough for anyone not to miss the comforts of home.

But, then I go outside. Even though I sleep on a wooden plank, wash my clothes in a bucket, and use a cup to rinse my body in a candle-lit bathroom, I realize that what is important in life is not what we have but what we are able to do with what we have.

_Squatting Boy

I have the ability to read and write, I was born free and equal, and I am loved by a family that would move heaven and Earth to ensure my health and safety. I’m set. Much should be and is expected of me. The children and young adults here, however, can’t read or write, they are neither free nor equal, and their families can hardly afford to put food on a table they don’t even have. Despite living at the bottom of what will soon be the most populated civilization in history, however, the children here are among the happiest I have ever met. They exude hope even when others have lost it. They are skin and bones but tough as nails. They act as though they have everything going for them even when everything is actually going against them.

_Daulati on Stepping Stones 2

The slum’s residents have every right to be angry at the world. Throughout their lives, they have been treated as inferior 4th class citizens. They perform back-breaking, unhealthy, and often demeaning work without ever second-guessing their status. They and their ancestors have been denied healthcare, education, and opportunity for so long that even when they are offered such services they do not trust or understand them. When I take patients and their families to the hospitals, some doctors scold the parents for waiting so long and having to have a foreigner bring them in for treatment. However, are they really the ones to blame? I don’t think so.

Living in India is no longer the novelty it once was to me. Being 8,000 miles from home now seems pretty normal. I no longer flinch when I round a corner to meet a massive bull staring into my eyes from three feet away. I no longer want to fumigate myself or my clothing after spending the day in a slum.

The hardest part about my return to India has not been adapting to the culture but adapting to the scale of India’s problems and the widespread lack of regard for them. Education of the poor here is a disaster and I believe it is the central root of India’s vast poverty, overpopulation, and massive public health dilemmas. To make matters worse, the caste system cripples altruism and any attempts to promote equality. Some of the high-caste locals who only know the basics of our work think that our impoverished children from the slums cannot perform to the same standards as “normal” students. In true Indian honesty, they tell me directly that I am “wasting my time.” All someone needs to do is meet one of our students to know that this is not true.

How can you think I am wasting my time if you have never met our students? How can you understand their problems if you never go to their communities? How can you stand to watch them suffer and even die without wanting to find a solution?

I experienced the most egregious and bewildering example of the caste system last year in, of all places, church. It was my last Sunday mass with the sisters before returning home and I planned a special, surprise event.

psIMG_6298–Above: Moni, Manish, and Chandani. Below: Prianka–

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During mass, I had all of the pediatric patients I had been caring for (and their families) come meet me at the church entrance. When the parish priest finished his sermon, he signaled me to come address the congregation (all of whom speak perfect English). I walked down the aisle from the back of the church with six severely deformed children and their parents following me. We all turned around and faced the congregation. I took the podium and introduced each of the children, their medical conditions, what I had done for each of them to date, and when their operations and/or treatments were scheduled. I then made one simple request for help transporting the children to and from the hospitals and physicians that would cure them. I thanked the congregation in advance for their generous help and for their hospitality during the three months I had attended their church.

Once the service ended, I stood at the back as everyone passed to shake my hand, hug me, and thank me for my work here. They then passed by the children, entered their cars, and drove away. No one ever said a single word about helping these unfortunate and astonishing children. Even when I brought devout lifelong Catholics children with obvious and dire problems and explained exactly what each of them needed and when, they unanimously declined to help.

When I told the sisters that no one had offered to support us, Sister Pushpa said, “We knew that no one would help you but we did not want to crush your hope.”

India, like these children, has so much potential. A relatively recently liberated democratic republic with 1.25 billion hard-working and patriotic people should be one of the world’s most formidable economies and superpowers. Yet, the ultimate definition of success here is the ability to leave. It’s a race to the top and every man for himself. The brain drain and caste system are debilitating and undeniable problems for India and its future.

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Several of our new students this year, including Raj Nandani (above) are of the Scheduled Caste, otherwise known as the Untouchables, Dalits, or Shudras. They are members of the the lowest castes that make up approximately 16% of India’s population.

_Fingerprinting

Many of our students’ parents are so illiterate they cannot even sign their names. The photo above is of a mother having to use her fingerprint to sign her daughter’s application for school.

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I took the above photo of Manisha 13 months ago, when we wrote her name because she could not.

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This is Manisha now, holding up her impeccable homework that has been marked “excellent” by her teacher. When people believe in you, you believe in yourself; you become proud of your work and you try even harder the next time. All these beautiful children need are opportunities for challenging learning and positive feedback when they succeed. We have done this at Squalor to Scholar and in one year our students have shattered everyone’s expectations of them.

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Once our students are finished rocking their exams later this month, I’ll be heading out into the slums before dawn every morning with an iPad to Skype with sponsors and donors all over the world. I’ll be in touch soon to organize the video hangouts and share with you in live broadcasts some of the most inspiring children you’ll ever meet.

_Facetime in an Alley

What a Year!…

…It was 365 days ago today when I walked into the Carmel Convent School and met Sister Pushpa for the first time. She sat me down in her office and, for the next hour and a half, we had a conversation that I knew would change my life. We discussed such topics as the purpose of our existence, the plight of the poor, and the perseverance of the human spirit.

Little did I know, however, that I would walk into that same office one year later with more than three dozen slum children under our wings, that we would celebrate their outstanding academic and athletic achievements, or that I would be back here in India.

_Ajeet with Ice Cream
–Ajeet enjoying an afternoon at the local park with his much deserved ice cream–

As of this time last year, Ajeet had no plans of ever attending school. He is now the top student among his high-end class of 160 students. In only a year, he has learned how to read nearly anything in English or Hindi, have entire conversations in English, and multiply and divide in his head even faster than I can. He didn’t have any dreams for his future 365 days ago. Now, he wants to become an engineer. NASA, I think you should get ready for one of the best employees you’ll ever have.

_Daulati MRI
–MRI of Daulati’s Pott’s Spine–

Daulati had never been to a doctor before her condition became severe and her family brought her to us. She has now had full radiology and lab workups and is under Directly Observed Treatment (DOTS) for her disease: tuberculosis of the spine. DOTS officials will visit her every other day for the next 9 months to administer her medication. More about her recent hospital visits is coming soon.

_Priyanka Ladder on Roof
–Prianka was rescued again–

Marital and family disputes ended in violence for Prianka (our student) and her mother. Fearing for their lives, they fled together to a place no one could find them. After searching far and wide for over a month, we finally found Prianka and have returned her to the peace and love of our care. She is not only safe but happy and excited to return to her friends in the classroom. We have arranged temporary transportation to and from school for Prianka until her mother and she can find permanent and safe housing.

_New Slum School Group
–The first day of Mamta’s new school–

Inspired by our progress over the last year, Mamta started her own slum school this week. She found a bilingual teacher and is fundraising on her own to begin a new chapter for herself and many children in the slum. On the first day, 53 children and families showed up. Within the first three days, more than 100 children came for admission.

_Mamta in Car
–Mamta and Shri taking supplies to her new school–

_Looking Through the Gate
–Children waiting to enter the new slum school–

_Versha with Writing Competition Certificate Prize
–Versha holding her recent award–

This week, Versha (our student in Lower Kindergarten) won “First Place” in her English Writing Competition among 164 of her classmates. We always knew she was talented; now, everyone else does too.

_Roshan on Rickshaw
–Roshan–

Many students have had impeccable attendance. However, Roshan’s has been nearly perfect with 222 days of attendance since we started recording last March. One must remember that our students attend school from early in the morning to late in the afternoon 6 days per week. This young man is dedicated, ambitious, and as photogenic as they come.

_John with Slum School Children

_Green Lighting with Kids
–Searching for talented, driven children in need of an opportunity–

As you know, we’ve been hard at work looking for more high-potential children to give the chances of a lifetime. There are thousands who deserve our help. Some, however, stand out immediately. It’s like they’ve been preparing for our arrival all year…or perhaps their entire lives.

_John with Chanda
–Taking down Chanda’s information–

_Caitlin Teaching Class
–Preparing our newest and youngest students for their first day of official school–

We’ve chosen our 15 young girls for the class of 2027 and have begun preparing them for the first day of school on April 1st, 2013. In coming days, I’ll be introducing them to you.

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–Simran, age 4, showing off her ABC’s–

_Seeta and Geeta with Sister Sweta
–Nurturing our newest and youngest students–

We are not the only people nurturing and caring for this new class of students. Our older students have, as I expected, begun treating our newest students like their little sisters.

_Indu Carrying Gopika
–Gopika (age 3) being carried by Indu after being separated from mom for the first time–

This time last year, Indu was sweeping homes to support her family with an additional income of $20 per month. We took her and put her on an entirely different track. She is now one of the most hard-working students her teacher has ever seen. I wonder why!

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–Santosh before his surgery–

Santosh died in January, shortly after his first birthday. His mother wailed and cried in my arms when I visited his home the day after he passed. Even though his death was caused by easily treatable diarrhea, his family has carried on. His 3-year-old sister is a student in Mamta’s slum school and his mother has already given birth to a new baby boy.

_Santosh's Little Brother
–Santosh’s mother and new little brother–

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–My farewell sendoff last May–

In only a year, we have impacted directly and indirectly thousands of people’s lives. We have promoted the value of education, the importance of healthcare, and, perhaps most importantly, the ideals of equality that sometimes seem so absent here. We are small, so small; but our determination and long-term outlook certainly set us apart.

_John Reunited with Priyanka
–Welcoming Prianka back…I can only imagine what she has been through–

Although many lives have been transformed here, I feel that I am the one who has grown and learned most from this epic journey. Over the past year, I have learned more about public health, business, education, politics, poverty, corruption, illiteracy, religion, spirituality, web design, photography, charity work, and humanity than I could ever learn in a classroom. As a strikingly honest and insightful physician correctly concluded earlier this week during my visit to a government hospital, I’m slowly transitioning toward a much more macro level of thinking and problem solving.

To the hundreds of people who have volunteered their services and donated their money to Squalor to Scholar over the past year, I am and will be forever grateful for your vital and unwavering support. None of this would have been possible without you.

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/)

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.