De-planes are de-layed

Plan was, fly to Colombo, wait a few hours and then fly to London in time for a late breakfast at TC. In actuality, as both planes have been delayed, the plan has changed.

The one from Bangalore was delayed by 4 hours, but Arun, who has fingers in every travel pie, had specially made friends with the manager of Sri Lankan airlines who phoned him up personally to tell him of the delay, which meant that, instead of sitting at the airport for hours on upright, minimally padded metal tube chairs with only enough knee room between rows for the significantly shorter Indian thigh, I sat around with his lovely parents eating appam and sambar for supper, chatting.

The drive to the airport contained the most poetically perfect example of Indian traffic chaos to send me on my way. Despite leaving for the airport at 10.30, it wasn't long before we came upon a stationary line of traffic. My driver, who seemed to be from the more restrained part of the spectrum of Indian drivers, duly pulled up behind the car in front. We were on a two-way road with a single lane in each direction. After a couple of minutes of not much happening, I looked up and noticed that the number of lanes had expanded to 3. Courteously, the new lane makers had left enough space for a small car with no worries about losing a wing mirror or two, to get by in the other direction. But not for long. As soon it everyone else noticed how much more progress you could make by driving on the wrong side of the road, they all wanted a go. We made slower but more legal progress to the junction, where a lane divider separated the patient from the impatient drivers. A couple of the latter group made swashbuckling left turns cutting across all the legit and less legit lanes. In the midst of this swirling maelstrom was the most bemused and ineffective traffic policeman I have ever seen. He looked like a deer caught in 6 rows of headlights.

Anyway, after the first short flight, here I am, sitting gritty eyed at 3.40 am in Colombo airport listening to piped classical music, played, it would appear, on comb and paper, whilst a lot of christmas tree lights in this famously buddhist and hindu country twinkle rhythmically in plastic garlands and on trees. Occasionally, the music stops for an announcement made by someone who clearly trained at the the Karma Sutra School of Public Address. It's impossible to make out what she is saying but she sure says it in a suggestive fashion.

I hope the next (12 hour) flight is not delayed longer than the two hours they so far have promised. I don't have a very good record of getting back from India at the original scheduled time. The first trip, I was delayed by 24 hours and no-one, despite promising they would, informed Mum and Dad, who came to the airport to meet me after my being away, and at one point believed lost forever in revolutionary China, for 7 months, only to wait and wait and wait until everyone except me had got off the plane, which wasn't surprising, because I was in Dubai. The second trip to India, the plane from Calcutta was also delayed by 24 hours, but luckily, not only had I been away for less time, with no ventures into unstable war zones, I also managed to make the necessary phone call myself. This time I have managed to contact the most reliable member of my family, my Grandmother, who will disseminate the information as necessary.

I sincerely hope, however, that I don't make a hatrick of being 24 hours late.

Coming home for Christmas

Tomorrow I leave RUHSA for a last weekend in Bangalore before flying home to the UK for Christmas. I am really excited at going home and also really happy I am not leaving India for good. It’s a luxury to be able to spend enough time living in a foreign country that you get to go home for holidays, whilst knowing that you get to go home to stay eventually as well.

My suitcase is full of nothing but presents. I have packed no clothes at all, as currently I am only wearing "summer" clothes. Of course, in fact, it is winter here with a few concessional chill Christmas breezes-only somewhat cooler than the hairdryer-hot wafts of high summer. It is a lovely ambient temperature during the day, around 25 degrees, but for the average South Indian, these are arctic temperatures. The fleece and balaclava salesmen on the roadside are doing a roaring trade. Many an Indian scooter rips by with entire Indian families, of course, perched on them, all wearing vile puce coloured fleeces zipped up to the chin with a cheek-and-chin encasing balaclava hat and, if male, a lunghi. I feel like yelling out as they pass to forget the headgear, which looks ridiculous, get a pair of trousers and pair of socks on and even out the overall body temperature, but in reality, as a friend of mine pointed out, being warm-blooded animals, this whole charade should be unnecessary. My theory is that they are trying to recreate the 100% humidity and 40 degree heat of summer, inside their clothing.

Over the last few days I have been enjoying cycling up to the village to continue with my medicals. Vellore district is on the plain beyond the Deccan Plateau which spans almost the width and length of South India and makes the ride pleasant rather than arduous. The bike, like Mum’s school one, is a Hero with no gears, so despite the practically imperceptible undulation of the land, I still find it difficult for my legs to keep up with the pedals. I have attached my rickshaw hooter to the front, which affords much entertainment for both me and the school children, bus loads of men, passing rickshaws, solitary walkers and cows at whom it is a necessity to honk. Occasionally, during particularly enthusiastic knee activity, I accidentally hit the hooter for extra fun. Seeing the Indian countryside passing slowly by as I, comparatively speedily, cycle, is wonderful; the sinuous punk-headed palm trees bordering the brilliant green glistening paddy fields, where a figure with cloth-wrapped head and loins, bends tending to the young rice shoots.

As I pass by the rope-making village, I see the whole process of creating rough, strong hemp rope from insubstantial piles of brown fluff. The village consists of a row of several houses set below the road. At the extremities of the long spaces between the huts, fixed to the ground, are iron hand-winding frames with a central cog. Four hooks are evenly placed around the wheel, making a square, and rotate faster in the opposite direction.

The first strand grows magically. A woman, holding a basket of raw fibre under her right arm, keeps the rotating strand taut, feeding it the mahogany candy-floss, while walking backwards slowly away from the winding machine. Yesterday, a white-haired, slender lady, very gracefully wound the handle, never breaking pace or seeming to find it an exertion. Dotted around the work yard are huge mounds of raw hemp, on which a teenager or two lolls lazily, watching their mother and grandmother working industriously.

Once the smaller strands are formed, four of them are attached to each hook on the machine’s wheel. Another family member, far away at the edge of the village, holds all four strands attached to a hand hook which also revolves, in rhythm with the twisting of the rope, whilst the handle remains still and stable. A man, needed for his strength, winds the machine handle and all the strands dance separately yet synchronously, intertwining themselves into a recognisable single strand of perfect rope. On the road side, from the branches of the Neem trees, half-coiled like Kaa the python trying to leave his tree to snack on Mowgli, hang their finished handiwork for sale. It is a beautiful spectacle.

Arriving at the village today, I had to do a home visit. It was a little different from those I did in Kirkby or Dalton. We walked through the village on and beyond the tarmac to a sand track weaving between palm-roofed houses. Outside one, in the blazing sunlight, the old lady I came to see was seated on the ground, a sack on her lap to protect her legs from the sharp-edged, dried leaves she was weaving deftly, despite arthritic hands, into more thatch for her house. Mobility was impossible for her because she had fallen a couple of years ago, and despite probably having fractured her neck of femur, was unable to afford surgery. She has been unable to weight bear or move without being held by two people since then. She is the sole carer of her achondroplastic, staturely challenged, 40 year old son, who, having limited marriage prospects, has remained single. No new generations are available to help with the burden of care.

Home visits in India, unlike the UK, are a popular and well-attended spectator sport. Confidentiality is impossible when there are friends, relatives, neighbours unashamedly listening and contributing to the old lady’s story. Whilst they are not missing a detail of her complex medical history, they manage to find out whether the funny white doctor is married ("No." "Why?" – How do you answer that?). It has been an extraordinary experience doing these medicals, requiring quite different skills from those utilised at home. It is amazing how much of a barrier there is between a doctor and patient who can’t communicate directly. In some ways too, there are surprising moments of connection, through non-verbal means. When, via the interpreter, I asked if the lady had any problems moving her bowels, she tutted, shook her head and rubbed her knees furiously. I patted her arm and said, "I know exactly how you feel, my knees are killing me too." We laughed.

Sometimes, though, I know the interpreter hasn’t understood why I’ve asked a particular question and asks a different one. The subtlety of nuance and impression revealing important cues crucial to understanding someone’s health beliefs are mostly lost. Sometimes, the interpreter is embarrassed asking certain questions. I find it difficult not to be able to broach difficult topics delicately myself, framing and leading into the sensitively-phrased questions according to the patient’s response. Having an interpreter brutalises the consultation process.

The great bonus in doing these home visits, is that I am a walking, talking sandwich board for the project and there is a palpable interest in what is happening. By paying attention to the more usually neglected or ignored elderly, we have, I hope, elevated their status, and will encourage them to continue to engage with us. A potential problem to be overcome was the shame of someone coming to the clinic and showing the rest of the village that they were not looked after by their families. The level of interest being shown to us as we wander through the village suggests, at present at least, that people want to come and join the program. We shall see in January if that’s the case.

Back at RUHSA campus, there is a suggestion of Christmas, despite the un-seasonal weather. In the hospital yard is a huge, familiarly palm-roofed crèche, surrounded by seated saried and lunghied patients, staring inquisitively at me as I take a picture of it and the "Christmas Tree" (straggly, wilting fir branch with one star on the bowed top). On the ceiling of the outpatient clinic, where brisk-walking nurses in their regulation plain, sky-blue, crisp saris, ferry trays of equipment and notes to and fro, are strung rows and rows of coloured twisted crepe paper and tinsel. The other day, I even heard ‘Hark the Herald Angels Sing’ wafting through the coconut palms. Hindu sandalwood-striped foreheads and Muslim embroidered hats mingle easily amongst the Christian decorations.

So today, I start my journey from RUHSA’s tropical Christmas to a more familiar celebration with my family. Last night, as is my long-held, intractable habit, I was up until 4.20 am, packing and generally footling (in reality writing this posting instead of packing). I am very much looking forward to getting home, although, it would also have been an amazing experience to spend Christmas here. I can’t wait to see everyone and hear what has been happening in the four months since I left. Most especially I am looking forward to being greeted only by people who know me; no random shopkeeper or passing giggling school girl will ask me for my "good name, please, Madam". I will enjoy being anonymous and not an unintentional source of constant entertainment.

Hopefully, for the next 10 days I will be laughed with not laughed at.

Taking their first medical history in 70 years

As mentioned, over the last two days I have been carrying out medicals on some of the elderly villagers of Keelalathur. It was a sobering experience and I am never going to tolerate people slagging off the NHS again. The people I saw are amongst the most vulnerable of the villagers and have been targeted for exactly that reason.

There are many compounding reasons for their vulnerability. Firstly, elderly people have increased morbidity, secondly, there is a concomitant loss of function which makes self-care harder. This is true of all elderly the world over, but in India there are other factors to be considered. Traditionally, people live in extended families of up to 40 people, or even more. In arrangements like this different generations live together and, apart from the expected in-fighting and petty jealousies, there is mutual support between family members. This sounds like a good, non-governmental method of creating a welfare system, but when you add a dash of poverty, the recipe changes.

Village houses vary in type, from concrete squares with 4 solid walls, a roof, windows and several rooms, to a small, low, long hut made of adobe (cow shit) covered in withering palm leaf thatch. One room serves every function from kitchen to bedroom (the loo is "open plan", ie, you shit on the road side) and there is no chimney. Cooking is usually done over a stick fire or kerosene stove. There has been some effort to utilise biogas and bottled gas, but the latter is expensive and the former, although a brilliant idea, only works where there are enough cows to provide enough crap to provide enough gas to cook a chappati on, and there aren't. As a result the huts are full of health-destroying smoke which has nowhere to go. The only filtration system is the capillary gas exchange of the many occupants' lungs.

This is just one of the multitude of health problems resulting from the villagers' lifestyle and I haven't even mentioned malnutrition, gastroenteritis, mosquito-borne disease, TB, undiagnosed cancers, leprosy (fortunately drastically reduced since I last visited, but India is still one of the 7 countries remaining worldwide not to have controlled it adequately), injury (from the total absence of health and safety measures), rising diabetes problems; and doesn't even begin to touch on the possible mental health effects of such an existence. A colleague at RUHSA conducted a study in the area and found a staggering suicide rate of 148 per 100,000, with the highest number in young girls from 10-19, as compared to a rate of 2.6 per 100,000 in the UK.

The lovely romantic notion of family members living side-by-side in mutually beneficial harmony (a difficult image to sustain once you have seen the adobe huts) is not the reality. In the villages, there is so little money to be made by staying put, that the younger generation often leaves to work in the cities and leave the older people behind. Several of our elderly people are widowed and living alone. Alternatively, if the younger generation has stayed put, living in extended families, the meagre income is prioritised to feed those family members who can generate more money. This is rarely the crooked white-haired grandmother with a ragged cotton sari and barefeet.

The government has a partial solution to this problem. Elderly people who have no sons (whose responsibility, traditionally, it is to look after the elder family members) get 200rs per month (₤2.35), which is a pitiable sum, but those who have sons get nothing. As there is not enough money for basic essentials, you can imagine what the spending is on health care. Zilch. Except in extreme emergencies, when the essentials are forgone. But even then, the elderly do not pass the criteria required to count for an extreme emergency. They are old, they are going to die anyway. Why waste money. It's the brutal end of a spectrum we are surprisingly familiar with in the UK, but we pretend we are not.

Our project is a small attempt at introducing the concept of elderly care into a culture where even to be old is an achievement. With the "greying" of the population - India has the second highest number of people aged over 60 in the world - occurring here at a faster rate than in the UK, with no provision for elderly healthcare, nor even for a consistent universal primary healthcare, it feels like a futile drop in a stormy ocean, but the ocean, too, started as a drop. And before that there was also Chaos.

Sitting in the yard of the Community Centre building, with the tamarind leaves gently dropping onto our precious note paper, watching the stooped, barely clothed people coming across to us, handsome faced and dignified, I thought of how far from my UK practice I was. We greet each identically with hands clasped in front of our faces, smiling, our heads rocking in synchrony. For each of them, the first question, through the translator, is: "Have you got any medical problems?".

It's a peculiarly difficult question to ask when there are no notes, no previous records, no knowledge of their life for the last 70 years; it seems to create an undulation of despair in them. Where can they start? Of course they have medical problems. Even the act of going to the loo, without the benefit of Occupational Therapy putting in handrails in or raising the loo seat - they have to get up and down from squatting 6 inches off the ground - causes problems for their elderly, arthritic, undernourished joints. Forget about the fact that they are trying to earn one or two rupees a day by sweeping the temple floor with a brush made of coconut fibres, requiring requires a posture akin to someone actually picking the dust up from the floor by hand.

On the first day, I met three people. None of them weighed more than 37 kilos (less than 6 stone). They all had marked kyphosis - dowager's hump - caused by osteoporosis and all of them looked bewildered at the interest we were paying them. Yesterday, I saw 5 more people. The first lady cried when I asked about any medical problems. She rattled off a long list of concerns - poor sleep, difficulty breathing, no appetite, problems swallowing, constipation, pains in her stomach, to name a few. She lived all alone, hunched and helpless. She had never been inside the community centre to see the doctor in her life. She was telling her medical history for the first time.

During the examination, it became apparent that this lady, in addition to her long list of existing chronic problems, was acutely unwell. She was pyrexial, tachycardic, tachypnoeic with a low blood pressure. It was at this point that the wonder of the NHS truly became apparent. At home, I would have sent her into hospital. I would also, probably, have known more about her than I did. The receptionist would have called an ambulance, it would have come to the surgery, picked her up and taken her into hospital, where hopefully, the source of her infection would have been investigated, she would have been treated with antibiotics and been discharged back home, with perhaps a care package to ensure she could cope at home. Now obviously, sometimes, details within the NHS let us down, but we never stop expecting it to look after our health. We take for granted that our doctor, although perhaps she (or he) can't maybe give us enough time, knows what pills we are on, what problems we had with our bowels last year, that we had a crisis of confidence at the start of a new job. We take for granted that, as women of childbearing age, we will be called for a smear test every few years; that we can go to countries where polio still exists, safe in the knowledge that we have been vaccinated against it.
And all this without having to make the choice between health and nutrition.

Staring, helplessly at the darkly wrinkled face, I weighed up the options she had. To go to hospital she would need transport, a bus, for which she needed money. To receive treatment from the hospital, she would need money. To get medication from the chemist, she would need money. She had none. She could do none of these things. There was an option of coming back to the mobile clinic in 6 days, where she could get some pills, and they would probably waive her fees, but she needed some treatment now. The best we could do was to buy her 12 paracetamol for 12 pence and hope for the best. On a little slip of paper I wrote a note to the doctor in the following week's clinic hoping that nothing disastrous happened over the next 6 days. So now, you can understand why my tolerance of people moaning about the NHS will be very very low.

Awaiting Committee(s) Approval

Today I used a stethoscope for the first time in 3 1/2 months. I went to Keelalathur village to do medicals on the elderly people who are going to be attending our community centre. It sounds so simple, but being India of course it wasn't. Actually, today is the first day that I have been frustrated to the point of having my mood affected. Usually, a good old head wobble and a grin is enough remind me that I am a guest in this country and with a bit of luck, charm and persuasion anything is possible. However, today, the limits of possibility seemed to be visible.

I am the only person who seems to be in the least bit anxious about the project’s time scale. In one week and one day I am leaving RUHSA for Christmas. In 5 weeks, we have planned an inauguration of our community centre. Dr William Cutting, a retired paediatrician from Scotland, who was instrumental in the inception of RUHSA, is visiting for two days in January. Back when it seemed easily possible, we planned for the community centre’s "Grand Opening" to coincide with his visit, for him to cut a ribbon or two. The Grand Opening is gradually becoming less grand and there is less and less to open.

For the last month or so, I have been agitating and putting direct and indirect pressure on RUHSA’s engineer, Donald (about whom I can't say anything bad because he is responsible for the future installation) for him to get the kitchen built in time. Donald has a list of 26 jobs to do (the kitchen makes the 27th and my loo, which has snuck in through the mosquito flap, is number 28). Donald looks terrified of me and on principle says "No problem" to everything I ask, until I ask for specifics, in which case he just says "No". It is a small comfort to find builders and workmen are the same the world over. There is a fluidity of neck muscles amongst Indian workmen which is absent in their British counterparts, but the sharp intakes of breath accompanying the head movements, drawn in through clenched teeth, are identical.

On Monday, we had a frustrating but ultimately useful "site meeting". We now have a plan, which can be presented to the Committee which allows plans to become formalised and set down on paper, before the paper version can be submitted to the Committee which agrees whether this plan is ok and forwards it to the Committee which decides how much money is needed for the project before it goes on to the Committee which decides whether the amount decided is enough, blah, blah blah. As you might imagine, it is unlikely that Donald will be able to get through the 47 required Committees before the 11th January, let alone get the first brick laid. Despite this self-evident truth, always the answer is "No problem". On a side note about Committees, I am reliably informed that the CMC Hospital (of which RUHSA is a department) excels in Committeeship. It you want something done, you have to form a Committee. And if you want something not to be done, you have to form a sub Committee. To excel in Committeeship in India is an achievement indeed.

So now, we are thinking, perhaps, instead of a Grand Opening of an unbuilt kitchen, we can have an Open Day instead - an exhibition informing the community about the plans for the centre – and also start the food program. The Self Help Group women can make the food in their homes and bring it to the centre. Great idea, sounds possible even in the short time frame. Give the centre a bit of spit and polish (only 3 Committees needed to approve that) and get some furniture, benches, chairs, mats, eating utensils etc, with the money sent over from the Trustees in October. Then I discovered that the money, which is sitting in a bank account somewhere in Vellore, is not able to be spent because it needs approval from a Committee. There is a glimmer of hope. It is possible that a quick word from the Director (Dr John) to an Emergency Accounts Committee will allow some emergency funds to be released. Unfortunately, he is freezing in Denmark (without socks) for the next 2 weeks so nothing can be done until then. By the time he returns, I shall be freezing in England (with socks) eating crunchy vegetables and no curry (I hope).

Feeling a little bruised but by no means quashed (yet) after all of this, we began to plan how I would carry out the medicals. Mr Jebaraj, one of the team members, has been traipsing around the village conducting a quality of life questionnaire. The team had decided that my attendance might be detrimental so I couldn’t do the medicals at the same time. I had been promised that these would be finished two weeks ago but something has always come up. Never on first asking. No. On first asking it is always, "No problem". However, when I ask to see the finished QOL questionnaires or ask exactly how many have been completed, then the truth seeps out, reluctantly and ambiguously.

A plan was made at our Wednesday staff meeting, which is being attended by fewer people each week. Despite it being a regular weekly occurrance, people still manage to look astonished when I ask them if they are coming. I get the distinct impression people are starting to hide when they hear me coming. As I have a peepi-peepi on my bike, they get plenty of warning. Whilst sitting in the meeting, looking around at the sparse blue concrete walls and empty beige plastic chairs, I had a brainwave. Every week a mini-bus takes medical supplies and a few staff to Keelalathur where I was going the next morning to catch any of our target group who might attend the clinic. I felt a bit faint at the idea of trying to mesh my needs in with the clinic's and I thought it would be better if I could take everything I might need and not interfere with the other staff at all. So, my brilliant idea was, why don’t we take 3 chairs from the meeting room with us (knowing there are only enough to run the clinic).

You would think I had asked to borrow their own personal bedding for an orgy. For once I was told directly "No it’s not possible". Why? Well, firstly, you need to ask permission (of who?) and then get a receipt (from who?) and then ask permission of the transport department to allow them into the van and ask the clinic staff if they minded sharing the van with some renegade chairs. Feeling slightly stubborn, I said, fine, who do I ask. No direct answer. So I asked a few people who all gave me equally indirect answers and finally narrowed things down a tiny bit. Apparently the chairs in the meeting room were definitely taboo, but I could take some folding metal chairs (perfect) which were in the Community College next to the Transport Department, whose permission I still needed in order to take them to the village. Happily, I cycled off to find the various Important People to ask. I was feeling triumphant. I had Beaten the System. I was back in the world of No Problem. Every one I asked was more than happy to help. Just to be sure of my victory, I went again first thing in the morning to check that all systems were still go. They were. I waited excitedly for the clinic bus to arrive. Of course there were no chairs in it. Apparently I had got permission from everybody except the person who had the chairs (I still have no idea who that is) so all anyone was every agreeing to was the principle of transporting chairs to and from the village.

We ended up chairless at the village, the clinic started late and no-one turned up to see me. We wandered around the streets asking in all the houses trying to find our target clientele. Eventually we found 3 people. Even seeing and examining those three was a lesson in itself.

What a hoot!

Every object with more than one wheel has some mechanism for making a disproportionate amount of noise. It's mandatory. As per the instructions "Sound Horn OK" painted on each tailgate beween Shiva's third eye and garish but arresting flowers (and a slightly peculiar maxim I have yet to get to the bottom of, but apparently is a veiled reference to family planning - "We two ours one"). There is therefore stiff competition for the few molecules of sound-empty air space. Today, I contributed to the hullaballoo.

I went in search of some rickshaw hooters (in Tamil it would appear they are called peepi-peepis). It was really, considering the difficulty I had in trying to get someone, anyone, to understand about tin-openers, astonishingly easy to make myself understood. It could be something to do with the fact that there is a huge density of hooters per square metre - one indeed, a big Daddy Parper, was parked outside the first shop I asked in. Not knowing the word I needed was peepi-peepi, after a few futile minutes of me opening and closing my hand over an imaginary bulb and making farting noises being met with familiarly blank looks, I stepped neatly to one side and opened and closed my had over a real bulb and made real farting noises. The message was understood and I was directed to a shop was only a few metres away.

History will never reveal what the shopkeepers thought a white Englishwoman, who seemed inordinately amused by the sounds of the peepi-peepis, wanted with them. A new Rickshaw wallah on the scene perhaps.

The trip back through town was surprisingly unimpeded. A rickshaw came to a stop just in front of me and leant out to ask if I "wanted a ride, madam" He nearly jumped out of his skin with my reply. He had no horn to respond with. A man, not looking where he was going, nearly walked into me. There was no collision, but there may have been a ruptured eardrum.

Before I went back into the library, where I would have to curb my enthusiastic use for the peepi-peepi, I went to the tailor (of Innerwear fame) to buy some material. The One-Woman-sideshow-with-Peepi-peepi went down a storm and we spent a happy hour alternately chosing material and honking back at the traffic. Many passers-by did not know in which direction to jump. I can't wait to affix it to my bike and go cycling madly up and down the villages, parping at anyone and everyone. It's amazing how much entertainment you can get for just 50p.

Land of Hope and Glory

Yesterday was Graduation Day for the Class of 2006, some of whom I have got to know a little, so I went along to see what was what. CMC, as explained before, was set up in 1901 by an American woman to address the need for women doctors to minister to the women of India, who were not allowed to be attended to by men. In the late forties CMC admitted the first male undergraduates. The number of students per year remains at the level of 60 per year, as established by Ida Scudder. The ratio this year was 28:32 women:men.

The course is based on a traditional English Medical degree, with some American structure thrown in. It is a 5 year course during the first 2 years of which they do Anatomy, phyiol, biochem, blah blah. Then they start doing clinical rotations. After they qualify they spend a year as an Intern at CMC and then start residency (which is the American bit). The graduation ceremony takes place half way through the graduates Intern year.

As a ceremony it ranks with the Trooping of the Colour for pomp and circumstance. In fact Pomp and Circumstance was played as one of the key marching tunes. The final year medical students, the girls in beautiful white saris and the boys, with slicked back hair and nervous smiles, in blazers, carried 2 long strands of fabulous-smelling tuber rose and jasmine flowers twisted into a thick rope, leading a procession of all the graduates, postgraduates, MDs, PhDs and Faculty professors around the campus garden grounds before enteing the auditorium for the prize-giving ceremony. They slow walked to the tinny strains of Fanfare for Common Man, by Aaron Copeland and Land of Hope and Glory, by Edward Elgar. Hundreds of proud mothers, fathers, sisters, brothers, aunties and uncles stood around with the finest array of digital camera-ware seen, capturing every moment as tiny electrical impulses. Younger sisters were wearing dresses stiff with nylon lace and starch, younger brothers had army-shiny shoes and hair. Parents who had gone through the same ceremony many years before, of whom there were many, were humming along with full eyes and a quivering lip. The graduates looked proud, nervous and defiant as they marked the start of their new life as a doctor.

All the girls wore saris and it was clear that they weren't use to them. Some had uneven hems, some even showed the skirt underneath, many walked not really knowing how to accomodate the thick pleats at the front, but they all looked beautiful.

The ecermony went on for a couple of hours or more and I sat outside with a friend and watched as the dusk turned to blue fairy lights strung through the garden and along the edge of the building. The delicious aroma of dinner, organised and served by the students in the first and third years, wafted through the trees. We went back in and had a look at the end of the ceremony. The fans busily turned above the heads of patient families waiting for the 3 seconds of glory for their son or daughter. The clapping was minimal by this stage, until the award for the best teacher, awarded on the basis of a student poll for three years. A retiring professor, who had been teaching for decades and therefore known by old and new students alike received an overwhelming spontaneous cheer and standing ovation as his name was called out. My friend, with tears in her eyes was clapping furiously, he had taught her 25 years ago. Everyone stamped and clapped and roared their approval at this accolade. And the professor, Dr Rao, beamed delightedly. A beam for which he is famous and no doubt contributed to his award.

After the dinner (which I did not attend) there was student entertainment. We sat and watched for a while. Pictures of class outings and people studying in messy bedroom; in jokes about the class clown; cheers at everything the class dude did or said; beautiful serious singing interrrupted by tuneless joke singing all encouraged by shouted comments, clapping and laughing from the audience of their fellow classmates.

If I felt even faintly nostalgic about my medical student days it would have brought back memories for though this college is thousands of miles from my college, it seemed just the same. Medical students are curiously alike.

Opening a tin of salmon

For lunch today, I had salmon salad with tomatoes, cucumbers, onion and a lime & wasabi mayonnaise. Sounds impressive and wasn’t bad.

As a treat, I’d bought a tin of salmon in wasabi mayonnaise at the supermarket. I’ve only been to the supermarket about 4 times and I feel like a kid in a sweet shop whenever I do. I buy things I wouldn’t even look at twice in the UK, but, as mentioned before, the unremitting diet at RUHSA can cause extraordinary things to happen. On one visit to the supermarket, I became so overexcited at a tin of processed cheese, that the security guard thought I was planning a raid and nearly escorted me from the premises. I mollify myself with the thought that every Indian friend I have ever had cannot exist in England without chillis and curry, so I shouldn’t feel guilty for craving things that resemble stuff I might have at home every now and then.

It’s not that the flavours here aren’t good, it’s just that it seems to be a bit of a one trick pony. Rice or bread with soft vegetables or, occasionally, chicken, in a sloppy sauce – which looks much the same on entry as exit. I remember last time I was here, craving, from deep within my soul, crunchy boiled French beans, and even now (at home) they still have the power to truly excite me. My teeth long for crunch, my masseter muscles yearn for resistance, in short, I want something to bite into and make it worth while having teeth. Nothing in India really requires them. As it is, despite the amount of sugar consumed, most people here have fantastic teeth, perhaps its because they hardly use them. The vegetables dissolve in the mouth, the chicken pieces – which are anatomically pretty unrecognisable (I think the butcher just chucks a whole one up at the fan when it’s going round at top speed) - have barely a morsel on each piece and usually the best one can do is suck the juice off.

And everything has sugar in it; the bread, the tea, the coffee, the tin of salmon in wasabi mayonnaise. It’s not really surprising India has such a phenomenal rate of diabetes, I can feel my own pancreas is exhausted. Not only does everything contain sugar but it contains it in vast quantities. Every drink ordered comes with added sugar, even fruit juices like pineapple. I ask for everything without sugar, even fresh lime soda, which is not unreasonable to drink sweetened. Everytime I order it, I get the same reaction.

"Fresh lime soda, no sweet, no salt, plain, plain". I look at the waiter’s face. He hasn’t taken it in; it doesn’t register.
"No sweet, no sugar," I reiterate (otherwise it comes with an inch of sugar in the glass).
"Ok, ok," he says, "Little sugar."
"No. No sugar. Plain, plain."
"Ok, ok. Salt."
"No. No sweet. No salt. Plain, plain." Sometimes it comes plain. It’s a little ritual I shall miss when I’m home again.

Anyway, back to lunch. So, I was very excited at the prospect of my salmon salad. I had it all planned out. I would cycle to KV Kuppam and buy tomatoes, cucumber, maybe some mint and coriander and a few limes. I set off, waving like the queen (except she rarely uses a bike) to some of the many, many children who yell out "Hello, Madam" as I ride by (it’s going to be very strange being anonymous again, when no-one is the least bit interested in my passing) and ignoring the many, many men who, with balletic grace keep their eyes fixed on me as they ride past on their mopeds without a wobble, despite paying as much attention to the road ahead, as a 1940’s film star driving through a Hollywood backdrop.

I got to KV Kuppam and, without any effort, found tomatoes, cucumber, limes, onions, coriander and mint. I found great difficulty trying to find a tin opener. I went into a shop which sold tins and kitchen utensils and asked for a tin opener with a faintly hopeless air, as it was clear that no-one could speak English. And why indeed should they. I bet no Guildfordian in Robert Dyas on North Street speaks Tamil. Not even a flicker of understanding. So, I tried miming opening a tin. Despite my previous success on the Stage of India, this performance met with blank looks and Tamil mumblings followed by a questioning glance as he pointed at a water jug. Try again. This time I attempted drawing what I wanted. I drew a tin closed, a tin open and a tin opener. A look of dawning comprehension mixed with desperation passed over the shopkeeper’s face. He pulled out a wok. I gave up and went to the next shop. I was marginally more successful in conveying my needs, but no more successful in fulfilling them. I decided not to try and purchase a tin opener as it was exhausting me, maybe my friend would have one. Whilst doing a bit of sneaky Christmas shopping in a silver shop, I texted her. It turned out she didn’t have one either. The prospect of having salmon for lunch was rapidly fading, but as I was having a lovely time browsing through the extraordinary array of silverware, I sort of forgot about it for a bit. I was also beginning to draw a crowd.

When I finished choosing, the man in charge added everything up with one hand and opened new boxes of things to show me with the other, all the while chattering away in good English. Suddenly it dawned on me, I could ask him where to buy a tin opener.

"A tin opener?" he replied.

"Yes," I said, the tin of salmon beginning to drift back into reach.

He burbled to his wife for a bit in Tamil, and then suggested a shop I could find one.

"Could you write it down for me so I can show it in the shop, because no-one understands me when I ask for it?"

"No problem," he said, picking up a piece of paper and pen.

Meticulously, he wrote: T-I-N O-P-E-N-E-R.

There was a brief pause, before I couldn’t help myself saying "Yes, I can write it in English. Could you write it in Tamil?"

"Yes, yes," he said.

He put brackets around "TIN OPENER" and, somewhat confusingly, wrote underneath "TO OPEN BOXES". I persisted stubbornly and a little bit rudely, probably, but, having found myself in a similar situation in Barrow with a "Korean" interpreter, I was keen not to leave him with the impression I wasn’t fully conversant in my own language.

He was so kind and only wanted to help me, because he actually sent his wife or daughter off to try and find one in his own kitchen. She came back with a selection of articles, including a chisel and pair of pliers, which he assured me were perfect for opening a tin, especially if I could hit the chisel with a hammer. I didn’t like to say I had no hammer, nor refuse his assistance, so I cycled home with a bag full of vegetables, silverware and a selection of Black and Decker tools. You know what? The tin had a ring pull.

Au revoir to Romi and Malin

We have just spent a fantastic but bittersweet weekend in Pondicherry, the "Riviera of the East", a small district which used to be French, and now, still, amongst the deafening smell of curry leaves, coconut oil and latrines, pervades a faint Gallic whiff. We stayed in an old colonial guest house which the owner, Patricia, had decorated stunningly with carved wooden furniture, colourful drapes, cushions and light fittings and brightly painted walls. I went with a slight variant on the original joke gang, this time it was a Norwegian pharmacist, 2 Swedish Nurses, an Australian Social Worker and an English Doctor. It was fun but sad because, by the end of the weekend, we would be saying goodbye to the Australian Social Worker (Romi) and Norwegian Pharmacist (Malin) who have been brilliant company and great friends over the last 3 months, such as is only possible when you are all miles from home and trying to cram in as much as possible in a period of time which you know must end.

Romi has been my closest companion in RUHSA, we have spent loads of time chatting on her balcony while she had a fag, moaning about her so-called supervisor who, as far as I can tell, needs some serious tuition in how to "supervise", and co-students a staggeringly dysfunctional group who were extremely unpleasant to her, potentially making her time at RUHSA disastrous. Luckily, she and I became friends so we used to go and play with the others in Vellore, so, actually, in the end, she got the most out of her time here and had by far the most fun. Especially as she discovered the joys of a Swedish Massage.

Malin, whom I met first at the tsunami camp all those weeks ago in August, has been a blast from then til now. She is a powerhouse of organisation, motivation and realisation. We have spent so much time together drinking, eating, laughing, shrieking, singing, enjoying, playing, living and her leaving will leave a quiet, cavernous chasm. The good news is that I now have someone to visit in Norway, where I have always wanted to go. It has moved right to the top of my "Next Place to Visit" list.

Pondicherry was fantastic. We knew we were going to have a good time when, going out to dinner on the evening of our arrival, we saw on the menu "Herb Chicken – chicken cooked in continental herbs, vegetables and French fries – Enjoy with French loaf". You can’t really appreciate how exciting a prospect that is unless you’ve been eating rice, sambar (a watery lentil water with leastly lentils and mostly water) and chapattis for 3 months. Ture ordered it and asked the waiter if he could "enjoy with French Loaf". "Very sorry, sir, we have no French loaf, only Naan bread". We laughed all the way through dinner and then, when walking home, just as our hilarity was beginning to recede, we saw this:

The owner of the flat must wonder why gangs of tourists hover outside his door, clutching each other, incapacitated with laughter and taking photographs of his instructions for thoughtless car users in Pondicherry.

The next day the weather was a bit miserable, very overcast and unbelievably humid, but we wandered around the very pretty Mediterindian area, which has wide empty open streets, large looming broad leaved trees and a few Hindu temples. So just like Nice. We were even blessed by the resident elephant for a few rupees. We then went totally bonkers and bought huge amounts of "French" cheese (all made in the nearby commune of Auroville, started by Sri Aurobinda a Guru whose ashram is in Pondy), crackers (not the Diwali type) and expensive wine (not the Indian type).

Before we tucked into our cheese and wine party we went to a fabulous restaurant overlooking the sea. Scandinavians have to be the greediest people in the entire world and I am including the Onslows in this. They talk about nothing but food and drink between and during enormous meals and then, when reclining, bloated and belching from one gargantuan feast, they are planning and drooling over the next. I’m no stranger to gluttony, but I was totally outdone. Unfortunately, despite this, I still have the biggest arse. Their excuse is that, as eating out is so expensive in Sweden and Norway respectively, they can barely afford to do it, so they go completely bananas in India, where the most expensive meal still only comes to about 10 quid a head. Consequently, whenever I go away with any of the Scandinavian posse, I need to double up on the anorexic worms to keep things even. Saturday night in Pondicherry was no exception. The food was absolutely delicious. I started with Chandra bangra which was the most succulent and massive prawns cooked bengali style in mustard oil and masala. Bloody hell, they were good. Then I had some spicy tandoori lamb dish with grilled vegetables. It was all fab. The Scands must have taken a hundred pictures of the food in various combinations and degree of magnification (I must confess to taking a sneaky picture of the lettuce salad I forgot to mention I had) and Ture even filmed the arrival of Malin’s "Drunken Prawns". The waitress was most entertained.

We then had a short walk back and a brief pause before tucking into the cheese and wine. The Auroville brie taste just like the Auroville camembert, but it was at least free of curry leaves or black pepper which the Indians usually can't stop themselves putting into everything. As it was our last night together we sat up in our sitting area in our gorgeous room hooting with laughter about all the fun we'd had together.

It made it all the more sad to say goodbye to Romi the next day, whom we left in Pondi to get a bus to Bangalore. We just hugged. But we’ll meet again in Delhi.

Here are a few "Best of" pictures:

Me and Romi Sharing a Swiss chocolate

Outside "Patricia's"

Deep sea diving?

Classic Pondy

And finally, we get to enjoy french loaf......

Project Update

Things are going so well with the Project. Currently, we are developing our evaluation and monitoring methodology so that we can take baseline measurements of the first wave of beneficiaries for the community centre, ie the neglected elderly. We will be administering a quality of life questionnaire, a full medical check up and several baseline investigations, including full blood count for anaemia. It was decided that it would not be helpful if I was present when the QOL questionnaire is administered, as the results might be skewed in one way or another, by the presence of a (clearly quite well fed) foreigner watching them answering questions about their life and food intake. However, what is quite exiting is that I will be doing all the medicals, which will be done after the QOLQ. It will be the first time I have wielded a stethoscope since the Tsunami camp and I am looking forward to it, I have missed patient contact.

In addition to this, a young American student from St Olaf College, somewhere in the States, is interested in mental health and will be assessing the mental health status of all the elderly in the village for her undergraduate project. She comes at a fortuitous time and will contribute greatly to our project. If re-assessed at the same time as the evaluation process, in 12m, it will give us a good idea of whether mental has been improved by any of the services in the community centre, as we will be able to compare those who attend with those who do not. For once, a student project at RUHSA will not be stand-alone (and leave alone). RUHSA is bulging at the seams with amazing projects, information, data sets; mostly done by foreigners who come, use RUHSA’s resources for 4m, do a fantastically interesting project, but then leave. Nothing further happens with the project recommendations or data as the key movers and enthusiasts for the project have left. The only activity is the gathering of the dust on the paper copies in the various staff members' offices. Rarely is the audit or learning cycle completed, but there is so much useful which could be done with it all. I hope this marks the beginning of an ideological change whereby projects must be done for RUHSA’s benefit, and not just for the interest of the foreign student.

As if that wasn't thrilling enough, Dr John, the Director of RUHSA has asked me to help him develop a GP training program at RUHSA and to try and get accreditation for the MRCGP (Int). It is very early days yet, and not common knowledge, so if you meet someone from CMC or RUHSA, don't say a word, but it would be utterly perfect for RUHSA's future to secure it as a place of excellence for GP training. India doesn't have a formalised GP training system; any doctor who has finished his/her internship can set up as a family doctor. Medicine in India is entrenched in hierarchy and money, most students are from the upper echelons of society, therefore the incentive to work as a family doctor in rural parts of India is practically invisible, however, the government, in their National Health Policy 2002 (see link on left), which is a very interesting ideological statement of intent, advocates the importance of developing primary care in India.

As if that weren't enough, the current module I am working on in my MSc is on "Research Methods in Primary Care: Developing Primary Care"; how perfect is that?! This trip gets more freaky with co-incidence the longer I am out here!

Mamallapuram Mia!

I came to Mahaballipuram, as it was then known, in 1989. At that time, it was a dusty little village with no paved roads, about 5 houses (it seemed), a guesthouse or two and a restaurant. Man, has it changed. It's now a travellers mecca with millions of shops, hawkers, tarmac, beachside restaurants, westerners in skimpy clothing and a swimming pool. I was gobsmacked and bored every one rigid about the good old days when you could wander undisturbed around the shore temple without anyone trying to sell you an elephant carved from soapstone or a pair of comedically baggy trousers.

A group of 12 or so of us international workers went for the weekend last week, mainly because, sadly, Malin and Romi are leaving this week (but we get to spend one last crazy weekend in "French" Pondicherry together, which will be an interesting experience!). We hired a car to take us directly to Mama, in 2 3/4 hours, thus, for about £10.50 return, avoiding a three hour train journey followed by a 3 hour bus trip. We were embarrassingly excited to discover the in-car DVD player and made a detour via a DVD shop to get some films to watch. So, with our driver (who didn't look old enough even to buy Diwali Fireworks) we bounced, hummed and chatted our way through some classy Bollywood numbers.

We ate seafood (a lot), some of us rode scraggy horses, (not me, I didn't think they'd bear up to it), a few rode white horses of a different type as they went out on a fishing boat on a sea that looked pretty rough to me. And I. Well, I spent a long time lounging by and swimming in the lovely swimming pool which had a view of the beach. As you can see from the photo, having a view is the best way to experience the beach as there is stiff competition for towel space from fishing boats, cows, rubbish and the occasional Indian Mr Whippy.

At the pool, I finally managed to slightly reduce my builder's tan of brown flipflop marked feet (thanks Robert) brown forearms and forehead and a round brown semicircle below my neck on my back, with the remaining portions of skin being luminous white. Now there is a faint beige tinge on my legs and a less abrupt delineation on my arms. I am hoping at Pondy I can capitalise on my gains.

Me & malin on the Beach at Midnight

Photo update

Now the internet connection is working better, I have been able to upload some photos, so on the Diwali site and upwards there are more photos to make you envious.

Project Funding and Assignment Sending

Since I’ve been away, the Trust in the UK who had expressed an interest in contributing to a project in RUHSA received our project report very favourably and have committed 2.63 lakh rupees (263,000rs = ~£3000) to the Keelalathur Pilot scheme, which is great news. This is the projected budget needed to get the community centre building up and running, a new kitchen built out the back of the building, the buying of equipment and furnishing eg chairs, benches, kitchen & eating utensils, also future costs of daily newspapers and a few magazines, as well as the 20p per person food ration. The building work will probably take a few months, and we are hoping that it will be ready to coincide with the visit of one of the Trustees in January with the 30th anniversary of RUHSA which takes place on 17th January. Time marcheth on, however, and I’m not sure if it can be done in time, as it’s only 2 months away now.

Meanwhile Matthew and Kalaimanai have been clarifying exactly who are the elderly who might potentially use the centre and, out of a village of 1500, they have a list of 36. Each of these people will be visited and a baseline evaluation questionnaire including information about demographics, economics, quality of life and physical and mental health will be conducted. All of them will be invited to attend the centre and we will have to wait and see how many people actually come.

In the meantime, I have, very excitingly, submitted the first assignment of my MSc. Since coming out to India, I have been doing an online MSc in International Primary Care which is utterly brilliant. Not only is it amazing to be able to do a course based in London whilst sitting in India, but my first study partner was in South Africa and my co-moderator for our first seminar was in Thailand. As a subject, it is relevant to both my work in the UK and in India and has already been incredibly useful in giving me better theoretical understanding of what we are trying to achieve here in Keelalathur and also was helpful in my lectures to CMC medical students about managing diabetes from a Primary Care perspective, because they had no idea what primary care meant. I hope that, in the long run, it will equip me with a greater understanding of the infrastructure of Primary Care so I can understand where the future of the NHS lies, but I also hope it helps create opportunities to teach the theories of Primary Care internationally. It is so exciting to be part of the NHS, this project and this MSc and realise what amazing future potential there is out there for improving community health.

"The train on platform 1 will leave 20 minutes early"

Last night Alexander, Eliza and Mary Waugh and myself went and had a fantastic Indian seafood dinner on their last night in Bangalore before they went back to the UK and I finally left Bangalore to go back to work in Vellore. Their last truly Indian epxerience, before their flight home at an unbelievably antisocial hour was, at Mary's request, to take a rickshaw back to their Hotel.

As for myself, I was booked on the 8.30 Bangalore-Chennai train which was supposed to arrive at the station I boarded on, Cantonment, at about 8.50. Arun is always quite relaxed about catching public transport so I was agitating to leave, knowing what Bangalore traffic can be like. Initially we couldn't find a rickshaw, so I, and 2 large suitcases (1 rucksack of 2 weeks worth of holiday clothes and 1 bag full of Christmas presents) wove off sitting behind Arun on his bike. As he is quite "compact" and the passenger seat on the bike - he has upgraded from his scooter to a 150cc motorbike - is perched above the driver's, he must have looked like a mahout sitting in front of an overloaded Howdah in which wobbled a plentiful memsahib. The passing commuters certainly thought it was funny. Luckily, after about 5 minutes we found a rickshaw, I and my baggage decamped into it and we carried on in convoy. Unfortunately, Arun and the rickshaw driver violently disagreed as to the best way to the station and conducted a flaming row between themselves whilst negotiating the rush hour traffic. The rickshaw driver turned out to be right and we arrived at the station at 8.28 just as the train pulled in, 2 minutes before it was supposed to be leaving the main station. I have never been on a train in India which arrived on time, usually they are 15-20 minutes late, but arriving 20 minutes early is definitely a first and could only happen in this country.

As the train pulled in, we saw, tucked just behind the engine, my carriage. Indian trains are usually 20 carriages long and as the entrance to the platform is halfway along, we had to walk up 10 carriages top get to my seat. We arrived at carraige number 6 just as the train began gently pulling off. Arun handed me my bag and we bid a hasty goodbye as I scrambled onto the train, 4 carriages away from the one I was supposed to be in. Negotiating, with 2 large bags and one large person, the narrow corridor, filled with saried knees, playing children, sacks of rice, streams of hawkers selling everything from "bread omelette" (omelette sandwich) to "joos, joos, joos" (fruit squash) to little concertinas on a stick which squeak when you hit someone with them (who do they sell those to?), was exhausting. When I reached the car I thought was mine, I sank gratefully, glowing with effort, into a seat. It then became clear that I had one more carriage to go. The conductor was sitting nearby so I went and asked him if I could stay in this carriage (C2) instead of the correct one (C1) as my bags were heavy and I was exhausted.
He wobbled at me. "No problem," he said. "You can just carry bags through."
"No, no," I said. "Can I stay here?"
"Yes, yes," he said. "Carriage just through there."
"No, NO," I said, becoming increasingly more frantic, re-enacting as I did so the ordeal of carrying my heavy bags, sweating, puffing and panting throught the carriages and miming my iminent state of collapse if I had to go any further and then, for a dramatic finale, pointing in desperate relief at the nearest seat. Judging by the audience reaction, which by now included the entire carriage, had there been an Emmy for "Best Comedy-Drama on Indian Rail", I would have won it.

Still, I got to stay where I was and, like all one-hit wonders, sank into blissful obscurity for the remainder of the trip.

Not so Bumpi ride back from Hampi: Part 2

On our visit to the rest of Hampi the next day, we went to the amazing Vithala Temple complex which had musical pillars. These are clusters of small pillars around a central pillar on which is a carving denoting the type of sound they make, for example, bells or stringed instruments. If you then tap the smaller pillars with a stick or knuckle they make different notes. Listening with your ear pressed against the stone made the sound incredibly loud.

Now we can see where Alexander gets his musical talent from:



We also went to see Krishna Deva's stables. For his elephants! I can imagine that if Dad had elephants he'd build stables like this. They were in a row, made of granite with, obviously, huge entrances and each one was separated by walls, but there was a small doorway through which the mahout, but not the elephant, could pass. However, she could stick her trunk through and chat to her neighbour, or perhaps, for a couple of rupees, bless her. Each stable had a domed roof in alternating Hindu and Moghul styles, domes and triangular, with a central tower above the stable in which the prize of the collection, an albino elephant, lived. I have taken millions of pictures of Hampi, but as my pictures of monuments are identical to everyone elses, here is a link on the left to loads of them on one site, which saves me masses of photo uploading.

I forgot to mention that the downfall of the Vijayanagaras was at the hands of the invading moslems and Shiva, our guide, related it to three causes. Firstly, the Hindu emperors had a moslem army and as the moslem invasion grew in force, they changed sides, which is always a bad idea. Secondly, apparently the Emperors had made life with their concubines - women with impossibly pert breasts - so comfortable that they were at it all night and knackered during the day, so when the moslems galloped along they lay there, waving their hands feebly, saying, "Oh you go ahead, I can't be bothered". The final reason, which I think had some serious historical point, had nothing ridiculous about it so I've forgotten it.

Later in the day, we met up with some more of my relations as Alexander, Eliza and Mary joined us in Hotel Malligi. It is a very long time since I have seen any of them, but I resisted the urge to say to my 12 year old cousin "My, haven't you grown". As a child, really, that is all one does, so having adults commenting on it is phenomenally irritating.

The next day Teresa, Richard and myself left everyone else and went to Chitradurga which is a dusty town with a hilly fort apparently on the oldest rock formations in the country. The fort was ruled by more Viyanagars one of whom was entertainingly called Chikkana Nayaka, which sounds like something on a Japanese menu. Their rule here lasted longer than at Hampi - right up to the 18th century. Having experienced climbing up and down the hill (twice) and seeing the size of the walls, with no visible places for concubines to sap the strength of warriors, I can see why it lasted longer.

We spent a lovely few hours clambering around the temples and tanks on the hill, it was quite stunning. One of the most amazing sights was that of a local boy climbing up and down the wall like spider man. Below is a photo that you won't believe.

This is the view almost from the top of the hill overlooking the temple tank. It was beautiful, but the water was pea-green and when you got close, stink smell is coming.

Not so Bumpi ride to Hampi: Part 1

Have just spent an amazing few days with my Aunt Teresa and other members of the wedding party from England, visiting Hampi and Chitradurga, which are extraordinary historical sites of former Hindu Emperors, dating from the 7th to 16th century. It started with an aircon, sedate and leisurely drive in a Toyota Qualis from Bangalore to Hampi, with their Keralan driver, Selim, who appeared to have had driving lessons in a less frenetic country than India. It was a very smooth and comfortable ride, partly due also to the road being a properly surfaced two-lane highway. This did not stop the occasional rickshaw from driving on the wrong side of the road in the fast lane, virtually hidden from view until you could see the whites of the passengers eyes.

We stayed in Hotel Malligi, which is by far the plushest place I have stayed in so far, and required the services of a credit card. Despite that, it was still cheaper than the Barrow-in-Furness Travel Lodge per night. As we entered, the flash lobby looked like a smaller version of a Hilton atrium, but going through towards the rooms there was a courtyard, (onto which all rooms opened) which was having work done. There was no sense that, perhaps, pretending the centre of the hotel was not an ugly building site, would be a good idea for aesthetic purposes. On the site, women in saris and flip flops, wearing specially adapted hard hats with little platforms moulded on the top, ran around carrying loads of bricks, cement, piles of rubble etc on their heads, whilst men perched on scattered beams, in threes, smoking cigarettes.

On arrival with Teresa and Richard, we met two sisters of my late Uncle and two Americans who were also wedding guests. I had met the sisters before, when I was a child, and I'd always been slightly terrified of them. They are incredibly intellectual and literary, being children of Evelyn Waugh, and also belong to a diminishing number of 'blue-stocking' bohemian type of Englishwoman. It was like travelling with Mapp and Lucia and they argued constantly, in the way only sisters can, with deep bite and vitriol lasting a nanosecond, but leaving no trace. I thoroughly enjoyed spending a few days with them, rather than the just the usual fleeting, decennial seasonal greetings of my childhood and look forward to seeing them at the next round of family occasions. Being a 'scientist', although, most scientists who know me, consider me to be more of an artistic type, it was slightly strange to be around people who had little interest in practical functionings of matter and form, because I am hopeless at history and can only remember the ridiculous, which doesn't make for a very complete view of past events and therefore felt unable to contribute much (didn't stop me, of course), but they all made me feel very welcome, especially when they discovered I knew my way around a menu and was therefore voted MC For Ordering every night.

The first morning, after a kerfuffle involving trying to contact other relatives staying nearby, lost glasses, waiting hours for breakfast and various other trivial but time-consuming events, we set off in convoy to Hampi, which is a ruined city, covering many kilometres alongside the Tungabhadra River and spanning many centuries. It is an amazing place, once the capital of the largest post Moghul empire, the Hindu Vijayanagaras who ruled from the 14th to 16th centuries and flourished particularly under Krishna Deva, who ruled for 20 years from 1509-1529. We started on Hemakuta Hill, which is awe-inspiring. Huge boulders perch on the barren landscape, like marbles stopped mid-roll, with four-pillared mandaps or stone canopies strewn between them. One could almost hear the chatter of ancient Hindus as they sat beneath them, discussing their daily activities. The boulders are believed to be the consequence of a competition of strength and power between the monkey gods, of whom Hanuman is the most well known. Apparently, in a fury of simian testosterone, they hurled rocks around, trying to outdo each other. Standing amongst them, one could almost believe it really happened.

The first temple we visited had a huge pot-bellied Ganesha statue, who was depicted sitting on his (rather squashed) mother, Parvathi's, lap with his enormous belly inadequately contained by a serpent and riding his trademark vehicle – a mouse called Mooshikam. His gigantic girth, we were reliably informed by our appropriately named guide, Shiva, was entirely due to a predilection for sweets. It's important not to laugh at the thought of a tubby elephant riding a mouse, because when the moon did, Parvathi cursed it. Ganesh was racing his mouse chariot when Mooshikam stumbled on a snake crossing the path. Ganesh, fell off, his belly split open and all the sweets fell out. He grabbed the snake, stuffed the sweets back in and tied it as a belt. The moon started laughing at this and Ganesh hurled his broken tusk at it and Parvathi, who was nearby (probably recovering from being sat on) cursed the moon so that anyone who looked at it during Ganesh's festival would be accused of wrongdoing.

The story of how Ganesh got the head of an elephant further epitomises the crazy brilliance of Hinduism. Apparently, Parvathi fancied a dip in the river, once her husband, Shiva, had left for hunting one day. Whilst splashing around in the water, she started fashioning a doll from mud. She was so pleased with her handiwork that she breathed life into it. Once home again, she charged her newly acquired son with guarding the bedroom door whilst she washed off the remains of the mud in a bath. Meanwhile, Shiva, having finished his godly activities comes home and tries, not unreasonably, to enter his wife’s bedroom, but is prevented by a muddy child, who wasn’t there when he left for work that morning. In a fury he chops his head off. Parvathi, despite the brevity of their relationship is distraught. Shiva, in a typically male fashion, tries to make amends and sends some henchmen off to find an alternative head. The first creature they came across was a sleeping elephant so they chopped off the head and brought it back. What the mother of that elephant said to her husband is lost in the annals of history, but in a display of sheer DIY brilliance, Shiva affixes the elephant’s head onto Ganesh’s body so peace and tranquillity is restored in the household and a genius God is created.

The main part of the morning was spent wandering around the hill, making our way to Shri Virupaksha Temple, which is at the heart of Hampi. Being quite touristy, there were a few hawkers and there was one of particular skill. He fell into step beside me and started his low persuasive patter about the necessity of postcards in my life, and then, as always said “Your good name, Madame?”
Being generally quite polite, I replied, “Arabella. And Yours?”
In thick Karnatakan accent and with a smile of such whiteness that the cloudy day brightened considerably, he said. “Edward.”
“Edward?” I repeated in astonishment, “Really? That’s an unusual name for a Kannadan”
“Yes,” he said, still beaming, “it’s my business name. My real name is Muni”.
Well, I had to buy his postcards after that.

After parting with 2 rupees and our shoes we entered the huge temple complex which is still in use and our guide, Shiva, who was brilliant and charming, showed us fantastic carvings of animals, gods, anatomically impossibly pert women, beautiful columns, steel supportive girders, put in by the British made in Middlesborough (now, ironically bought out by Tata) and the Temple elephant, who for a further 2 rupees blessed us with her trunk. He took us into all the nooks and crannies of the complex, except for one. When we asked him why we couldn’t go in, he said it was because it was dirty, full of bats and worst of all “stink smell is coming”. That is now a phrase which is fully integrated into my Englian vocabulary and gets regular outings, as there are many places in India where stink smell is coming.

After a fascinating but exhausting morning we walked through a banana grove to The Mango Tree Restaurant which had great food, a great view, a great swing and most importantly, a great loo.

Run little elephant, run:



My Aunt Teresa and My Cousin's Aunt Hattie:



The "Slightly-older-than-I-usually-hang-out-with" Gang:



Or maybe not....

An Indian Bus driver

Have just spent a few lovely days on the beach at Mangalore, which is on the west, Karnatakan coast, usually bypassed by tourists who go to either the Keralan or Goan coasts, consequently, it was blissfully empty. The sand was white, the sea was calm and the food was delicious. On one night we had a special dinner with two kinds of fish, lady fish and something else I've forgotten the name of, clams and crab, which were so fresh that I'm sure I had been swimming with them earlier in the evening. In fact, I think I trod on one of them. The clams were delicious and cooked with a spicy coconut masala which I tried to get the recipe of, but language was a slight barrier. Anyway, the chef did manage to understand that I was keen on the food, which was not difficult, owing to the enormous quantities we ate and the remants seen still clinging to my chin and clothing when trying to discuss recipes.

After the beach trip, we came back to Bangalore in order for me to meet my aunt who has come over to India for a wedding. The mode of transport booked was sleeper bus. This is, in essence, a double tiered (not decker because there is only one floor) bus with seats on the bottom row and beds on the top. The beds would have been very comfortable - if the bus had been stationary.

However, not only were these beds on a moving bus, but they were beds on a moving bus driven by an Indian bus driver, and there is enough on this blog about the habits of these particular skilled individuals for people to realise the significance of that. As if that wasn't enough, this bus driver didn't believe in gears. And the road was very windy. And the majority of the road's surface had been destroyed by overloaded mining trucks driving up and down, creating enormous potholes. And he also, clearly, had an important appointment in Bangalore for which he was determined not to be late . And, I have a very high wobble factor. Net result: it was like spending the night on a trampoline with an enthusiastic seven-year who has eaten too many sugary snacks and needs to work off his energy. And does so continuously for ten hours. Everyone else on the bus seemed oblivious and slept like babies, despite the addition of sleep-preventing, hysterical cackles of laughter coming from me every time we went round a bend and I ricocheted around the little cubicle the bed was in. I think perhaps I shan't travel on those buses anymore.

Crackers about Crackers

I had thought there was no better example of India’s disregard for health and safety issues than could be seen on the highways and byways of this generous, foolhardy land. I have almost managed to get used to the sight of two carnation and marigold bedecked TATA lorries screeching towards each other on 2 wheels in a palpably vibrating cacophony of horns, demonstrating the perfection of the Doppler effect, and then passing each other by an unmeasurably narrow breadth, usually leaving a hiroshima style dust cloud to settle, out of which emerges, like a phoenix from the flames, an upright cyclist in a lunghi, on a Hero bike, sedately and unhurriedly pedalling with his legs splayed, his knees moving up and down slowly beyond the handlebars.

However, Diwali has introduced me to an entirely new level of disregard for personal safety.
It is probably the most well-known of Hindu festivals – the festival of lights, which like most Hindu occasions celebrates the victory of good over evil, the killing of demons and ultimate triumph of one of their many colourful gods. When I asked how it was celebrated, I was told that it is usually a quiet family affair where people throw crackers. Initially I assumed that throwing crackers was a slightly eccentric Indian alternative to pulling crackers and couldn’t really see the fun in it, but I was keen to experience it, so when Arun asked me and some other friends to spend it with his family, I jumped at the chance.

Myself, Romi & Olwyn – Australian social work students - and Ture, the Swedish nurse, set off for Bangalore (again) on Friday evening. As the train left and the night deepened, we began to understand about the throwing of crackers. The night air reverberated with deafening, even subsonic bangs. Diwali, we came to learn is the festival of sound and lights, where loud sounds are believed to chase demons away and the lights leave no place for the demons to lurk. The crackers were not the tacky crepe paper tubes of Chirstmas containing novelty (useless) gifts, but H-bomb potency bangers which cause perforated eardrums at 200 yards.

When we arrived in Bangalore, it was quite late so we went to dinner at a Kashmiri restaurant serving delicious chicken tandoor and handkerchief roti and then went straight to our hotel. The explosions were continuous and occasionally there was a burst of light. This went on all through the night. As the bed was quite hard, I woke up several times and everytime I did, even if it was 3am, I could hear bangers going off.

The next day after bacon and eggs!!!!!!!!!! for breakfast, we went to Arun’s house for lunch, where his parents, who are unbelievably hospitable and lovely had prepared a delicious lunch for us all, so we stuffed our faces. We killed time in MG road – Bangalore’s equivalent of Oxford street - until we could hold our own firework and cracker Diwali celebration.

Walking to Arun’s house after dark on the main Diwali night was when the true extent of recklessness became obvious. Firstly, fireworks are sold indiscriminately to anyone regardless of age or degree of responsibility. Secondly, once acquired, the fireworks are lit anywhere, and I really mean anywhere. On the way to our own display, there were boys younger than the eggs I had for breakfast, piling fireworks up in the middle of the road and lighting them as cars drove by, making, I should at least acknowledge, a vague attempt not to drive directly over the lit explosive. As they were placed on tarmac and not in any holder or anything to stabilise them, the firework usually shot out in totally unpredictable directions, at one stage, directly towards us, cowering behind some pillars in someone’s driveway. If, by some miracle the firework went upwards, then the probability of it not hitting an overhanging balcony or tree was minimal. After I expressed some concern about the careless use of firecrackers in this country, Arun said to me “You would be amazed how many injuries there are every year.” Oh no I wouldn’t.

Having said that, once we got into our own display, the seductive power of creating sound and light from little piles of paper soon overtook us. We started off being really girly about getting involved, including Ture, and refused to light any, come near any or even open the box. The first bang Arun let off to signify the beginning of the festivities for us, was so powerful and unexpected that it was like being defibrillated after a cardiac arrest. I fully expected the roof to come sliding off the building underneath which we had prudently set up our fireworks.
However, it was so much fun seeing sprays of white light like fountains, green and red rockets, enormous fat sparklers, that we became increasingly reckless. Our first rocket, lit whilst propped in an empty plastic water bottle, fell over before the fuse ran out and it shot all around the road and ended up going straight for Arun’s father. Luckily for Arun his mum was not watching at that time and even more luckily, his father was watching quite closely, and managed to dodge out of the way in time.

Flushed with the success of our exploits and sustaining only a minor fingertip burn where I forgot to let go of the taper when it burnt down, we went to dinner on the roof of a high rise hotel and watched the rest of Bangalore continue their celebrations around us. We had totally delicious food – half of us had Thai and the others had Pharsi. We went to bed with our eardrums ringing to a continuing night-time chorus of dogs barking and fireworks going off.

Here are a few pictures of our Diwali Day.

Arun's Mum and Dad joining in the fun



The Survivors


Left to right : Me, Romi, Olwyn, Arun's Mum, Ture, Arun's Dad
Front: Arun (inexplicably doing the splits),

Dinner on a rooftop terrace:

The Project

We have finalised the project proposal and sent it off to the Trustees of the Charity we are hoping will give us loads of dosh to start it up! It's been an amazingly busy week with having to analyse the data, write the report, moderate a virtual seminar for my MSc and teach medical students, so I have not had much time to write Betty, which slips down the list of priorities, fun as it is!

However, I am just off to celebrate Diwali with Arun and his family with some other friends, Romi and Olwyn, Australian Social Work students and Ture the Swedish Nurse. After that I am sliding down the alphabet to Mangalore, which is on the coast, for a few days before meeting my Aunt for a trip to Hampi. Life is soooo exotic!

Would you like me to service your mattress, Sir?

You probably won't believe me, but I spent last weekend selling mattress cleaning services at a trade fair in Bangalore. Arun asked me if I, as an "English Doctor", could enhance his friend's launch of a dust mite busting hoover in India. Now, I don't mean that this vacuum is now orbiting the earth, killing dust mites in its wake, sporting a figurehead of majestic proportions, but that this is the first time such a product has set toe in India.

Being game on for most things I have never tried, with the exception of unexpected nudity, I thought, well why not. I agree there may be a slight conflict of interest and I did feel a little bit like a hooker selling myself, but it was a real laugh. Apparently someone expressed "An Interest"but was politely put off- if I'd only known that all I have to do to get noticed is to wield a vacuum cleaner - 50y of feminism has clearly made no impact - I still wouldn't do any housework.

It will be of little surprise to many of you to learn that a country, which has not even a passing acquaintance with the principles of health and safety, whose people regularly pile all their nearest and dearest on a single moped, none of them with helmets, nor any road sense, is unlikely to be concerned about the effects of living with dust mites in their mattresses. And so it proved to be. Our descriptions of what would happen if you left your mattress un-dustmite eradicated, became more and more outrageous until, at one point Arun was trying to claim the dust mite pooed out twice as much as it ate, which is clearly an impossibility, but definitely sounds scary. People's reactions varied from wanting to see a dust mite; wanting to try out the hoover; wanting to buy the hoover and thinking, having seen the magnified picture of a dustmite, that we were selling prawns or squid.

This week, luckily, I have re-engaged with my normal profession by teaching 2nd year medical students the joys of managing diabetes in the community.

The Project Continues

In between having an amazing time at Mysore and selling the services of a mattress cleaning agency (you'll have to wait for that episode), the project has been quietly gathering pace. It started out, sometime in July with a 42 page document detailing grandiose plans to "help the most vulnerable" members in all the local villages, incuding mentally/physically impaired/elderly/widows/destitute and the poorest of the poor. Clearly the scope for this was too broad and it was impossible to make any headway into the project as it was. Consequently, the project team, which consists of RUHSA staff - experts in delivery and development of rural programs, as well as a couple of doctors and of course, myself, decided to do a pilot rehabilitation project in one of the villages. We started out with plans to gather relatively hard data about the physical presence of need, ie numbers of elderly, physically handicapped etc, and also, if possible, about mental illness, which as mentioned before is very difficult, as there are no "hard" signs/symptoms which can be used as identifiers. The RUHSA staff were sure that the villagers would know the difference between mental retardation (a word which sits uncomfortably with me, but is still in full use here) and mental illness, but that there just wasn't any mental illness in the villages. Well, clearly that's bollocks and when I asked the staff to ask the villagers what they understood to be the difference, the only thing they could come up with was that those with mental impairment drooled more. It has therefore become clear that both staff and villagers need education into mental illness before the community centre can provide a meaningful service addressing it.

As far as the data collection is concerned, it is interesting how it has evolved. Quantitative data collection methodology is set out before the data collection begins, and regardless of any flaws which come to light, is usually adhered to. Qualitative data collection is a very different beast altogether. You might remember that we started with the PRA and were going on to interview key village members, ie those identified as being most vulnerable, in order to assess the nature of their needs. However, it was clear that the PRA was too lengthy and yielded too much quantitative data and not enough qualitative data. Also it was clear that interviewing to assess need would be far too cumbersome a process because there was so much need in the village that we might end up interviewing almost all the households. Consequently, we decided to hold a "Rapid Rural Appraisal" which is essentially a village meeting, whereby the project team stated their intent to set up a community centre and asked the villagers to discuss what they think it should be used for and how they would keep it running - ie sustainable.

It was extraordinary that the overwhelming concern was for the elderly in the village who were not being takn care of by their families, through poverty. They felt that the best possible use for the community centre was to provide these vulnerable older members of the village with one meal a day, because some of them weren't even getting that. As far as the rehabilitation services were concerned, they were interested, but it fell very far down their list of priorities.

Our plan now, therefore, is to set up an elderly day care centre where they can come and get a meal, with volunteers taking food to those who can't make it to the centre. Once the centre has a relatively fixed population, we can start bringing in other services for both those who use it and their carers. So for example, physiotherapy for the elderly and training in physiotherapy for the carers; nutrition advice esp with regard to diabetes which is increasing in significance, even in the villages, with their absolute distance from a Western lifestyle. Other issues of interest which were raised included a woman who mentioned that her husband was, currently independent, but would gradually become more dependent on her and she was concerned about this as a future burden. This is a very exciting avenue, because it opens up the discussion about preventative medicine, screening, monitoring and lifestyle education in order to minimise future health risks, something which has traditionally been very hard to focus on in a society which lives a hand to mouth existence.

One idea for funding which we have been discussing in the meeting is to try and develop some "Community-to-Community" programs along the lines of person to person funding (like sponsoring a child, or paying for an individual's hospital care), where a community abroad is linked (like twinning) to a village and holds a few charity events, raises some money and then sees exactly how the community spends it. The funding needs for programs like these centres would be minimal. The cost of feeding one elerly person a day is estimated at about 20p. As our plan is to set up community centres in every one of the 100 or so villages in the KV Kuppam Block (similar to district) there would be lots of scope for this. I would be interested to know if anyone had any thoughts regarding this idea. I chucked that question in to check and see if anyone has read it to the end!

Footsore in Mysore: Part Two

The second part of the weekend was fantastic, apart from a tiny brief bout of the mandatory Delhi Belhi.

We woke really early on Sunday and were driven to see the palace in the beautiful clear morning light, before all the pollution rose up to obscure things. Then we went to Chawamundi Hill, on top of which is the temple to the goddess celebrated on the last day of Dasara. There were millions of people queuing to get in, they went around the temple inside and out in a line 5-6 people. We reckoned it probably was not worth queuing too as there were loads of other things to see. Next stop was a large statue of a bull (whose balls had been enthusiastically puja'ed by the men!).

The highlight of the day was the stunning Keshava Vishnu temple of Somnathpur, which is one of the finest example of Hoysala Architecture built in the 13th century and is, unusually amongst other Dravidian styles, star shaped.

Interestingly, the temple was used for teachings as well as worship and one of the classes available to pilgrims in the 13th century was the Karma Sutra. I expect it was quite a popular module and early registration was recommended. I can’t quite imagine the Rector of East & West Clandon offering a similar subject. Anyway, the temple, as you can see from the pictures, is covered in exquisitely well preserved and crisp carvings, apart from the ones depicting lectures from the Karma Sutra which have, unsurprisingly, quite a worn look. All are the work of a single artist, Malitamba. The carvings are in strips and depict scenes from various Hindu texts, including the Ramayana, Bhagavata Purana and Mahabharata. They are read walking clockwise around the temple.

Inside, the ceiling is in multiple bell shapes with more carvings deep into the roof space of the towers which surmount each of the three shrines inside. The whole effect is beautiful, peaceful and delicate.

Unfortunately for me, that was the end of my site-seeing for the day, as I spent the rest of the time in the car concentrating very hard on not throwing up (I succeeded) before spending an intimate evening with my lovely, lovely, lovely, non-squat loo at the hotel. If the rest of Mysore had been a disaster, the sheer joy of not having to squat over a hole in the ground where other people’s early morning poos emerge if I “flush” too vigorously (ie pour water down the hole from a bucket), whilst having frequent, pointless bowel movements, would have made it worth the trip anyway. As it happened, I had magic curds for supper with a roti and was right as rain the next day. In fact, as everyone else was extremely exhausted by the previous day’s vigorous site-seeing, and I had had an early night, I was bouncing around like Tigger at Eeyore’s party. Which was perfect for the Jumbo Savari - the elephant parade.

The wonderful Arun had managed to get us last minute tickets for the parade and they were great tickets too. They were right in front of the palace amongst some minor bigwigs. In order to get a better look at the elephants as they passed, I wove my way right to the front, noting as I did so how many uniformed policemen, including a few women in Khaki saris, lined either side of the parade. After a while, it became clear that the enthusiasm was for the uniform rather than the duty and there was lots of the usual Indian exuberance to give weight to the theory. Myself and Krithika, throwing caution to the winds, joined in and ducked under the fence into the parade ground, crossed across the two lines of policeman and stood facing our other friends in the stand, while mingling amongst the TV cameras, politicians, elephants and, as previously mentioned, khakied policemen. Heady with success, I wolf-whistled to the others to attract their attention. They were about 100y away. The many, many policemen standing less then 5 yards away, in a manoeuvre truly worthy of their uniforms, turned, as one, towards me. I looked down sheepishly, briefly, and when I looked up, I caught the eye of one. He looked fiercely at me and said.

“One more time, please, Madame”.

I obliged and a wave of happy grins illuminated the Khaki sea.

The parade was wonderful. There were uniforms with hats of all shapes and sizes - made the British Army headgear look almost reasonable. There were dancers, acrobats, children painted as tigers, fire eaters, brass bands playing the Indian version of Colonal Bogie and drummers playing fast and furious primal rhythms. There were some truly inventive floats, including one with a temple, complete with genuine “tourists” taking pretend photos. They were the only white people in the parade!

The elephants were beautiful. I don’t know why they make me want to cry whenever I see them, but they are so lovely. We got up really close and stroked the leader carrying the Goddess Chawamundi. We were even allowed to take each other's photos in front of them. The official photographers, kindly paused to let us do that.

This is a photo of the prize winning costume as far as I am concerned. We thought maybe they were a group of house-proud house-husbands.

After the parade finished, we had to get back to Bangalore in order to catch a bus and so missed the torchlight parade in the evening, sadly, but we set off, 6 of us, in a car the size of a Ford Fiesta. It was quite a hair-raising trip, especially as Arun was concerned we wouldn't make the bus. We didn’t, in fact, because it was so overbooked that people were actually throwing their children into it as it was driving into the bus station, to ensure their family’s places. The husbands hurled the smallest child through the open windows, whilst the wives screeched “Don’t forget the luggage!”. Disappointed, but secretly relieved not to be spending 5 hours on a bus were people were prepared to risk injury to their most vulnerable family members in order to get on, we went back to the car park. There we found that we had been boxed in. Someone had parked in the opening of the bay, blocking our exit. Having walked through crowds of thousands, we felt it unlikely we would track down whoever owned the keys to the offending vehicle. Luckily for us, but foolishly for him, the driver had parked using the hand brake but leaving it in neutral. It took a concerted effort, but we managed to bump the car back into the bay where our car was, enabling us to drive out. As we did, we noticed another car driving into the “space” we had kindly created for it and parking. I still occasionally wonder what the driver of the first car thought when he found his car cunningly contained in a fence of other cars: where he had most emphatically not left it himself.

As if that wasn’t enough entertainment for the day, we then were, very briefly introduced to a famous Kannadan film actor. As each state has it’s own language, it has it’s own film industry and Bangalore and Mysore are in Karnataka, the language of which is Kannada. He was very shy of being amongst so many gorgeous English speaking Flowers, and stayed only for a couple of minutes, but he too was impressed by my whistle and requested a repeat performance.

Arun, pretended to be looking for a hotel for us to spend the night but was secretly phoning his mum who instantly said that we must stay with her, as he knew she would. So we spent the night with the Diwakar family and black cocker spaniel puppy called Streaky. So named owing to his habit of streaking around the apartment like, well, like a streak. Sound familiar? He was noticeably less grubby than the other cocker spaniel some of you may know, which may be due to the fact that they never let him off the lead outside, he doesn’t have a water trough for a drinking bowl and they tie his ears back with a scrunchie when he has his dinner.