Leadership - The Mother Lode

It is already a couple of weeks since I returned from India and if I weren't wearing my sparkly bangles I would barely remember I had been abroad. Time moves on so quickly and covers its tracks so well. My English life has re-established itself effortlessly; I no longer expect to be entertained by posting a parcel or have to fight to get information about how things are working. No hang on, I work in the NHS, of course I still have to do that.

The main lesson I learnt on this trip is that leadership is the key. How one person can make so much difference; not because they do everything themselves, but because they empower others to be the best they can. Effective leaders are resonators - they emit an emotional frequency which resonates with people and increases each individuals ability, capacity and, most importantly, willingness to work together in unison. They coalesce activity so the noise in the system is reduced and the energy expended becomes so much more productive. Often the amount of net energy can be reduced which has the knock-on effect of keeping people healthier. Also, there is the more subtle effect of creating a unified ideology, the buzz word I think is ownership - by generating the feeling that the doorstep belongs to people reduces their tendency to crap on it.

RUHSA, New Best Life Shelter and Karuna Niwas are prime examples of this and, not coincidentally I feel, each one is lead by a fabulous, strong, determined, clear-headed and passionate woman - Rita, Catherine and Celine. Going back to the beginning and we find the story also begins with another impressive woman - Ida Scudder. The women are extraordinary role models and I feel blessed to have found myself a part of these women's lives.

Karuna Niwas photos

Here are some photos I am hoping to put on the website. They are taken with my new camera to which I am still adjusting, so the colour is a little funny, but they give a flavour and people can do amazing things with photoshop nowadays.

Binsy, Celine's lovely second in command. With flower.

Celine, Binsy and Karuna Niwas

The Manayani Complex and classroom inside where the woman and local villagers are currently taught English and computer skills and where classes in Ayurvedic Massage are going to start.

A website, two saucepans and a cockroach

After I left RUHSA on Thurs I came to stay at Celine's partly to see her and partly to finish the bl*&%*y website which has been hanging over my head like a sword of Damacles. We started it at least a year ago. In January, fed up with the delay, I put a firecracker underneath it, so it took a leap forward. A few weeks later, it then came grinding to a spectacular halt and nothing, but nothing has moved since, despite a few plaintive emails trying to ascertain why no headway was being being made. Although, I am the person who is raising funds for it, it is not my website and I do not live in India, so it should not depend on my having to bully everyone like a starched nanny to bring things together. So, truthfully, I was a little narked with the situation, even with dear Celine. She does want the website, but she wants it to be a fait accompli; she is not at all interested in the hows and whys of it, which I can understand, but it won't happen by itself. Anyway, now there is an ultimatum on the table, and I hope that will be the end of procrastination.

Once the weight of sorting out the website was finished, I felt much lighter, so Celine and I could really enjoy ourselves. Today, she gave me a cooking lesson; I now know how to make dosa - a half crispy half soft rice pancake - brinjal curry, a coconut and cabbage dish, Indian fried rice, sambar - the lentil dish eaten with all meals in South India - and garlic pickle. We ate really well today! I even took some of the coconut and cabbage dish before it was cooked and fusioned it with lime, mango and roasted peanuts to make a sweet and hot salad. They don't know it yet, but I shall be experimenting with the medical students when they come for the end of term barbeque.

In anticipation of all the cooking I would be doing, I had already decided to buy a dosa pan to take home. My suitcase when I came out was light as a feather, weighing a mere 12kg of which at least 6-7kg was the case. So I thought to myself that I could afford to do some shopping. Giving myself licence to shop is a like an alcoholic saying "Well, I'll just have a small one." I can now barely lift the suitcase off the ground. As if the dosa pan were not enough Celine, after our gastronomique triumph this afternoon, went out and bought me a pressure cooker. It is nestling between underpants, incense sticks and packets of biryani mix, tamarind rice mix, fish fry masala, two pots of honey and a bottle of mango squash. I haven't even mentioned the shirts, earrings, bangles and delicious tooled leather laptop bag. Or the Indian board game. I am going to have to put more than my wallet and my phone down my bra.

Revoltingly, when I emptied my hand luggage case completely to repack it, I noticed a shimmering in the corner. I looked a little closer and realised I had brought a friend from RUHSA with me. There was a cockroach in my bag. I don't know why they are so particularly unsavoury, but they are absolutely disgusting. I really had to steel myself to catch it and throw it out. It's partly their incredibly long feelers which somehow look so knowing, as if nothing escapes them; they sense exactly where you are, what you are doing, they can taste your fear and they revel in it. I have to say though, once the chase was on, the fear equilibrium tipped in my favour, which sent the roach scurrying onto the deepest crevices of the case in a very unhandy way. At once point I was worried it had got between the lining and the frame never to be removed, resulting in me having to take it as hand luggage and it emerging sometime during the inflight meal causing a commotion on the plane. I did not relish the thought. Luckily, however it hadn't and, with a plastic bag over my hand as if I were picking up dog poo, I managed after several attempts to catch it and chuck it outside where, bemused, it scuttled off leaving me shivering in revulsion. I have to say, as I was sitting here writing about how I managed to outwit and outscare the roach, a huge mayfly type thing landed on my bare shoulder causing me to leap off my chair shrieking (which I am not usually wont to do) flapping my shirt ineffectually to get the thing off me. Revenge of the insects. Me 1, bugs 2.

Parcel for United England

One of the joys of RUHSA is a post office just opposite my room and although I failed to take full advantage of it my first trip, every time I go now, I take a long list of people to whom I should have written but have been too busy and, between crazy village visits or knitting, I catch up on my letter writing. This time, I also decided to send some parcels. Last visit I also sent a couple and although I remember it exercising the sub post master general somewhat, I did not remember it being quite as spectacularly Indianish as this time. The time taken to undertake the whole thing was gargantuan. I should have brought my knitting.

The sub post master general is a distinguished looking man with a toothy sidekick, who is less distinguished, but sees more jokes. The sidekick roared with laughter when, after telling me to write my return address "Madam, small, small" in the corner, I started writing in letters barely bigger than the width of the pen nib. He laughed and laughed (I was doing a bit of smug chortling myself) and with several "Saar, saar"s encouraged the SPMG to join in the gaiety. He was not impressed. Chastened, I wrote it in normal writing.

The SPMG, despite having an enormously broad, smooth upper lip with barely a crease for the philtrum between nose and mouth, has one of those moustaches that was almost as fine as my writing. In fact it is so thin, that I didn't notice it at first, but when you are sitting looking expectantly at the same face for over an hour, these things start to filter in. It is the mark of a pedant, I would suggest, who can be bothered to meticulously shave every hair from his face apart from the bottom line of single hairs along his upper lip. But not to let them grow. Oh no, that would be frivolous. They too must be kept in check and not allowed to stray beyond 2mm. Scintillating. I spent much of the time wondering how long it took him, what happened if his hand slipped, how long was too long, was 3mm outragously hippy-ish, did he every ring the changes and do the penultimate row above his upper lip? Sadly, I'll never know the answers as the subtleties of shaving are beyond the scope of his English comprehension and far beyond the bounds of my 6 words in Tamil.

Two of the parcels were to the UK and one was to the US. Well, that caused confusion number one and we had at least a 10 minute conversation about which parcel was for the US or UK, despite being clearly addressed as such. And once it was cleared up, the round of clarifications started again. Everyone joined in enthusiastically, including the sidekick and wandering locals coming in for a bit of entertainment. Gesticulating to parcel number one. US? Yes. America? Mmm-hmm. USA? Yup. United States of America? Yes, yes, head wobble, pointing, pointing at address, the works. Ah, OK. Ding, ding, round 2. Parcel 2. US? No. UK. Ok. United States? No, United Kingdom. Not America? No. Ah Ok. UK? Yes. Ah Ok. You get the general picture. Carefully, the SPMG puts the two for the UK on one side and the one for the US on the other. Then, they are weighed and the weights written on the back. During this process they are shuffled. My heart sinks. The round of discussions re the parcels eventual destinations starts again. I'm getting better at it now so it is resolved quicker.

In order for the SPMG to give me the correct stamps he has to telephone the higher eschelons of Postmastergeneraldom to find out the postage for the weight of the parcel. This is when the fun really starts. It becomes clear that the entire conversation about whether the parcel was for the US or the UK was merely a theoretical discussion because no-one actually knew what UK meant. This subtlety eluded me til about 20 minutes into the phone call, during which all I can hear is a stream of Tamil, with occasional familiar tamil numbers, then either US or UK repeated, repeatedly. Sometimes he turns to me, points to a random parcel and says US? or UK? depending on his whim. Reading the address I confirm or deny the answer. I hear him saying "Serie, saar" (OK, sir) or "No, saar" (No, sir) throughout the conversation. But there is no real sense of progress until he turns to me and says ""UK, is United States?" Er no. United Kingdom. Realising perhaps a little more clarification is required I say "Great Britain? England?" "Aaaah, Uk, United Eng-eland, saar" A few more serie saars, a couple more United Engelands for good measure then unexpectedly he hangs up. I sit waiting, wondering what to do whilst he gets on with some general SPMG stuff and pays no attention to me. After the furious and prolonged interchange of moments before, the quiet is disconcerting.

The phone rings. Phew. The God of PMGdom has spoken and the prices are duly written down. Expensive compared to seamail, but worth it for the pleasure given to small godchildren and nieces at receiving a parcel from India. 542rs for the heaviest and 397rs for the lightest. You have guessed it. The largest stamp available is 20rs which means that each parcel has to be literally covered in at least 20 stamps, especially as I buy him out of his stock of 20rs stamps and the next largest denomination is 10rs. Luckily, at least two of the parcels are quite sizeable and there is space, but the heaviest is also the smallest and there is only just room to fit all the stamps on. In times of old, the stamps used to have no glue on them, so you had to stick them on with cheap-gloy like paper glue which usually just made every surface soggy and semi-tacky, but did not really confer proper adhesive properties onto the stamps. Nowadays, the stamps do have glue, but the prospect of licking the backs of over 60 stamps with glue made from god-knows-what was daunting and made my mouth pucker, so when they offered me the glue pot (clearly they did not believe in new fangled technology like stamps with glue on them) I gratefully used it covering myself, the parcels, the sidekick and luckily also the stamps with glue. The whole process took a mere 65 minutes and we all had a jolly good time doing it. I am going to bring an even longer list of people to send presents to whilst I'm out there, I can't wait to do it all over again.

Mrs Catherine

A couple of days ago, as I alluded to, I revisited Mrs Catherine, the extraordinary woman who started not one but two schools for children with learning difficulties. Both schools were set up with private funds - she and her husband took out substantial loans and borrowed from the families and when the first school was taken away from her, she set up another one. Her whole life is immersed in the school. She was driven, as I mentioned before by the fact that her son caught meningitis and developed profound learning difficulties. Since then her whole life has been caring for children with learning difficulties, but that is not all. She does not just provide a place of saftey for them, not indeed is her school simply a place of learning, the whole philosophy is about equality despite disability. Three of her teachers, including a progressive special educator, who works with the children increasing and improving their capacities, have physical disabilities.

Interestingly, although her school is primarily for children with learning difficulties, the system in INdia for some of the rural children is inadequate to say the least and therefore children with physcial disabilities, for example cerebral palsy, especially if there are speech difficulties, are assumed to have learning difficulties. One of the children who was brought to her was so oppresssed by his treatment as a result of his physical disability, that he was presumed ot have MR and sent to her. He did not speak and was very withdrawn. The special educators worked with him and gaining his confidence brought him out. Eventually the psychology assessment showed that he had no learning difficulties at all and now he is integrated into a normal school. All these stories are so extraordinary, that it beggars belief. This is not being done as a result of a government program, this is being done despite government apathy. She forges ahead making a difference to so many children and families simply because she believes so strongly that they deserve better. And she is right.

There are 47 children on her register at present of which 36-8 attend regularly. Her school costs 60,000rs a month to run. She receives 13,000rs from local sources, including a paltry government grant and notional fees from the children (if they can pay, they give her £1.30 per month) leaving 47,000rs (~£650) to find through other sources and they are difficult to come by. I would like to help her and if anyone is interested in learning more or becoming a donor, please email me.

Some photos

Driving through a political rally at night with fireworks, cracker and mayhem all around.

Playing a game in Keelalathur which involves flicking a ball into a basket. Much hilarity and scattering of little tiny balls.

The car kept needing a push, but there were loads of willing, photogenic young lads wanting to push, until one fell over and put a hole in his trousers, which he then tried to make me pay for. Cheeky bugger.

Not quite used to the new camera, but another brilliant road safety awareness message that saves millions of lives.

Glossary

I've had a sensible request about explaining some of the abbreviations and terms used here. Of course, I have been jotting things down for (amazingly) 4 years now and so forget that terms familiar to me may be completely obscure to others. If there is anything else needing explanation, comment on this post and I will add to it as I shall refer to this post whenever there are loads more terms. I expect there is a neater way of doing it, but the dust is in my wiring and I can't work it out.

RUHSA: Rural Unit for Health & Social Affairs. This is where I have been staying all this time whenever I come out. It is a campus 30km outside Vellore a city in S India. It is a department of the CMC and provides health care through outpatient clinics, hospital care, community clinics and nursing services. It also provides training in development for local people to learn skills such as air conditioning servicing, 2/3/4 wheeler mechanics and other vocational courses to improve employment prospects. It is also a training centre for student nurses and intern doctors.

CMC: Christian Medical College. An enormous tertiary hospital and medical college in Vellore, originally started in 1901 by an American woman called Ida Scudder. See link opposite and also http://belons.blogspot.com/2006/09/project.html for the whole story. It's quite amazing.

SHG: A self help group. These are government recognised groups of women who work together in a micro-business model. They must have a bank account and keep clear accounts and then they are eligible for funding from the government to start a micro-business. SHGs are designed to empower women and only allow women members. Sometimes, you hear the men moaning that there is nothing similar for them, which is true, but there is still sufficient inequality that they are still, in general, better off. In KVKuppam block, which is the catchment area of RUHSA the SHGs are highly valued, both by the community and RUHSA. There are over 350 active groups known to RUHSA alone in the region, which has a population of 120,000 and each group can have around 15-30 members, so there are many, many women who belong to an SHG. The canteen and the waste management scheme at RUHSA are two prominent micro-businesses run extrememly efficiently by SHGs. Of course at least 4 EWCs are also run/to be run by SHGs.

EWC: Elderly welfare centre.

CHEW building: Community health education and welfare centres. These are buildings built by RUHSA over 30y ago in the villages in order to hold health or development clinics or provide health education in the villages, enabling them to disseminate health messages or health care deep to rural parts of KVKuppam block. We have renovated 3 buildings, as many of them had not been maintained sufficiently over the years, and are using them for the EWCs.

Anything else you need to know, let me know.

Inventive solutions

After I wrote yesterday, we spent the afternoon going to another village where there is to be an EWC and after that we re-visited the lady in Ranipet who set up her own school for children with learning difficulties . Over here, it is difficult to listen to, but they still call it mental retardation, or MR. It is a strange thing, because ultimately they are just words, but they sound very hard and unyielding to me; however, a more progressive, aware and experienced woman would be hard to find than Mrs Catherine, who, as you may remember from my visit in January http://belons.blogspot.com/2010/01/plump-delicious-models.html set the school up as a result of there being no help available at all for her son who developed developmental arrest after meningitis. She knows more about MR/LD than most people and has an exemplary attitude towards it and as such it softens the blow, but it still takes some getting used to. I will fill you in about that trip in a later post, but first news of the other EWCs.

At the beginning of the afternoon at Rajapuram, we held a village meeting to discuss the finer points of the 4th EWC. It is a very poor village and the local community requested that an EWC be started. During an earlier meeting, some interns performed social mapping with the villagers and identified 40 extremely disadvantaged elderly people. Unfortunately, this is not a village with a RUHSA building, but interestingly, there is a building that the locals are offering free to enable the centre to run. It's capacity is only 20 so the group of possible participants had to be further divided into poor and very poor. No-one in the village wanted to exclude anyone whom they identified, but as the constraints dictated, eventually they whittled the group down to 20. Another complication is that there are two SHGs in the village and they both want to run the centre. In addition, where were the women going to cook the food as the volunteered room was just that, a room, with nothing else. Today was simply supposed to be a meeting to finalise the details and decide which of the groups should be the ones to run it.

As we are in India and therefore used to expecting the unepected, the meeting took an interesting turn. Neither SHG wanted to give up the chance to run the centre and no-one wanted to prevent 20 people from attending. Is there a place big enough for 40 in the village? I asked. No. The undulating chat rolled backwards and forwards between the RUHSA staff and the villagers. Where will they cook? I wondered. It transpired that an unusual solution was evolving through the discussion. There was no single room big enough, but the villagers offered not one, not two, not three but four rooms for the project. 2 rooms for the participants and 2 kitchens to do the cooking, enabling 2 parallel centres to start, meaning that no-one need be left out and both SHGs are able to provide the service. The most gripping part of the whole meeting was when Mathew told me that the reason the SHGs were so keen to start an EWC was that their community had been asking them what they were contributing to the community. Self help groups, which are a well-established, government recognised scheme to empower women and enable them to form small businesses are perceived by the community as an asset. Perhaps, they are considered to be "lucky" and therefore expected to give something back. I don't know whether this village is unusual in this; interestingly, it is a predominantly Christian village and therefore there may be different cultural expectations, but none-the-less, in all the areas we have worked in, the SHGs have all been keen to come forward to run the centres, but I attributed that to the financial benefits, but it would appear that there may be something more subtle at play. What an amazing mobilisation of resources and what a way to deliver community welfare.

Starfish Day

Yesterday I had a starfish day. I realised that over the last few months I have been so busy that my brain has been buzzing like a bee on acid. Add into the mix that I have been doing more physical exercise in the last 6m than I had done in the previous 6y and as a result I was exhausted. Jetlag, heat and humidity has rendered my body unable to function, so with a double whammy of no functioning brain or body, when I tried to make any decisions or do anything, I couldn't muster the energy. So the only decision I made was to be a starfish for the day. Firstly, I went to the pool and lay like a starfish in it or by it. Reading. Then I went out for lunch with Dr Rita and her daughter. I managed to resist the urge to lie like a startfish on the floor of the restaurant, but it did require some effort. Then I came home and lay like a starfish on my bed reading. Or knitting. Or, believe it or not doing tapestry. Or, lets not beat around the bush, sleeping.

Today however, the starfish awakes. This morning I had a stellar conversation with Dr Rita and we have nailed several issues and started to develop several more threads. The Elderly Porject formula is coming along nicely and we are beginning to develop an exportable model. RUHSA is the overseer and, with charitable funds, sponsors a local self help group to run an elderly centre, providing a couple of meals per week and snacks for the other days. In addition, they make a small porift and provide some recreational activities. Other charitable funds may enable RUHSA to buy a goat for each of the beneficiaries after they have been attending the centre for 6m at least. The beneficiary must give RUHSA their first female kid - if they fail to do this or the goat mysteriously disappears, they must refund the money. If the elderly wish to partake in other activities, like develping a garden or something, funds can usually be found to help start the work up, but it must be sustainable. There are now 4 centres running and the model is working well. There is considerable interest in running them from the SHGs because it gives them an income from a reliable source, in addition, in enables RUHSA to start these centres at a very low cost using local resources. It is interesting how the model has evolved over the last 4 years. I think it is about right now and the proof of the pudding is in the fact that 2 centres have been initiated by people other than me or RUHSA.

Today I went to lovely Keelalathur, although we almost didn't make it as the car had a flat battery and needed pushing. Mathew & I were sitting in the car chatting when there was a flurry of Tamil. A hoard of nursing students poured out of a lecture room and surrounded the car, but instead of going past it, we felt the car rocking as they pushed it. It jumped into action and off we spluttered waving merrily to the obliging students. We arrived at Keelalathur - my how bustling it was. There are 6 new participants owing to recent deaths (poor Sukkupattu) and the centre was full even though we arrived at 11.30. Previously when I have been, there have been only a few there. We spoke to some of the newcomers. One woman, who is blind has no-one at home to look after her. Her husband and son borrowed a large amount of money from a money lender and then, unable to pay it back, snuck away in the middle of the night leaving her alone. Being blind she finds it difficult to care for herself and is grateful to have a meal and company at the centre every day. Another new woman, has a son and daughter who live in the same village as her but they do not acknowledge her because she is simply a burden to them. The blind woman has another problem. Without a family, she has been unable to get to the eye clinic for much needed treatment. Now she is finally able to go as one of the other women at the centre also needs to go to the eye clinic and therefore they can go together. If all the centre does is reduce peoples isolation, then it is a good thing.

A shiny new bicycle

Rita looked very well when I saw her this morning. She was very pleased to see me, we hugged and kissed enthusiastically. It is so nice not to have to work out what my reception is going to be like and to negotiate my response accordingly. It’s very simple now. She is delighted to see me just as if she were a genuine friend, which she is. We had a half hour catch before the engineers arrived to discuss the details of the new outpatient block which has finally been approved by CMC who are also funding it. At one point, RUHSA applied to us to support this, but we felt that this was not the best use of our funds, because it should be core business for the organisation and would cost an enormous amount, meaning the small, small grass roots stuff would not get done. RUHSA has, due to personal politics, been quite isolated and forgotten for about 25 years and so the campus has been neglected, despite receiving about £25,000 annually from us for maintenance in the past. There has been no evidence really of this money being spent well in the previous, previous administration. One of the reasons I went out in the first place, was because VRCT (the English charitable trust I am now a trustee of) had stopped sending any money because no-one could or would say how it was being used and the new director, Dr John, my old contact from many, many years ago as a 19y old on my year off, had made a request with his proposal for a project to work with the vulnerable and they wanted me to see whether it was a sensible thing to fund. In the last 4y since I have been involved now, VRCT has been much more rigorous about what they send money for and overall campus maintenance is no longer considered to be our responsibility. It was important for RUHSA to start shouting about the work it does and get the recognition it deserves and the exciting thing is that this seems to be happening. Credit to Dr J, I think it started with him, but Rita has cranked things up by several gears. So Rita has not only obtained both approval and money from CMC, but the work is starting and scheduled to finish in 2012. The little hospital at RUHSA is going to be a proper DGH and be able to do much more without having to send people up to CMC by bus.

When I went in first to see her, there was another doctor in with her. She introduced him. He is a newly appointed Family Medicine doctor. This is the first time there has been such an appointment at RUHSA. His wife is also an FMD and they are bringing their whole family to live on the campus as soon as his wife’s current post finishes. Half was through the conversation, after he had gone, there was a knock on the door and another man was standing out side. She introduced me again. He was the newly appointed chaplain who, with his family, is coming to live at RUHSA. Two new young families with children is a turn around compared to the previous long standing depletion of RUHSA through retirement. Even since I have been here, at least 3 people have retired and not being replaced, but there are new physicians here and at least 2 permanent families, not to mention the now guaranteed flow of interns, nurses and students from TUFTS in Boston. RUHSA seems to be slowly but surely coming back to life again. Of course, the fact that two of the new appointments are primary care physicians, makes my little heart skip with joy.

A completely unrelated but very exciting thing to happen the very day of my arrival was an email I received from a Dr in Delhi, with whom I had been intermittently communicating when I had been doing my MSc. I can’t quite remember why I contacted him to start with, I think it was something to do with trying to find out more about primary health care in India and discuss the principles of the 2002 health policy document which was so interesting and did theoretically put primary health care at the forefront of the health service in India, but of course the reality is that is is considered very much a second best option, not a vocation so much as a cop out if you can’t make any of the specialty grades. Of course, that is complete rubbish. Primary care is an extraordinary discipline in its own right but this fact needs to be actively promoted in order to attract young medics to consider it as a career option. I can’t remember where I found his email address, on a paper or something I think, but anyway, we have been intermittent corresponding all that time and we both have the same views on the importance and value of primary care and when I arrived in India, there was an email he had sent in a timely fashion telling me that as the president of the newly set up Association of Family Practitioners in India he would like to ask me to join as an honorary member. My God. How thrilling is that? Whole new vistas are opening; new contacts, new ideas and new futures.

As far as the projects which VRCT has been involved in there has been progress. There are now three EWC (eldery welfare centres) with another one due to open soon. I think the model is working well now and seems to be easily transferrable to other regions. They all depend on willing slf help groups who run the centres, feeding and providing exercises and company for very disadvantaged elderly. This not only provides a meal for people who would otherwise not get one, but also creates some employment for village women. It is an attractive model too, for overseas donators, because 2 of the EWCs are funded by people other than VRCT so there is growth beyond our involvement. Apparently, there has been some stasis on the development of the vegetable garden, which may be because it is easier to take than contribute and being passive is quite easy. However, this was a request made by some of the women at the centre and some of the stalling is due to an inefficient RUHSA community officer. Mathew says that they have finally started digging and Rita told me before I asked that since they asked for it, they will do it. Typically, there are often obstacles in starting something but once it gets going it is easier to maintain. The monkey net is up, but the pipes, although they are there, are not connected, neither to each other nor to the mains supply, but that too is in hand. Usually, there is a fury of activity whilst I’m here, so that may all take place in the next few days.

On Monday I am gong to see a couple of the centres and I look forward to seeing how things have moved on. There are new people at Keelalathur, although of course I shall miss not seeing Sukkupattu’s smile any more. The goat fund is generating money now with the sale of first kids which is great. In Kovasampet, there was a little controversy as some of the goats went “missing presumed consumed”, but they have repaid the money as they could not give RUHSA a kid. On Tuesday, I am going to see the expanded mental health clinic which now has started seeing children with intellectual difficulties in addition to adults with mental health conditions in anticipation of the newly appointed OT who will start in 2w or so. Wednesday I may try to see the kindergarten set up by Sally, for they have also started an elderly welfare centre and on Thursday I will go to Kovasmapet, so I will be busy. I am also going t try and see the woman who started her own school for children with intellectual disability after her son developed global developmental impairment following meningitis.

Meanwhile, I have a shiny new bicycle. It is too thrilling. Last time I was here I gave some money to buy three bicycles or so for any international visitors or interns, because it is so far from anywhere it is difficult to get around only on foot. Truthfully, I had totally forgotten I had done this until I arrived and asked for a bike and there was this glorious apparition in silver and green with a basket and a bell. They told me they have kept it specially for me and my bum is the first one to be on it. It is an exgtraordinary thing in India, that despite the overage height of the population, especially in Tamil Nadu being orders of magnitude smaller than me, the bicycles are enormous, I can barely touch the floor when I am sitting on the seat, but apparently this is standard size. I am wobbling all over the shop when I first start so although the bike looks glorious, its rider does not. God knows how the locals manage to do it and not look as idiotic as me, but I went for a ride today and like most bikes here, the only way you can cycle is incredibly upright like the queen. It’s a very regal experience and I’m glad to say that my new bike lives up to the image, so hopefully that will detract from the less than regal rider.

Let the itching begin

I love India as might be obvious but one thing I do not love is the bloody deliciousness of my blood to the local 6-legged population. I swear they don’t eat between my visits. They save themselves, so they are starving by the time I come back again. Word goes round pretty quickly, I think they must have a very sophisticated communication network . I don’t even see them as they sneak up on me for their All-You-Can-Eat extravaganza. They are somewhat discerning in their tastes though, it has to be said. Location and ambience is clearly important, dicated by the effort required to get to their food. They are not interested in having to work for their food by digging through layers of adipose, which means that the small selection of bony areas (which are a premium on me as might be imagined) are the most desirable spots to lunch on. Net result is that I have agonisingly itchy ankles already and I’ve not even been here 24 hours.

Anyway, enough moaning about the mozzies, let me fill in the details of what has happened so far. Fiirrstly, I had a totally mammoth taxi ride from the airport. Of course, not having access to my own personal chauuffeur any more, which has it's own downsides, I had to figure out how I was going to get to RUHSA from Bangalore which is about 160km away and usually takes around 4 hours. I could have woven my way into the city, a mere 40km away in the wrong direction, waited for a train, on which I probably would not get a seat, and get another taxi or rickshaw to travel the last 30km from the station to RUHSA, or I could spend the princely sum of £50 getting a taxi directly there. I agonised for about a picosecond before asking Dr Rita to arrange a cab. The driver arrived late, meanwhile, I had been wandering disconsolately along the line of enthusiastic drivers furiously waving papers bearing an extraordinary array of names. Even if the name said Mr Krishnan Gupta, they still shook extra vigourously at me in case it might have been me. Sadly, there was no sign of a Dr Arabella. After walking along the line as many times as I could bear their pitying eyes, I decided to try and get some money out and then wafted around aimlessly, wondering how I was going to phone RIta when my English phone had no power and my Indian phone had no inclination to work. Eventually, a sweet man, who I think I have seen before came up and shoved a sheet with my name on it under my nose. I was v happy. I guess he had been told to look out for a large sweaty English woman.

We walked to the car, he pushing my suitcase containing all my knitting and I got in. I was absolutely shattered having slept very little on the two flights out. The car was probably a Tamil people carrier, but it was barely big enough for me in the back. If I sat up straight, my head touched the ceiling and I was desperate for some sleep so I tried to lie down. It reminded me of my first trip on the bus all those years ago when I felt like I was simply on a different scale to everyone else. Similarly, the entire back seat was filled by me. In order to get comfortable I had to put my legs across the back of the front seat and lean them against the window. Meanwhile the driver was so tiny, that in order to reach the pedals, he sat so close to the wheel that his seat back came halfway across the window. Whenever we stopped at traffic lights or a toll station people looked in in amazement at the cargo he was carrying. Still, I managed to drop off pretty quickly and slept solidly for 2 hours. When I woke up, we were still in Bangalore. He had got comprehensively lost and remained lost for quite some time whilst I dozed. In total, it took 6 1/2 hours to get to RUHSA, everyone was very concerned wondering what on earth had happened. Although it took longer than if I had done the schlepping through Bangalore thing, it was worth everything to be dropped off at my room, which was lovely to see again. The resident insect population has increased somewhat since my last visit and the water heater is still purely for decorative purposes, but truthfully, I didn't care as I crashed out completely until this morning.

On my way out

In case you are thinking this post title suggests that I am feeling peaky, nothing could be further from the truth. Although it took me a little longer than 2 months, I am, once again, sitting excitedly on the train to Manchester Airport on my way out to India. Although this time will be a little different for reasons I shall not be going into (send an sae for further information as required) in essence I am very much looking forward to seeing what has been going on down at good ol' RUHSA in the 6m since I last visited and I will be trying to bloody well get the website for Celine finished. The latter job is proving extremely tricky owing to the fact that it is turning out to be as arduous a conversion to electronic infonology as it would be if someone had tried to get Winston Churchill to tweet the content of his speeches to the troops instead of orating them. If it does not work this time, then I will threaten her with retirement.

This trip, I have to confess, I surpassed even my previous PB for disorganisation. I bought my ticket on tuesday and started packing thursday morning at 6.30, ready to leave on an 8.10 train. I feel I pack rather like you might expect a Border Collie would, were they to go on holiday with accessories. I sort of round up my belongings into an ever decreasing area until I have a wobbly pile, then I pop everything in the suitcase. Usually this rounding up process starts several days, even weeks, before I am due to go asI come upon things I might want to have out with me. They then swirl around my house as they get nearer to, but not actually into, the final receptacle. In between these Herding Manoeuvres occur Random Thoughts, which need to be written down immediately or they are lost forever, referring to things I've remembered I would like to do or take, but have not yet come across. These RTs are written on equally random bits of paper which join the moving flock of debris circling the suitcase. This time however, I outdid myself. The herding process itself only actually started on Thursday morning, I have no idea what was going on except perhaps there was something at a subconscious level ...... As a result, I have plenty of knitting and underwear, but no actual clothes. I hope to God I remembered correctly and I did in fact leave a suitcase full of salwars with Dr Rita, otherwise I am going to have to knit an outfit pretty quickly and that's not a good look in 35 degrees heat and 150% humidity.

Anyway, I'm on my way and I'll keep you posted