My layover in Delhi is 5 hours, during which I make my way from the international to the domestic terminal on the free hourly shuttle that keeps leaving 20 minutes earlier than scheduled, causing me to miss it 3 times before finally catching it.
Though the flight to Patna (the closest airport to the village I will work in) is only one hour, it takes two tries to land.
On our first attempt, quite close to the ground and within a few hundred meters of landing, we abruptly lift up again and circle the city.
After 3-4 minutes, the captain comes on over the intercom: "Ladies and gentlemen, on our first approach, we noticed another plane was attempting to land at the same time as us.
That was not very polite.
We will circle and try again.
Nothing to worry about."
The second approach was successful, and I had arrived in the notorious Indian state of Bihar.
I was picked up at the airport by a man named Dilip from the organization I was working with.
Exhausting a full third of my Hindi repertoire at that point, I asked him if he spoke any English.
Negative.
I thus resigned myself to a rather quiet 3 hour journey to the village.
There were plenty of Hindi music tapes strewn about the jeep, so I popped one of those in; soon we were both singing along to songs in the very language that had prevented us from conversing in the first place.
After about 2 hours of weaving in and out of traffic, swerving around trucks and buses while dodging oncoming traffic and the occasional cow, we stopped at a little roadside stall/restaurant.
Dilip gestured for me to take a seat at the table and then went towards the back after saying something I didn't understand.
So, naturally, I followed him.
He stopped, looked at me rather confusedly, and asked me something else I didn't understand.
Homer Simpson-esque blank stare.
Damn, I think to myself, I got to learn more Hindi.
After momentarily returning said stare, he resorted to a gesticulation that will go undescribed.
Epiphany.
“Oh!” I said, grinning sheepishly, “you're going to the bathroom.”
Very good.
I'll be right here, then.
I really got to learn more Hindi.
..
It’s oppressively hot here; the heat just brings you to your knees.
While there are no thermometers (they probably would be bad for morale), I know that it's well past 100 degrees Fahrenheit by 9am, and easily reaches 120 by 2pm.
Among the most refreshing feelings is taking a cold bucket bath in the evening, not bothering to dry off, and then, if the electricity is working, lying on your bed under the ceiling fan.
For about 5 minutes, it's complete relief.
On the whole, though, the heat is almost insufferable.
It radiates everywhere, overpowering the windows, the walls, ceiling fans, the shade, even the dark.
Forty-seven degrees Celsius again today.
..
Efficiency carries the day here at the eye hospital where I spend most of my days. Monday, Tuesday, and Wednesday the outpatient clinic alone is open, and between the 5 doctors/surgeons here, we see between 350-450 patients per day, with an average of 80 per doctor per day. If I weren't slightly near-sighted myself, I could now recognize a pseudo-phakia or aphakia from a mile away. I've seen all sorts of cataracts and patients with glaucoma—which are far and away the most common cases—and even rare things that I'll never see in a developed country. Yesterday I saw an old woman who had smallpox as a child, as evidenced by pustule scars on her cornea, followed by two polio patients. Thursday, Friday, and Saturday are surgery days, and the operations are done with factory-like efficiency in the 2 operation theaters, with 3 surgeons working at a time. The overwhelming majority of procedures are cataract operations. At about 20 minutes per routine surgery, in peak season, the hospital, with its 5 surgeons doing surgeries 3 days per week, does up to an astounding 1200 operations per month.
Since the population served here is almost exclusively poor villagers, the cataracts and other ailments are routinely at the most advanced stages.
Only when the problem becomes severely debilitating—and, incidentally, often too severe to effectively treat, especially with the budgetary constraints of a free rural eye hospital—do they come in.
So they go blind.
..
The surgeons are trained to be rather callous—to objectify the patient in the interests of performing their functions; they are, after all, technicians. In observing all these eye surgeries, I too find myself falling into the trap of seeing what's on the operating table not as a patient, but simply an eye to be repaired. Indeed, their entire face and head are obscured by a large white cloth leaving an oval hole only for the eye of interest. One almost treats them as if they're dead; or perhaps more accurately, as if they were simply an eye, independent of any adjoining body.
..
I remain troubled by the way we treated the villagers—like cattle, and with such detached condescension. Still, I wonder, how can any other way be accommodated given the circumstances? How else do we see 400 patients in one day? Meanwhile, 200 more are left waiting in a situation in which to be unseen is to go blind.
Nearly every family I spoke with has lost at least one child—and often many more—to a miscarriage or in early infancy; cholera outbreaks still come with every monsoon; and the overall life expectancy for a person born in rural India—a demographic representing almost 75% of India’s one billion people—is roughly 58 years.
Poverty is a powerful force.
It transforms even compassion into a prohibitively costly luxury.
I kept reminding myself before I came that Bihar is India’s poorest state.
It strikes me today how hard of a superlative that is to truly fathom.
..
Originally written in June 2003
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