The struggles of introducing local sustainability into our work in India.
For anyone reading our blogs about World Medicine’s long term project in Chaparda, India, they will certainly get a flavour of the enormous popularity of this project. This is true for our hosts, the community we serve and the volunteers that commit their time and energy to it. There is a special energy and palpable buzz during our time there and over the years we have built up close relationships with the staff at the ashram and Jay Ambe hospital where we run our clinic.
Every year we have local staff that assist us for the duration of our work there… this may be clerical staff who book patients in and organise the waiting area, physiotherapists who come to assist in the clinic and more recently student nurses who we train to help us with specific treatments, such as cupping or moxabustion therapy. We see their input as enormously valuable to both us and to themselves. We try to model good practice in clinical care but also to demonstrate that empathy and respect should be part of the work when treating patients. Last year particularly we were able to see our local students gain confidence in their skills and witnessed their growing commitment to good patient care.
This is incredibly important to us as a charity since we are mindful about our wider aims when delivering a complex project such as our Chaparda one. In the past, previous teams had explored ways of trying to encourage a self sustaining dimension to the project. We had been hopeful that by training local staff to use a microsystem, namely Auricular acupuncture, that they could continue to run a meaningful service for the community in between our visits. This was an ambitious target especially as acupuncture as a profession is rightly regulated to a high professional standard. ( we are self regulated within our professional body which requires adherence to a robust code of ethics and practice, professional accountability and a requirement for continuing education) This made it complex when considering safety and supervision in our absence. However, the other big issue that is a real block to local sustainability is migration of local staff. We find, that with exception of a few staff, many of the hospital staff do not have long term posts. Younger female staff often leave the area after marriage and other staff leave for opportunities in the cities. It is always lovely to see familiar faces but we also have to accept that sometimes we will only work with staff for one visit.
I believe the future of our work in Chaparda is very much on a firm footing. The communities surrounding the hospital are familiar with our work now and we do see returning patients to our clinics which is also wonderful. We always remain open to ideas that will make the project more expansive and inclusive.. it’s important that we continue to build strong relationships there that support opportunities for local staff to develop their own skills and knowledge, so that wherever they end up working they take a sense of professional pride with them which we hope they achieve during their time working with us. We certainly value them!
Emma Vaughan, Chaparda volunteer and World Medicine Trustee, describes her journey…
I live and practice Chinese Medicine on the west coast of Scotland. Ordinarily, I would say I live in one of the most beautiful parts of the world, unscarred by development and with a perfect combination of remoteness and community. However.. when it comes to travel the journey even from where I live to Glasgow can be fraught with difficulties and can involve 60 mile detours when we experience landslides through the hilly pass known as “ the rest and be thankful “, sometimes unexpected ferry journeys and often shocking weather conditions making driving extremely challenging.
So I wanted to describe this years journey to Chaparda to give a flavour of a different aspect of our time.
On Tuesday the 7th of January a friend dropped me off with my cases at the bus stop in Lochgilphead. The journey takes 2.5 hours to Glasgow and it poured with rain the whole way. I feel excited but also vaguely sick. ( I am a notoriously bad traveler) To help with the nausea I eat crisps and chocolate. I feel more sick naturally.
Once in Glasgow, I have a 40 minute window before my train to Oxenholme in the Lake District, so I rush to Debenhams with my cases and get my eyebrows threaded… a travel essential. I am excited with my eyebrows ( I’m extremely vain sadly!) and lug the cases through the rain to central station.. where I find my train has been cancelled.. no driver apparently! I immediately text Barbara ( team leader and great friend) to share my panic and then Jude who I am staying with in Sedburgh. I am directed to another train pretty quickly however and am soon on my way on a 2 hour journey to. Oxenholme.
Jude , my wonderful friend and world medicine colleague comes to collect me from station along with her husband and dog. We immediately compare baggage, stress about weight allowance and pick each other’s bags up to decide if the stress is warranted! It is! They feel very heavy but we are sure we can manage. We have 3 bags each. One large case, 1 smaller cabin size case and a small passport etc size bag. I stay the night with a Jude, and then lunchtime on Wednesday, Hugh drops us back off at Oxenholme to catch the train to London. It’s my son’s birthday and I ring to chat to him and feel a little homesick before I have even left the country! Jude and I have journeyed to India together 3 times now and each time we feel stressed and excited in equal measure. We have developed small rituals now.. almond cookies and a cup of tea on the train to London marks the start of the journey..and a travel sickness tablet for me! We then both rummage in bags for things we think we have forgotten and generally find them. It’s comforting!
In London we wait at Euston about 20 minutes for Barbara who is arriving in on a different train. We soon see her huffing up the concourse, pulling two ominously large bags with her.. so far so good. We are a team of three!
We jump in an Uber with all our bags and head across London to a Heathrow hotel. We have a minor hiccup with our room booking, but once sorted we dump our bags and head to the bar ( no indecent haste, rest assured)!
The following morning ( Thursday 9th January) we are up early ready to meet the rest of the team at terminal 5. One by one we find each other, Sally, Marta, Catherine and Satish. It feels so wonderful and we are all full of beans and full of chat. We have a few more issues…. Sally exploiting the luggage allowance!!! Catherine’s travel jumpsuit! ( don’t ask!)
Our flight leaves for Ahmedabad on time but we have an extra 90 minutes of flight time as the plane was rerouted for political and safety reasons, giving us a 10.5 hour flight. I feel a little anxious about this as we have a train to catch from Ahmedabad to Rajkot and I know we will now be cutting it fine. Immigration clearance at Ahmedabad is a nightmare, long queues adding to the stress. Eventually, we emerge and secure a couple of taxis to the train station. We know we will be lucky if we catch the train!
It’s a wild ride in the taxi but we all feel we have arrived! Who doesn’t love an Indian taxi journey? We pile out at the station, a fairly shambolic group and race ( no exaggeration) towards the platform that says our train is at. We have a 5 minute window. We literally run with our bags, hurtle downstairs and find…. we are on the wrong platform. Out of nowhere 6 coolies arrive, pile our bags on their heads and instruct us to “ run” as they set off at an unbelievable pace to the correct platform. We hand over the rupees and jump on the train that our bags have been dumped on. The train is heading for Rajkot! We are now starting to feel exhausted, it is about 5am and we have a 4 hour journey ahead of us. The train conductor then informs us that only 1 of us has a confirmed booking and there are not bunks for everyone. Our fellow passengers were sleeping which we don’t quite grasp and manage to waken the entire carriage with the rumpus that ensues! Surprisingly several of them take pity on us however and make space until eventually we get a little cabin for the 6 of us. At this point we had lost Satish at the train station in Ahmedabad!! ( He found his way to Chaparda, don’t worry)
When we arrive in Rajkot we negotiate two tuk tuk drivers to take us to our overnight hotel. This process is rather chaotic as we have attracted a circle of onlookers and drivers offering to take us to our hotel, and demonstrating how 6 passengers, 12 pieces of baggage can fit into two tuk tuks! This journey marked my undoing! I have been on many tuk tuk journeys and this one was not exceptional. Fast, bumpy, thrilling! We get to the hotel remarkably with all our luggage intact and are shown to our lovely rooms. Jude and I shared, but within 5 minutes I am profoundly sick and need to lie down. Things settle quickly and after a wee sleep I feel much better. Jude and I have a cup of tea on our balcony and relish those first few hours of being in India.
We have a really nice dinner all together and then head to various beds ready for the last leg of the journey in the morning !
We are collected from Rajkot by car and our driver Jay makes easy work of the 3 hour journey to Chaparda. We are all excited to be reunited with the rest of our team and the Ashram staff. We arrive Saturday lunchtime…. it’s been quite a journey, but one I feel privileged to make and hope that I will make it many more times yet!
During the October training weekend for Chaparda 2020 four current and former volunteers members of the team, Emma, Alison, Jude and Barbara (behind the camera!) met to talk about the experience of working in Chaparda over the years, and what new volunteers can expect from the experience.
It's just over 8 minutes in length and very informative, so grab a cup of tea, click the video, and listen in!
Emma Vaughan, one of our Trustees and a volunteer in Chaparda, reflects on working with translators:
Our work in Indiawould not be possible without the skill, dedication and patience of our amazing translators. They form an integral part of the team and enable communication between patients and practitioners in a highly skilled and sensitive manner.
We ask them to offer literal translations rather than summarising conversations in order for our practitioners to develop a greater sense of what is really going on, and, most importantly so that they can identify what the patients’ needs are. This unique 3-way rapport can provide surprisingly rich, moving and sometimes humorous encounters.
Our current Gujarat speaking team of volunteer translators are fabulous, bringing a sense of compassion and integrity to their work that has been invaluable. They come with a great deal of goodwill, committing a lot of time at their own expense and have maintained strong, personal investment in the work of World Medicine.
Batul and Najma are two of our volunteer translators:
Batul describes her experience:
I thoroughly enjoy being a translator and part of the World Medicine team. It is a very rewarding experience and one that has seen me about to return for my third time in January 2020.
It feels good to be part of a project where you can witness on a daily basis the positive impact on patients’ lives.
On our last trip, Barbara and I saw a young man, a diamond polisher who attended the clinic with multiple problems that had resulted in very poor mobility. His medical history was complex resulting in many visits to hospitals, different specialists and complementary therapists. He was feeling desperate and was doing everything he could do help himself – including walking on cow dung! Over his course of acupuncture with Barbara, we observed gradual improvements in his mobility and more importantly he himself started to feel the change. It was fantastic to see, and also to be part of a process that brings positive changes to people’s lives. I definitely appreciate the contribution the whole team make to the people living around Chaparda who have no access to this type of health care. To provide the service at no cost to the patients is even more amazing!
Najma, another seasoned translator and also a trusteefor World Medicine reflects on the collaboration of the team:
I see my role of translator as a bridge between patients and practitioners. By feeding back to the practitioner the content of the patients’ story and what had bought them to the clinic we are able to begin a course of treatment, tailored to the patient’s problems and subsequent progress.
There have been times when it feels emotionally challenging, relaying these personal stories to the practitioner as often their issues reflect the harsh reality of living in isolated, rural communities. However, there are often lighter, funny and touching moments too. I was once very impressed when a patient very eloquently asked me “if the “doctor” could reduce the tyre around her waist!”….a familiar wish that many of us are conscious of these days!
It is easy for these nuances to be lost in translation but I believe that the team works effectively and efficiently so that every patients experience with World Medicine is a positive and worthwhile one.
Of all the work I have done in my life, I can honestly say that my work as a translator in this setting has been both the most rewarding and the most enjoyable.
Although our current projects are based in the UK and India, we are keen to build a database of volunteers who speak a second or indeed several languages who may like to consider working with us in the future.
Please get in touchif you are interested in working with us! We absolutely need you!