Last Day – Presenatations in Metpur, Vasna, Bhuvel, and Vatra

Today is my last day at the CCC and with this project so I definitely had a full day starting at 10:00 am. I am visiting the ONGC Health Center, Metpur, Vasna, Bhuvel, and Vatra.

I started my day at the ONGC Health Center, and although it wasn’t originally on my schedule, I wanted to share my presentation with as many women as possible. All of the women welcomed me so respectfully and offered by a bouquet of flowers. It was so sweet! I started with my verbal presentation and before I could even start my video they started asking me questions. They were so interested in the topic and not embarrassed or scared to know the facts about the disease. One of the women asked if it could start in the lymph nodes and I responded that it can and that it’s important to check under the arms during self-exams. Another woman talked about how her mother had been diagnosed with breast cancer 2 years ago and wanted to know if it could reoccur. I explained that it can come back and that her mother should get mammograms every year and also recommended that she get a mammogram and examination with a doctor since there is a family history. One woman asked if she could get cancer from the hot flashes she is having during menopause. I explained that there is no correlation between menopause and breast cancer but she should still go in for routine examinations. They were very happy that I was able to make time for them even with my tight schedule today.

Next I went to Metpur where we arrived an hour late because the women at ONCG had so many questions. Luckily, many of the women waited for my presentation so it went well. After the presentation, Angelaben did about 4 exams on women as they were just concerned about lumps but nothing that she noticed needed attention right away. One woman mentioned she had been feeling pain for a couple months so we suggested she go to the CCC for a mammography.

After Metpur, we headed to Vasana where I met with a lot of older women, many of whom could not read or write. Many of the women were not interested in my presentation and didn’t really understand why they needed to learn all of this in such old age. I tried to explain it in terms they would understand. I talked about how they care for their cows and buffalos and give them medicine when they fall ill so they can continue to produce milk. I explained that they have to care for their own bodies in the same way so that they are around to care for their families. I think it made sense to them.

We were soon on our way to Bhuvel where a small group of women sat through the presentation very quietly and didn’t ask any questions. Normally, I would have stayed to chat with the group but we were already late to our next stop.

We arrived in Vatra, the final stop of my journey, to lots of women who had been waiting on time but had to leave before I arrived. We still had a good number of women there to hear the presentation. After I was done, I asked if they all understood what I had said and if they understood the video. Most of them couldn’t believe that breast cancer was a real disease and had never heard of it before because they’re so caught up in their daily lives. . I reasoned with them to take 5 minutes of each month to take a break from taking care of their families and take care of themselves. Most women in these small villages are ignorant about health awareness due to a lack of time and fear of facing a disease.

My breast cancer awareness project came to an end after the presentation in Vatra. I had a wonderful time doing all of this and am so happy I had the opportunity to educate so many women. I will be going back to Khambhat for a day or 2 to finish up the project and say goodbye to all at the CCC.

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Presentations in Dhuvran, Khadodhi & Haripura

Today I visited Dhuvran, Khadodhi, Haripura, and I also did a presentation for the Inner Will Club.

We started the morning at the PHC in Dhuvran where I ran into Dr. Himanshu who I had met at the Balesa medical camp. Neither of us knew that the other was going to be there and it was nice to see him again. There was a wedding happening in the village at the same time as my presentation so only a few women had gathered when I arrived. The PHC sister went to call everyone who was waiting in line for lunch at the wedding and had them sit down to listen for a few minutes. It was more difficult to gather women for an educational event when there was a wedding going on! I don’t blame them though and totally understood their desire to be at the wedding. This presentation was shorter than usual but just as informative.

We had a few minutes between village visits so we stopped at the famous Dhuvaran Ocean . We went to the top of the Mataji temple so get a full view of the ocean. The area felt very peaceful since the temple was closed at the time.

Next we headed to Khadodhi, a very small village with a population of 1200 people. A large group of women had already gathered when I arrived. I completed my presenatation and the PHC sister encouraged all of them to ask questions without being shy. One of the women in the back of the room told her breast cancer story. She and her sister both had breast cancer. She had her breast removed when they found her cancer and did not go through chemotherapy. She explained that she did not believe her sister had chemotherapy, mostly because she had no idea what any of these medications are. However, when I asked if her sister’s hair had fallen out, I had a better understanding of the situation. I told them that they should have their daughters go through early screenings for breast cancer since it can be hereditary.

After the presentation we had tea and got ready to leave. On the way out, we stopped to look at these crane-like birds I had seen on the way in. It was a nice break to our day!

We ended out village visits in Haripura where the women had already gathered for a panchayat meeting. A very quiet ground of women had assembled within 20 minutes. They all listened very carefully and had no questions at the end of the presentation. I asked them to share the information with everyone in their lives to help spread the awareness. These women may save a life one day.

I returned to the CCC around 5:00pm and got ready for a presentation at the Inner Will Society. We started on time at 6:00pm with a welcome from the President. One of the society members had breast cancer a few years ago, but no one knew if she had had radiation or chemotherapy. Most of the health information is kept quiet in India and that kind of personal information is not share with others. Matran Madam from the General Hospital had come along with me as she belongs to the society. She closed the presentation by saying we have to care for our breasts in the same way that we care for our faces. Each part of the body is important so it is especially important that we pay attention to change. It was a great way to end the presentation and the day!

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Presenatations in Sarkarpus, Kansari & Jalshan

Today started a bit later than usual. I visited Sakarpur, Kansari, and Jalshan today.

I had mentioned earlier that Sakarpur is the village where many men die of Silicosis. We had a group of about 40 women gather for the presentation – many of whom were over the age of 40. We recommended that they all receive a mammography at the Center and a few women participated in examinations after the presentation but we didn’t find anything suspicious. It was Mother & Child Day at the PHC center so lots of mothers came with their children.

Next we visited Kansari, a village with a large Muslim community. This particular village is known for its kite-making business. It was also Mother & Child Day for vaccinations and other needs in this town. I was surprised at how many 17-18 year old young girls were there with their small babies. I suppose girls have always been married off at a young age in India, but I was still a bit surprised. A group of about 50 women ranging from young and older women gathered to hear my presentation. This community is incredibly poor so we were sure to emphasize the fact that the CCC will help women who do not have money for the mammography.

The final stop of the day was in Jalshan. We went to the PHC and stumbled upon a woman leading a session on how to have a daughter. Female infanticide is a huge problem in India and I thought it was great to see someone doing something about it. She suggested not doing a sonogram to find out the sex of the baby, which can often be incredibly important to mother-in-laws who want their daughter-in-laws to have a baby boy. She told them to stand up for their unborn child and not to let their in-laws give them trouble about it.

The PHC does a great job at providing information about so many different diseases, family planning, mother-child services, and women’s rights. However,
I’ve found that many of the village women are illiterate. Often times, I hand women my leaflet and they merely laugh and respond that it is of no use to them because they can’t read. I try to explain that once they sit through my presentation, the pictures will make sense and they will be able to understand despite not being able to read the Gujarati. I also encourage them to have someone help them read it. Additionally, I verbally explain how to do self-examinations and go over the 12 signs of breast cancer. I try my best to explain everything through my presentation and the video so that all the women leave with a solid understanding about breast cancer.

Unfortunately, the pictures from today somehow got lost or deleted. It was an excellent day filled with eye-opening experiences!

More Schools and Nurses

Since all of the village and PHC women are busy with Narendra Modi’s talk in Anand, I spent the day in Khambhat and had two presentations at school and one at a nursing school.

We arrive at Swaminarayan High School this morning where about 75-100 girls and 150 boys had gathered to hear my presentation. They started with a beautiful prayer and then heard my presentation. Once that was finished, the female students and teachers and I went to a separate room to talk candidly and privately about topics like menstruation, body odor, and hygiene. Most of the girls were between 8th and 11th grade and a bit shy. I told them that I have two daughters just like them and that they should feel comfortable to ask me questions. One girl asked if it’s okay to have a boy as a friend and not as a boyfriend. I explained that men and women can be friends as long as you know the difference between a friend and a boyfriend. I told them to keep distance and make the boy understand that they are only friends and nothing more. I did my BCA presentation as well and told them to share the information with their mothers, older sisters and masis.

At about 12:00 pm, we headed to the all girls 42 Ghaam School which is very close to the Center. The girls were mainly 11th grade students so I didn’t spend too much time talk about hygiene. I shared my BCA presentation and then had one young woman who asked questions for the entire group. She mainly asked about periods, breast growth pain, long gaps between periods, and menstrual cramps. When I visited India when I was younger, I remember noticing that women on their periods could not touch anything in the house nor could she enter or cook in the kitchen. She has certain areas in the house she must stay in and certain cloths to wear and dishes to use. Even if they want to sit with the neighbors outside she is on one side not touching anyone. I think the reasoning behind this was act was to make sure that the woman rested while on her period since such blood loss can cause weakness in some women. However, the community is so obvious about it and has made it embarrassing for the woman by announcing to the world that she has her period. The girls felt the same way as they don’t want people to know what is personal to them.

I returned to CCC by mid afternoon for a presentation in front of nursing students at the General Hospital that is connected to the Center. I had met some of the nursing students during our medical camps last week. As part of their training, all of the nurses are taught how to do breast examinations, which isn’t the case across India. It’s great that these women have the tools necessary to help other women, especially when village women might feel uncomfortable with male doctors.

This evening, Dr. Ankur Raval, who I met at the Lion’s Club, invited me to do my presentation at a CME diabetes that he was hosting. They discussed a couple cases and it was quiet interesting to hear the different treatment options and medicines that you can administer to patients.

I’m glad today was a little bit slow because it give me a chance to recharge for the rest of this busy week!

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Lots of Presentations to Kick Off the Week

I went to four different villages today. Angieben and I left at 10:30 am to visit Undale. Unfortunately, when we arrived most of the women were still busy with household chores and the only woman there was the nurse who organized the visit. While we waited for the women to arrive, I watched the nurse administer vaccines on a 15 day old infant who was born at 3 kilos and now weighed 2.8 kilos. The grandmother who brought the child was concerned and said that the mother was not making enough milk to feed the baby. Another woman came in to schedule an appointment for a tubectomy. She already has two children, and facing the realities of poverty in rural India, had decided that the only way to protect and feed the family she has was to ensure she did not have more children. Despite the little material goods that they have, the people in these small villages are always smiling and happy. I think we can all learn a lot from their outlook on life.

After about an hour, twenty five of the village women arrived. Although this was less than expected, I am more than happy to deliver my presentation to even two women because I know they can share the information with their family and friends. I’ve realized that I end up adding new things to my presentation every day because I learn about the new myths that exist in every village I visit. For example, I make sure to tell all of the women that wearing a black bra and tight clothes will not make you more prone to breast cancer. Following the presentation a few women approached me with concerns. One of them had a sonography that reported two lesions in her left breast and was planning to have a mammography soon. One other woman said she knew three women who had some complaints about breast pain and we advised her to encourage all of them to visit the Center for an examination and mammogram. The women were a bit concerned about who they would have to meet when they arrived at the Center, so we asked them to bring the pamphlet with them so that the staff would point them in the right direction.

At 12:30 pm we were on our way to Syama, a village about 10 minutes from Undale with a population of 3000 people. We ran into the same problem as Undale when we arrived. A female doctor met us at the PHC and informed us that the women were probably busy at home with lunch. While I waited for the women to arrive, I read over all the health awareness posters they have up. You only find out how much information these communities received when you actually go to visit. The ‘Kisoriben’s and Asha worker women do an amazing job of keeping track of the 1000 people to whom they are assigned to relay medical information. We only have to wait 20 minutes before about 25 women had gathered to hear the presentation. Although these women didn’t have any questions, they seemed to understand everything I had shared between the video and presentation. I’ve started spending a bit of time talking about daily life at the end of each presentation, just to make sure that women are hearing other important health related information often.

We were already running late to our next presentation in Vatadara when we finished in Syama. The PHC had invited all of the women to gather in Vatadara at 1:00 pm being conscious of the fact that they may run on Indian Standard Time, one hour late, and arrive by 2:00 pm, our scheduled presentation time. We probably shouldn’t have been so presumptuous because all of the women arrived on time at 1:00pm and waited an hour for us to arrive. I felt so bad that they sat around and had already left by the time we arrived. Hopefully we will be able to schedule another visit before the end of the week.

Before moving on to Khatnal, we called to make sure that the village women would be there for the presentation. We found out that Khatnal has a female panchayat that was already holding a meeting so the women would not be leaving until after my presentation. This group listened very attentively and had a lot of questions. They talked about a few different cases of breast cancer within their village and in neighboring villages as well. One 19 year old science student had a lot of insightful questions to ask. They offered us tea before we left and the PHC and Panchayat invited us to join them in Anand tomorrow for a talk by Narendra Modi.

Today was incredibly productive! I really enjoyed meeting the women from all the villages and appreciate that they treat me as their own.

Also, check out these websites for more information on the PHC system in India and the Role of the District Public Health Nurses in India.

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Presentation in Balesa

The 3rd day of medical camp started a little different. We went to Balesa, a village very close to Khambhat where the Lion’s Club of Khambhat had set up the camp at a Hindu/Sufi temple. We were expecting at least 250 people but the morning started out a bit slow. Ilaben, Bipin Uncle’s wife and Ushaben, Thakore Uncle’s wife and also Deepaliben, Pareshbhai’s wife also joined me as I set up the materials at my station. Pareshbhai is the one who organized for all the doctors from California to visit the CCC. I had a nurse help me as the mammography tech couldn’t be with me. I did a few small sessions and small groups of women gathered. There were more men than women today so Ilaben suggested that we go to a school while we were waiting. Milindbhai got on the phone and called the principal at one of the local schools and we were on our way.

When we got to the school the principal and about 80-90 girls were all ready for our presentation. They were all so curious about what I was going to asy and show them. First I just talked about hygiene and when menstruation starts how to keep their bodies clean. I also went over body odor and how to keep under arms clean, especially when temperatures are high and perspiration happens. I also talked about basic hygiene like washing your hands every time they come home from outside. Ilaben was taking pictures and Ushaben was helping me with the lecture. We wanted to talk to them about sex and boys but knew it is not allowed without permission from parents in India. The Indian culture doesn’t allow conversations like that in schools. These were young girls so I asked them to share this information and explain breast awareness to their moms, older sisters, masis and neighbors but not as a scary message but just as a wakeup call for women.

Just before the bell rang I asked if anybody had any questions or concerns. Some of the girls came around me and with shyness. One asked if you can get cancer from wearing a black bra and I immediately responded with a “No”. She seemed to have received her information from a very misinformed source. Another young woman was quite concerned about her breast growing larger if she didn’t wear a bra. I advised her that you should wear a supportive, tight bra so if breasts are large they have enough support. The teachers were very happy that we came and talked to the girls about hygiene and cancer. They want us to come back and talk about sex but we’ll see…

We all went back to the temple and had lunch and then I was off to Navagam with Rajeshbhai, the Rotary president for a BCA presentation. It was village very small and their income is basically from sale of buffalo milk. The women of this village were very eager and interested in learning and listening to what I had to say. They asked all kinds of questions but we were a bit limited as men were present which made them very uncomfortable. The woman pictured below reading a leaflet was quite talkative and stayed until the end. I had a good talk with her and explained quite a lot and asked her to pass it on to her women friends. Navagam is a very friendly village with very loving people. The biggest concern with these women is money. The first question is always “How much will it cost?”. You can imagine what their income would be from selling buffalo milk. I assured them that if anybody had a concern, the Cardiac Care Center would help in that matter.

At 8:30 pm, we had a CME at the Lion’s Club. My presentation was 1st and it went quite well. All the guest physician’s went one by one to give talks on a variety of issues, including vascular surgeries, hyper tension, stage I and II diabetes and kidney function and dialysis.

At about 11:50 pm we went the Town Hall near the main tower of Khambhat for the Republic Day celebration. All the guests were invited by the Pres of Khambhat to honor us and welcome us for the humanity work we are all doing. It was very nice of them to give us this respect and honor.

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Presentations in Naar and Undale

Today I joined Dr. Bipin Uncle, the visiting doctors from California, Bhupendra Uncle’s Mama and nephew and Mohan Kaka on visits to Naar and Rohini as part of the 2nd day of the medical camp. Mohan Kaka is very highly respected and well known in Khambhat because of all of the work he has done around education ehre. I really enjoy his outlook on life – be on time, don’t waste time, and get things done. The word “No” doesn’t exist in his dictionary; he always like to look for solutions to problems. I’d love to spend some more time talking to him. I think he has a lot of wisdom to offer.

There were already patients waiting to be seen when we arrive in Naar. It was a little bit chaotic at first but managed to settle quickly. There were a total of 4 doctors and nurses assisting with all the patients. While I was waiting to gather a group of women to chat with, I socialized with patients and also watched what the nurses were doing. The physicians and nurses were able to provide almost 150 patients with care before we left!

As the women were finishing seeing the doctor, I asked them if they could spare 5-10 for me to share information on breast cancer. They were all quite polite and agreed to hear my presentation. About 25 women gathered up and I gave my presentation on the other side of the room. As usual I went over all the details about BCA and what steps to take in early detection. My posters and leaf-lets are very helpful, especially the 12 signs of BC (lemons in carton). A few of the women approached me after the presentation to ask to speak in private. I advised both of them to see a doctor about their concerns as I am not a physician.

I left Naar earlier than everyone else as I wanted stop in Rohini on the way to Cardiac Center. However, I received a call from Chandrikaben Bhrambhat from PHC saying that I was late to my presentation in Undale. We had arranged it the last time I was in Rohini and it had completely slipped my memory. I rushed over to Undale as I didn’t want to lose the women who were waiting there. The meeting went really well and I left behind extra leaflets as well. The connection between PHC and Cardiac Center has been wonderful. They have really made an effort to schedule village visits for me and in helping spread awareness. They’ve helped arrange over 17 presentations in villages, at schools and rotary clubs between January 30th and February 5th. I can’t wait!

I was back at the CCC by 4 pm and took some rest. I went down to give my schedule for next week to Sarvangbhai and Dipalbhai when Bhupendra Uncle called to ask if I wanted to come see the last surgery he and Dr. Parmar were performing. I went right over to the general hospital to see a fistula in the arm of a 29 year old lady. It was my first surgery, and needlesstosay, very interesting!

At about 8:30 pm, we had the whole newspaper staff come interview us. Bhupendra Uncle briefed all of them about each of us, what we are doing and how it is good for the Center and its patients.

After a long, excitement packed day, we all enjoyed dinner together in the canteen.

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