Traffic

I don't know what this sign actually says, but I wish the people of Chennai would adhere to it. (I should've asked a local to translate the Tamil for me...) If you don't believe that Chennai has more noise pollution than Manhattan, then you'd have to go there and hear it for yourself.

(I found this sign on the grounds of Fort St. George, the first British outpost in India, whose construction began in 1640. Chennai was then known as Madras.)

Giggly girls, boisterous boys

Some camps were at government (public) schools in poorer neighborhoods around Chennai. We checked the kids mainly for strabismus and
refractive errors. Of course, boys are a little rowdier than girls, but all were surprisingly well-behaved when it came time to do what needed to be done. And all exuded an ebullience that I found refreshing. American kids hate to see doctors and make sure you know it. I didn't receive that message with these kids. I looked different and therefore very exotic to them. Indeed, during my entire three weeks in Chennai, there wasn't a day that passed in which I wasn't incessantly stared at by one person or another.
At the first school camp, each child would come right up to me, salute, and chirp, "Good morning, doctor!" Very cute. Totally disarming. Do you know any child in America who does that when he or she sees the pediatrician?

When I pulled out my digital camera, though, everyone went crazy, at both school camps I went to. I was like a yellow-skinned alien who had descended into school, freed the children of class for the morning to do some cover testing and refraction, and then pulled out a magic little device that could capture their smiles, something they and their families could only dream of affording. Taking a picture of them and then showing it to them on the camera completely delighted them.

Hande Hospital, Shenoy Nagar, Chennai

We did all of our charity cataract surgeries at Hande Hospital, which is like a hospital for the surgical subspecialties. Bilroth Hospital next door (not in the picture--too big!) is much larger and has an ER. The camp patients could also come for consultations (clinic visit) in the eye room on the ground floor free of charge. Hence, all post-op care was given here.






The two-bed setup in the ophthalmology operating theatre in Hande, with the Zeiss Lumera microscope in between the two beds. The AMO Sovereign phaco machine we regularly used is on the left.



One of my postops from my last day of work.

Latchatipati = Crorepati

In case you're wondering what the title means...

"latchathipathi" means "millionaire" in Tamil. I'm trying to make reference to the movie "Slumdog Millionaire," which was receiving huge publicity in India while I was there. I kept hearing about it constantly on the news. Some locals appeared impressed that I had already seen the movie in New York before I arrived ("It got released in America before it got released in India," I explained.) I think Indians are extremely proud of the achievement, especially that of A.R. Rahman--and yet ambivalent about the stark portrayal of corruption and poverty in their own country. Some Bollywood people were saying that it was a brilliant movie about India that no Indian would probably have had the guts to make.

The other volunteers really wanted to see it in an Indian movie theatre, so I tagged along on a Friday night because I just wanted to see what the theatre was like (the 4 of us were somehow able to cram into one rickshaw--I of course had to be the one to sit on someone's lap and fear for my life lest I tumble out as we weaved through rush-hour Chennai traffic). For the English version of "Slumdog," the auditorium was packed. Seats were reserved and assigned like at a Broadway show, and there was an intermission. But, no previews. And, for 150 rupees a seat, definitely cheaper than a Broadway show. I wish I had the chance to see a Hindi movie, though...

Beasts of burden

The cow may be sacred in India, but I think they and most other animals have it pretty rough here. Stray animals are everywhere in the city. During any casual stroll through town, you could encounter random cows--usually very thin--and goats chewing on trash in the streets, dogs dogs and more dogs, the occasional stray cat (they tend to hide during the day and thus remain largely invisible--how characteristic). Cows pulling carts of vegetables or with little necklaces and bells around their necks. And of course, in public parks, their duplication as havens for stray dogs are the rule. I took a picture of this stray dog taking a rest on the grounds of Fort St. George. Coming out of a friend's apartment one night, though, we found a poor little dog who slept on a corner of the staircase landing. She stared at us with large, terrified eyes and literally quivered whenever we went by. I caved one night...I had a half-eaten package of biscuits (cookies) in my bag and fed her one...then two...then she snarfed down all five of them. And then licked the crumbs off the ground. We started bringing her leftover food every few days, which made her very happy (I didn't take a picture of her because I was afraid she would be too startled by it). At nearby Tower Park, we attempted to feed two skinny puppies my leftover veg pulao but they were chased off by their own mother, who then proceeded to wolf everything down. Now that's what I call food aggression. I definitely kept my distance with those dogs. I was told by a Chennai local during my last week that the city does try to spay and neuter the strays...

I found the sign on the left near my hotel. The girls in the sari shop next door couldn't figure out what we were so amused about. They giggled themselves, amused at our amusement. People DO keep pets in India! But what I'd like to know is...what is a "barking fine"?? Does it mean that barking is fine, or is there a fine if your dog barks in the hospital?

Two weeks later, the sign disappeared. Sari shop, still open.

Camps

My first screening camp on the morning after my arrival in Chennai, in the slums north of the city close to the beach. I viewed the reed-hut slums on the sand, multitude of stray animals and indelibly chaotic traffic from the van on my way here (with Tamil music blaring on the radio). Three optometrists checked vision and refracted patients using trial frames. I was at the ophthalmologist station with another Tamil-speaking
doctor where I had a flashlight, a portable slit lamp and my direct ophthalmoscope and checked for cataracts. If other pathology was present that required further examination, I referred the patient to the clinic. There was a fair amount of corneal scarring/opacification, likely from previous infectious keratitis. A few had rAPDs with pale nerves viewed with the direct ophthalmoscope for unknown reasons. We didn't have the setup to do indirect ophthalmoscopy. If the patient didn't need cataract surgery and just had presbyopia, he/she went to the glasses station to get a pair of free reading glasses (dispensed by the other volunteers). If the patient needed surgery, I'd refer the person to another station for referral to Uma Eye Clinic for pre-op measurements and Hande Hospital for surgery scheduling. In the span of about 2.5 hours, we had screened over 200 people. For this particular camp, we decided to transport the patients who needed pre-op measurements back to Uma ourselves right after lunch (a delicious, non-veg thali cooked by the neighbors next door). Amazingly, we squeezed about 15 people in with us in the van--the right half of my rear end had a bouncy, precarious seat on the way back.


I tried my hand at giving out reading glasses to people who didn't speak English during my fourth camp, at left. The biggest challenge was really getting them to understand that they shouldn't be looking up and around in the distance with those things on (they would come back to me saying everything was blurry)--even though I had told them "for reading, for reading" ten times in Tamil.



The portable slit lamp came in handy sometimes. Most of the time, we didn't use it. With just a regular flashlight, even without dilation, it was relatively easy to detect cataracts. This young woman came to me complaining of headaches. Her AC looked pretty shallow with the slit lamp, so I referred her for further workup/gonioscopy at Hande Hospital.

UFS Donors, please read first!

For everyone who financially supported my efforts here in Chennai, a big thank you. You helped screen hundreds of Chennai locals for refractive errors, strabismus, cataracts and other potentially blinding diseases of the eye. You helped the physicians at Uma Eye Clinic perform over 30 cataract surgeries and during my three-week stay here, some which were performed by me.

India is a fascinating country. I was only there for three short weeks, and unfortunately didn't have enough free time to venture out of Chennai. But I learned a lot about the culture and the people of Tamil Nadu, and I hope to return.