More than five years ago, I visited Gujarat to do a project audit for Association for India’s Development (AID) related to post-Godhra riot-relief. In between my meetings and tours to the riot-hit areas of Ahmedabad, I had the opportunity to visit the Gandhi Ashram on the banks of the river Sabarmati. I met some kids that I haven’t been able to forget ever since. The Ashram has long since become a museum where tourists can view Gandhi’s slippers and spinning wheel on display.

But somehow I was more interested in a group of three girls playing on the banks of the Sabarmati river and a little boy who insisted on shining my shoes (flip-flops!). First about the boy. He was a real salesman — he offered to clean my dusty flip-flops for just Rs. 5 (around $0.13 US). We started chatting in Hindi. He told me matter-of-factly that he was in school till his mother fell ill and his father left home. Now he earns enough to feed his family. Life is hard but he insists that he likes cleaning shoes and he’s good at it. I don’t know if he gives much thought to concepts like child labor. This is his life, his work — and it feels legitimate to him. I want to give him the money as a gift but I can see that he takes such pride in his work that he would be offended. He mocks at the beggars around us. “I would never beg,” he scoffs. If Gandhi could see this — in his own ashram on the banks of the Sabarmati, small children working their childhoods away like this. Maybe he would be happy it is a refuge for them. I know that child labor is bad and all that, but I can’t help admiring the entrepreneurial drive of this little boy. I can’t figure out his age. Must be around nine or ten?

I walked to the river bank and met a group of three girls having a great time, laughing and playing in the sun. They were in their element, literally — and were amused by my camera. The girl on the extreme left especially caught my eye. I asked them if I could take pictures. They smiled shyly and nodded. Such uninhibited laughter and innocent play: t’was good for my jaded soul. After a day of listening to stories of innocent people stabbed, beaten, and molested — I needed this.

Right in the Ashram campus is a non-governmental organization called Manav Sadhana that is doing some pretty interesting work with kids. I visited and met the director there. It was reassuring to see that someone gives a damn. Like SOFOSH, they are on the frontlines, doing whatever they can with the limited resources at their disposal. I’ve heard that the founders of Manav Sadhana are also behind the Seva Cafe. Though Niya is not directly connected to this project, I am delighted to know it exists, and works for the children, like the ones I met in Ahmedabad. For the past eight years, I’ve been so lucky to visit many such organizations and meet their gutsy volunteers.

Fast-forward three years to 2006. I was thinking about an earn-and-learn scheme that would allow working kids to go to school. Child labor makes all of us cringe but it is a reality in India and many parts of the world. I showed a little brochure I’d put together to actor and activist, Ms. Shabana Azmi. We were on our way to the book launch of Wisdom Song: the Life of Baba Amte. (I wrote the book and she helped “launch” it on April 24, 2006). Ms. Azmi felt I should discuss my earn-and-learn entrepreneurial scheme with Mrs. Veena Mankar. Mrs. Mankar leads a micro-credit organization for the urban poor in Mumbai called Swadhaar.

Mrs. Mankar felt the most important thing is to raise awareness in India about micro-credit and entrepreneurship. She would like to see the public more involved in funding these schemes. There is no dearth of ideas and willing people — but the public support and buy-in are still missing.

I haven’t yet implemented my earn-and-learn scheme. But every time i go to India and see a kid selling magazines at a traffic light or shining shoes somewhere, I regret my inertia. It would be ideal if children didn’t have to work but if they must, can’t we do something to help them secure their futures at the very least?

Before I left Ahmedabad in January 2003, I went back a second time to the Gandhi Ashram. I asked the Mahatma a few rhetorical questions. Would he marvel at the enterprising shoe-shine and the carefree girls seeking refuge and play at his doorstep? Would he be happy to witness the work of Manav Sadhana, right on the grounds of the Ashram?

I couldn’t really concentrate on the important historical facts during my visit to Gandhi’s Ashram. Recently, I found a photo of a signboard. Now that I read it, the history of the Sabarmati Ashram is quite interesting. Among other things, it says, “Gandhiji started his historic foot march with 79 Ashramites to Dandi recalling Buddha’s renunciation of old with a vow not to return to this place until he achieved freedom for India.”

I lazed on a grassy hill just below Gandhiji’s statue and I surveyed the cottages and courtyard that made up the small campus of the Sabarmati Ashram. Gandhi is part of our mythology, and I don’t know how much of what we feel when we are here is real and how much is a desperate grasping for utopia.

Now, five years later, it’s the carefree girls and the entrepreneurial shoe-shine I can’t forget. I wonder where they are.

The Day Before the Camp Started

December 9th, 2004

5 p.m.

Dr. Pol casually says to me, “You must come to see the eye camp. It is an event worth attending.” We are accompanying Baba Amte on his evening walk in Anandwan, the leprosy community he founded in 1949, the first project of Maharogi Sewa Samiti, Warora. Baba’s MSS-Anandwan is famous around the world because for the first time, he boldly flouted conventional wisdom and declared that “Work Builds, Charity Destroys.” Anandwan became the first leprosy community where the rejected within society dig wells, harvest bountiful crops, build homes, lives and even families. They have proved beyond a shadow of a doubt that they can be productive members of society. “Give them a chance, not charity,” is Baba’s mantra, and to come here, is to see that mantra in action. In Baba’s Anandwan, leprosy patients here built a blind and deaf primary school and Anand Niketan College to benefit the very society that rejected them.

Today’s Anandwan is different. It is Dr. Vikas Amte’s Anandwan - Baba’s son, a creative man in his own right, has exponentially increased the scale and the scope of work, and today, there is hardly anything that Anandwan doesn’t do - from biogas to plastic reuse, agriculture to pisciculture, a multi-disability musical orchestra and an eye hospital. And that’s just the tip of the iceberg. There seems to be no limit to Dr. Vikas Amte’s endeavors. It is because of Dr. Vikas Amte, his wife Dr. Bharati Amte, and Dr. Pol that a large Intra Ocular Lens (IOL) Transplant eye camp has been co-organized by MSS/Anandwan, a Mumbai-based organization called I Care (part of the Zubedabai Akberally Zaveri Trust), and a team of doctors, led by Dr. Lahane, from Grant Medical College/Sir J.J. Group of Hospitals in Mumbai.

First Impressions

The team from Mumbai has arrived and the first person who grabbed my attention right away is one of the ophthalmic surgeons, Dr. Ragini Parekh. She’s bubbly and affectionate, and seems to be the life of the party. Without a formal introduction, she starts chatting with me. I ask her how she likes Anandwan. “Have you noticed,” Dr. Parekh said, looking directly at me, “when we come to Anandwan from Mumbai, we go through a profound change. The same people who are too busy to even call or drop by in the city, will check to see if everyone has eaten, and generally look out for each other. This cannot be explained to anyone who has not felt it themselves - being here makes all the difference. Coming to Anandwan is like a pilgrimage for me,” she said, “I look forward to this camp every year. It makes me feel alive! I would love to come here and settle down eventually.”

Diagnosis and Pre-Operative Preparations

December 10th

10 a.m.

I’m working on a book about Baba Amte so I’m trying not to get distracted by the eye camp. But there is an incredible energy reverberating from the hospital grounds - mandaps being put up, mattresses being set up, boxes of medical supplies being counted and arranged - and it is impossible to keep away.

6 Ophthalmic Assistants, 131 Villages, 9 Days

A group of six ophthalmic assistants (Archana Waghade, Kirti Gabne, Sunita Rawad, Purshottam Gurnule, Vaishali Shende, and Vidya Lavate) accompanied by the driver, Shaukat Ali, from Anandwan combed 131 villages in a period of 9 days (December 1-9) and recruited candidates for this camp. They covered all of Chandrapur district and parts of Wardha and Yeotmal districts. Vidya Lavate looks exhausted. In addition to recruiting participants for the past two weeks, she will be working from 8 a.m. to 3 a.m. throughout the camp, with the rest of the team. “We distributed 5,000 leaflets. We visited more than 20 villages every day. Now, we have really seen every tiny hamlet in this entire region. What an experience!” One of Vidya’s team members is already out of commission because she contracted malaria. This is one of the unglamorous side-effects of working in the trenches - par for the course.

A Sea of People

The candidates have been standing in line from 6 a.m. By the time the camp starts, thousands from all over Chandrapur district and surrounding districts have arrived. A total of 3,500 candidates will be examined by the doctors. Patients who do not have mature cataracts or have other eye ailments are given appropriate medicines and sent home. The rest of them are sent for blood pressure check-ups and urine tests. By evening, a total of 610 patients have been short listed for surgery. They are admitted to the hospital. They are given free tonics and medicines before the operation.

Their eye lashes are cut and a white sticker is affixed on the forehead above the eye to be operated. Additional patients will be rejected during the following three days due to high blood sugar or other life-threatening conditions.

Pre-operative Care

I tag along with Dr. Ragini Parekh as she examines patients lying on mattresses in neat rows. She enters the room like a burst of fresh air. She starts chatting with the patients in Marathi. If you walked into this conversation, you would think she’s known them for years. She puts her arm around a man who is constantly touching his eye. Now this is not typical feminine behaviour in this rural area. But there is something disarming about Dr. Ragini Parekh — you instantly feel comfortable with her and want her to take you under her wing. She exudes that sense of confidence that some doctors do - you know they aren’t God but somehow, their dedication and devotion to medicine make you feel that they would do everything in their power to heal you. She explains to the man in Marathi that he must not touch his eye and definitely not put a big red powder tikka on his foreheads, as is the custom around these parts. “Udya, mi aak motha bindi lawte, tar tumhi lavu naka, aikla ka? Samjha tumhich lawle! (Tomorrow, please don’t smear your foreheads with powder tikkas. Instead, I will put a huge bindi on my forehead and when you seen that, you just think that I’ve put a tikka for each one of you!)

It’s a trip to watch Dr. Parekh in action because she wins over the most unlikely candidates. Men, who would not allow their women to go out of the house without covering their entire faces, are nodding their heads in agreement, as she convinces and cajoles them to keep their eyes clean before surgery to avoid infection. Many of the patients are not educated in the traditional sense of the word — they have not completed more than a few years of formal schooling. Some don’t know how to read or write at all. But she gives them detailed and specific instructions - “don’t touch your eyes,” “don’t even let a cloth touch your eyes,” “if your eyes get teary, that’s okay,” “stay in your rooms, no wandering around,” “no eating tomorrow before surgery.” And till the 80-year old man, who can’t hear a thing, understands, she patiently explains the surgery and the pre-operative instructions. It makes all the difference because these people are often treated like dirt in other hospitals. Here, they are treated like human beings. Sure, there is discipline. And, misbehaving patients are reprimanded. But they receive the best possible care and top-class medical attention.

Cataract Surgery for the Rural Poor

Cataract (safed motia) is a clouding of the transparent lens inside the eye. Basically, the lens is behind the colored part of the iris and it helps focus light rays on the tissue at the back of the eye (retina). When the cataract develops, the lens becomes cloudy and prevents the light rays from passing into the retina. The picture that the retina receives becomes dull and fuzzy. Mostly, cataract develops in adulthood as people age. It is also caused by injury, illnesses, inflammation or other conditions. Babies can also be born with congenital cataracts.

Specializing in suture-less cataract surgery, Dr. Lahane’s team is able to send the patient back to work within seven days. The traditional method required a forty day recovery period which translates into forty days of lost wages - something they cannot afford because they live a hand-to-mouth existence. Dr. Ragini Parekh clarifies, “There are some complicated cases where the cataract has matured to a point where we, as surgeons, cannot fix it completely.” She thinks for a moment then says, “Let me put in simple terms, if you’re hair is very frizzy and you want to straighten it, you probably won’t be able to make it completely straight. It’s sort of like that.” The analogy rather hilarious - frizzy hair and mature cataract! But that is Dr. Parekh’s style. She has the ability to bring complicated concepts down to brass tacks and explain suture-less cataract surgery to anyone.

Many of the patients who came here cannot afford to pay for this surgery. If they did not get this operation, they would go blind eventually as the cataract matured and eventually exploded. Dr. Parekh exclaims, “Many people in India go blind because they didn’t get their cataract removed in time. It’s a tragedy when blindness is caused by something so preventable. In rural areas, eyesight is critically important to survival. These people are so poor that they cannot afford to lose their eyes.”

Inauguration & Day 1 of Surgery

December 11th

11:30 a.m.

I’m sitting with Baba’s sisters on their verandah where we have a great view of Baba’s cottage. The Deputy Chief Minister of Maharashtra, RR Patil and health minister for the state, Dr. Vimala Mundada have arrived. They will be officially inaugurating the camp today even though the diagnosis and pre-operative work was completed yesterday. Starting today, the surgeons will operate over the next three days - December 11th, 12th, and 13th. A couple of hours ago, a seventy-five person strong security force arrived - commandos, uniformed police, and plainclothesmen. They came into Baba’s house with metal detectors. But after inspecting the cottage thoroughly, they leave it unguarded for an hour - making the entire search meaningless. I think the security is more a show of strength than anything else. Baba has no security guards, no metal detectors, no commandos, but he has often put himself in harm’s way and suffered no harm. Ironic isn’t it!

Baba’s Threat to Exercise his ‘Right to Exit’

Mr. R.R. Patil goes into Baba’s house. Everyone is wondering what the two are talking about. Baba’s room was so full of security and journalists that it is impossible to get inside. We found out later, that Baba was giving R.R. Patil and Dr. Vimala Mundada a piece of his mind. For the past two years, Maharogi Sewa Samiti has not received the government grants that pay for the public state-funded schools and colleges on the premises. Baba threatens to exercise his ‘right to exit’ by refusing to eat, if the grant does not come by December 26th. (Baba’s dramatic statements make the headlines on December 12th). He exposed the fact that MSS had received some of the grant money just a few days before the ministers arrived. It appears that the local politicians and bureaucrats were trying to appease MSS so they wouldn’t mention this travesty to the high level ministers. Baba was insulted by the fact that the Social Welfare department is always willing to come by and do a head count (to verify the number of patients or students) but never bother to send the funds even though they find everything in order. R.R. Patil had once said to a reporter in an interview, that if he didn’t get re-elected, he would volunteer at Anandwan. He has also said that “Baba is like a father to me.” As R.R. Patil was getting ready to leave, Baba reiterated his decision to stop eating to his ‘surrogate son.’

The Formal Inauguration

The whole discussion about the grants was unexpected because the objective of RR Patil’s trip is to inaugurate the eye camp. After the meeting with Baba, the ribbon-cutting ceremony at the hospital, and the Anandwan tour, the emphasis is brought back to the camp. The inauguration included speeches by Dr. Lahane, R.R. Patil, Dr. Vimala Mundada, and other important dignitaries. The government officials promised to support Dr. Lahane’s work to the best of their capacity.

Dr. Lahane gave full credit to his team who works extremely hard, singling out Dr. Ragini Parekh for her tireless efforts in making every camp a success. He joked that the team loved the Anandwan camps because Dr. Bharati Amte personally sees to it that even when they finish surgery at 3 a.m., they get hot food. “Even my mother,” he exclaimed, “didn’t bring me hot food after I finished operating!” R.R. Patil gave an impressive speech - he talked about Anandwan being holy ground for him, he mentioned his promise to return and work here in five years. He expressed his admiration for Baba’s work - “he showed us how even the most disabled person can be independent and capable.” The award-winning SwarAnandwan orchestra, brainchild of Dr. Vikas Amte, performed for the visitors and after receiving a standing ovation, they ended the show with the song, “Kabhi Albida Na Kahna.”

Dr. Lahane and Dr. Parekh started operating at 8 a.m. Much of the morning on December 11th was taken up by the inauguration event so only 56 patients are operated on by 5 p.m. But the doctors stay up till 2:30 a.m. and complete a total of 168 surgeries that day. The doctors are assisted by their residents. The residents are allowed to do one or two surgeries per day under careful scrutiny.

Surgeons-in-Training

A lecturer, Dr. Siddharth, an advanced surgery student, Dr. Soni, and the eight residents who are training under them - Dr. Shweta Joshi, Dr. Anagha Vaze, Dr. Smita Dixit, Dr. Deepali Vyavhare, Dr. Meghna Chandiakar, Dr. Sachin Kokane, Dr. Atit Shah, and Dr. Divya Sarvayye are critical members of this surgical team. The residents are on their feet 18-20 hours per day. Working under Dr. Lahane and Dr. Parekh is no mean feat. They are tough taskmasters, and they will never sacrifice a patient’s eye, so even residents undergoing training are not allowed to make a mistake. Dr. Ragini Parekh said, “For the surgeon, it is one surgery gone bad, but for the patient, it is the loss of eyesight. We treat each patient’s eye as if it were our own. I’m very tough on my residents but it is for their own good. When they go out into the world as doctors, they will be the very best. Then they will appreciate me.”

A team of ophthalmologists is here from Chandrapur to observe. There are other doctors floating around - such a camp always attracts local doctors.

I Care. Do You?

While the stamina of the doctors is formidable, it is the I Care team whose chutzpah and energy cannot be described in words. They have been doing these camps for 22 years - first as members of Rotaract Club of Mumbai Downtown, then as members of I Care, which they founded expressly so they could continue this phenomenal project. Baba is extremely smitten by the group. He tells me, forget writing about me, you should be writing about them! They carry the patients back-and-forth, they clean the floors, they prep the Operation Theatre, they raise the funds in Mumbai, they bring all the equipment and supplies with them, and they never complain about the amount of work they do. They are always smiling. These twelve young men have won him over. While usually people ask Baba if he will pose for a photo with them, when it comes to I Care, Baba is the one who said, “I would like to have a photo with the I Care team.” Baba pointed out their banner outside the hospital. “What a beautiful name for a group that restores eyesight to people - I Care!”

The I Care team chooses the locations for their eye camps based on statistics regarding incidence of blindness. “The St. George System tells us if there is a concentration of blindness in a certain geographical area. It is set up by the District Blindness Control Committee. That’s one of the reasons we keep returning to this area - there is a high incidence of blindness in this region. We have noticed that tribal areas are especially vulnerable and there is a tribal area a few hours from here.” When the I Care team first started organizing camps at Anandwan, the operating theatre only had capacity for one patient at a time. So the team would come weeks before the camp, convert ordinary hospital rooms into operation theatres and get them certified so several simultaneous surgeries could take place.

I asked the I Care team what inspired them to organize these grueling eye camps for the past 22 years. “You cannot imagine the feeling you get when the patients weep and tell you that you saved their lives. Their gratitude and their love keep us coming back every year. Every year, we say, ‘this is our last camp,’ because all of us have families, responsibilities and careers. Our wives get frustrated. But if we don’t come, all these people,” said Shabbar, looking around the hospital, “would have gone blind within a year or two. How do you live with that?

Patients often walk up to the I Care team members and fall at their feet. “You have done for us what even our own children don’t do. We don’t have words to thank you.” They cry, they clutch the team member’s hands, and refuse to let go.

I saw an I Care team member carefully bring a frail, elderly man to the operating theatre. When the man couldn’t walk any further, another member came forward and the two of them lifted him in their arms and carried him. They showed him the utmost respect even while doing so and it would have been easy to think that this man was their own father - there was such love in that one tiny gesture.

The NSS and NCC volunteers from Anand Niketan College are assisting the team in caring for the patients. Shabbar Jam said, “Previously, we carried the patients on stretchers back and forth, and we all had huge blisters on our hands at the end of the camp. But at Anandwan, we are fortunate that this year, the NSS and NCC volunteers are here. This is our fifth camp at Anandwan and we find that every year, it gets better.”

The ophthalmic assistants are responsible for putting drops in the patients’ eyes every two hours. This is another task that the I Care members did previously. The doctors spent the morning hours examining the patients who have already had surgery before their dressings are replaced.

“We arrive a couple of days before the camps starts to get everything ready for the doctors. Many patients show up early because they are afraid that they will be left out somehow. They wait in the sun, in the cold, in the rain, for days just so they don’t miss the opportunity to be operated in the camp. When you lose your sight, you’ll do anything to regain it. They are willing to give us their life savings, but they just don’t want to lose this chance. They can’t afford to go to a big city to get this operation. You cannot imagine how upsetting it is to see the desperation on the faces of these patients.”

I Care team could not be successful if it wasn’t for the support of the doctors, medical staff, and other personnel from J.J. Hospital. Shabbar points to a man standing in the pre-operative room, “That’s Maruti Shellat, head of the OT staff at Sir J.J. Hospital. Without him, we could never run such a large camp. Impossible!” The I Care team is fortunate that no one in the medical team charges anything for their services. Otherwise, a similar cataract operation in Mumbai costs Rs. 11,000. I Care brings all the surgical instruments, medicines, eye drops, glasses, syringes, plasters, and other medical supplies with them. Hundreds of boxes and trunks of supplies are required and all this costs money. “Even if someone donates in kind it would make a difference- for example, we require surgical instruments, medical supplies, and expensive equipment. Because we can’t afford it, we have to beg and borrow it from other hospitals and clinics.”

The biggest hurdle the I Care team faces is in the area of fundraising. They spend half the year approaching people to sponsor one single eye surgery which costs approximately Rs. 1,000 ($25). “If we didn’t have to struggle so much to raise the money, we would have time to run more camps or train other people so such camps could be run around the country!”

Many people in the rural areas go blind because of the lack of awareness about cataracts. When their vision gets clouded, they feel it is a curse from the Gods for sins from a previous life. They have no idea that cataracts can be removed and vision can be restored. “Twenty-two years after we started,” said Shabbar, “we find that cataracts are becoming more common. Now we are seeing cataracts in young children and with diabetes on the rise, we expect that this problem is only going to increase.”

2 a.m. Daal and Rice

When the team finally finishes surgery that night, it is almost 2 a.m. They arrive in the Canteen to eat their dinner - their mood is still buoyant and jovial. Dr. Parekh’s feet are swollen from hours of surgery. I was worried that their fatigue would affect their performance as surgeons but surprisingly, they have the ability to sustain themselves - it’s almost like when they are operating, they are in a different mode altogether. They postpone their personal physical needs till after surgery.

Day 2 of Surgery

December 12th, 2004

5:30 p.m.

A Trip to the Operation Theatre

Today, I went into the operating theatre to watch Dr. Ragini Parekh perform surgery. I watched her finish the second half of the first surgery - she put a lens in the patient’s eye and cleaned up the eye. Then she started on another patient. First she created a tiny incision above the black part of the eye. Then she made a round cut around the cataract and through the incision, she extracted it. It was yellowish in color. Before she could fit the new lens into the patient’s eye, I fainted. I went in dancing and laughing; the I Care staff joking and teasing me about my first visit to the Operation Theatre. I was nervous about seeing the blood and gore of surgery but to my surprise, it was a very clean operation. I didn’t feel nauseated at all. But there was a strong smell of the fumicide that is used to kill all the germs, and with the surgical mask on my face, I was beginning to feel sick. As I started saying, “I think I need to go outside,” I was on the floor, unconscious. I had never fainted before so it was an interesting experience. Thankfully, I was nowhere near the patient’s eye so I didn’t do any harm.

I have a new respect for the doctors because I now understand the conditions under which they operate. There is no ventilation, the OT is crowded with equipment, patients, and medical staff, and the fumigation leaves a vile chemical odor in the room. For hours, these doctors do not go to the bathroom, do not drink water, and cannot leave this claustrophic environment. As I sipped water outside in the verandah, I watched the I Care team bustle back and forth, bringing patients in and out of the OT. They are not doctors and yet, they have become accustomed to this work and these smells. They suited up into their surgical robes, donned on their caps and their masks, and off they went!

Dr. Lahane & the J.J. Hospital Team

Dr. Lahane and his team have the camp routine down to a science. They have completed approximately 15,000 surgeries last year through camps held all over Maharashtra. They have reached every remote corner of the state. They did another 4,000 operations in J.J. Hospital in Mumbai and last year, they completed a record 19,000 surgeries. This is absolutely phenomenal considering just ten years ago; J.J’s ophthalmic unit completed only 600 surgeries. It isn’t just a matter of quantity. There is great follow-up by the team - they make two visits after the camp. The first visit is to examine the eyes and check for any problems and the second visit is to check the patients’ vision and prescribe spectacles if necessary.

The new Dean of J.J. Hospital, Dr. Shingare, came to see the camp with his own eyes. Dr. Lahane told his medical team in the canteen, “We have been doing these camps for more than a decade but this is the very first time that a dean has come to one of our camps. This is truly a historic day. And his visit,” continued Dr. Lahane, “is important because he has just joined three months ago, and despite the long distance, he has made it a point to come here. We have done camps just two hours from Mumbai and still no dean has ever ventured to visit.” The dean is a soft-spoken, down-to-earth sort of man. He is polite to everyone and observes quietly. He has traveled fourteen hours by train and two hours by road to bear witness to the camp. Then he will return by the evening train back to Mumbai.

Post-Surgical Care & Send-Off

December 14th, 2004

2:45 p.m.

Patients scheduled to be discharged are sitting quietly in the hospital courtyard waiting for Dr. Lahane to begin the send-off event. Dr. Lahane explains to the patients, “It costs Rs. 11,000 for every single cataract surgery so just because you haven’t paid a pie, doesn’t mean you take it lightly. You are not to touch your eyes. You must put your eye drops according to the following schedule,” Dr. Lahane starts explaining the schedule making the audience repeat after him, “Week 1, eight times, Week 2, six times, Week 3,….”

It is extremely difficult to get 100 percent compliance in the rural areas because of the high rate of illiteracy. But this doctor knows exactly how to communicate with his patients. He uses cultural references that they can understand. He cracks jokes with them. He makes them repeat his instructions back to him. And he’s got that ‘don’t mess with me’ air about him.

Unsung Heroes and Heroines

Lal Babu is injecting patients. It is an extremely painful injection but essential because many of the patients don’t have watches and forget to put the drops on schedule. Every morning and evening, we make a trip to the hospital and Lal Babu is always there. He ran away from his home in a village in Bihar because he had leprosy. “I had Rs. 300 in my pocket. I read about Baba Amte and Anandwan. I was sixteen years old,” he said with a big grin on his face. Bhagwan is another hospital staff member who has no job description but according to Dr. Bharati Amte, he is an ‘all-rounder’ who can do anything and everything. Vitthal Bhau is the compounder and paramedic. Chindha Bai and Sadhana Bai clean the entire hospital. These are the unsung heroes and heroines of this camp. They work behind the scenes and orchestrate everything. Without them, there would be no camp. The cooks who prepare food for almost a thousand people are rarely seen because they are standing night and day over the gigantic wood-fired cook-pots burning near the back-door of the hospital. The ophthalmic assistants, the bus drivers, the security guards, the gophers… their names never appear in the newspapers and they never win any awards. So during the send-off event, Dr. Lahane felicitated these extraordinary men and women. Everyone was exhausted and yet on an adrenaline high - 532 surgeries completed in three days!

Personal Conversation with Ophthalmic Surgeon, Dr. Ragini Parekh

After all the festivities were over, I ask Dr. Parekh if she would be willing to sit down with me for a chat. We sip cups of tea outside her room in the Loti Raman guesthouse, right next to the hospital. I ask her how she came to be an opthalmic surgeon. “I wanted to pursue gynecology but though I got really high marks in my entrance, I was getting any specialization I wanted except that one. I come from a Jain family, and my mother was against me taking gynac because I would need to do abortions.” A profession like radiology or pathology would never satisfy her, “I need that human connection to the person I’m treating.” She admitted that being a female surgeon is extremely challenging. Even today, the medical profession and patients alike do not accept women surgeons as easily as they accept male surgeons.

Dr. Ragini Parekh has seen her share of discrimination and disrespect. But the fact that she did not let these obstacles impede her progress is a testament to her inner strength and self confidence. “As a woman you have to struggle twice as much and you have to be twice as good as your male colleagues. That is a fact. Even today, I have to prove my credibility even though I’m probably the first woman in the world, not just India,” says the surgeon, “to have completed 175 successful cataract surgeries in 3 days.” She is quiet for a while, and then she says wistfully, “Without Dr. Lahane though, I would not be where I am today. If you had met me ten years ago, you would have seen such a different person. I did not have the stamina and courage to do a camp like this. It is because he had faith in my potential and developed my capacity over time that I am here today. We are best friends, we are colleagues, and we have seen all the ups and downs together since 1994. In sickness and in health, for better or for worse, till death do us part.” “Like a professional marriage?” I ask. “Yes. Sometimes, he forgets I am a woman. In the beginning, we were arch rivals. We hated each other’s guts. We had heard about each other through the hospital grapevine so we had our pre-conceived notions already in place.” Working together as surgeons, they slowly realized that they complemented one another. “Dr. Lahane has been my father, my mentor, and my friend at different points - though my father once said to me, Dr. Lahane is not your father. He is your mother.”

Dr. Lahane has only has one kidney and is alive because of immuno-suppressant drugs, but he doesn’t live safely. Dr. Parekh said, “Do you know any other person with his condition who would trapeze around the state doing thousands of surgeries in the most remote villages where catching an infection is highly likely? He can earn over Rs. 1 Lakh (around $10,000) per day if he opened a private practice but instead he works in a government teaching hospital.” She added, “When you face your own mortality on a daily basis, money, prestige, and power cease to mean anything. Dr. Lahane is single-mindedly focused on achieving as much as he possibly can. He knows that his days are numbered.”

That reminded me of something that transpired on the first night of marathon surgeries. After all the doctors and residents finished their meal, I waited with the canteen cooks and servers till the hospital staff arrived for their dinner after cleaning up the operating theatre. We started serving them at 2:30 a.m. and suddenly I noticed that Dr. Lahane was back. Was he hungry again, I wondered? Dr. Lahane had come to make sure his OT staff did not have to eat alone. It made a world of a difference that this famous surgeon was willing to forgo his precious sleep to ensure they were well fed.

Another time, as I was pouring daal in one of the doctor’s plates, Dr. Lahane said abruptly, “When you need your cataract fixed, I will be up there with Shri Krishna!” I didn’t understand what he meant - then Dr. Parekh explained that Dr. Lahane was referring to his single kidney and the risk of his passing away.

A Group of Hopeful Blind Boys

I am waiting outside the examination room. A group of blind boys walk into the hospital courtyard; each boy has his arm on the shoulder of the boy in front of him. The first boy is probably partially sighted so he serves as the guide for the entire group. They walk single-file into the exam room, all of them wearing their blue and white school uniforms. Dr. Lahane and Dr. Parekh examine these blind children as a favor - this is not part of the camp and after hundreds of surgeries they must be exhausted. The scene is difficult to bear. But I’m not upset because the boys are blind. I’m distraught because there are no resources for the blind. It is a daily struggle when the entire system is against them and every step they take is dangerous. There are no pavements, no Braille signs, no jobs, nothing… When blind girls go to the toilet, they are often raped. It is possible to come to terms with blindness, but it is much harder to deal with society’s response to it. These boys have such a hopeful expression on their faces - perhaps, this famous doctor from Mumbai can help them?

Saying Goodbye

The camp is over. The I Care team is loading up the new pick-up truck that was donated by a generous man after he saw the SwarAnandwan orchestra perform in Pune ten days ago. It is already proving so useful! The I Care folks shout instructions back and forth and it is truly a magnificent sight to watch them at work. Within minutes, everything is loaded up and ready to go. There is no confusion or arguments because the team has done this so often, they can almost read each other’s minds.

We drive to Warora Station where the J.J. Hospital doctors and the I Care team will catch the train back to Mumbai. Even though they have been working 18-20 hours every day for the past four days, the team is in high spirits. The I Care members are going round in circles singing “Ring around the roses” and enjoying themselves like little children. In just four days, we have come to respect these people very much. Shabbir Disawala, Zohar Attari, Zohar Nawab, Mustafa Malkapurwala, Adnan Masavi, Mustafa Kagalwala, Shabbar Jam, Zainab and Shabbir Rajgara, Yusuf Chaklasi, Hasnain Pardawala, Mustafa Dalal, Zulfikar Arsiwala, Esmail Safri, and Firoz Gandhi, have carved a permanent place in everyone’s hearts. It is difficult to fathom from where they get the sheer spiritual, intellectual, and emotional strength needed to pull off this mega-camp.

The J.J. team joins in and they do a strange dance to the chant of “chain coolie ki main cookie ki chain!” There is so much euphoria because they achieved the impossible this week. It is highly improbable that anyone else in the world has done as many cataract operations in three days. Dr. Parekh said, “We don’t feel tired during the camp. But when we get home, every inch of our bodies are aching. You get used to it. Yesterday, you saw the patients - they couldn’t see anything and they were miserable. Today, they were jubilant and clapping their hands. This is because when we re-did their dressing this morning, they were able to see again for the first time in a long time.”

Dr. Lahane, Dr. Parekh and the other medical staff waved from the windows till the train was out of sight. Dr. Pol looked exhausted but pleased. Another successful camp at Anandwan! I’m glad he invited me to attend. Though he never takes credit, he is the person at Anandwan who takes on the entire leadership responsibility for the camp. Of course, he never told me that when we were walking with Baba. But watching him in action during the camp made words unnecessary. In addition to organizing all the logistics and human resources, he was available 24 hours a day to the eye camp team at the hospital. He anticipated and took care of every need that arose during the camp. Just like Baba himself did in his time.

The camp was partially-funded by the District Blindness Control Program. Mr. D. R. Gawai, the Civil Surgeon and Mr. Sanjeev Jaiswal, the Collector of Chandrapur District played an important role in organizing this event. Dr. Pol said to me, “You must speak to Mr. Gawai and Mr. Jaiswal - they are the true authorities on the camp!” I promise to do so when I visit next year for the 2005 camp. Now I must leave for Somnath and Hemalkasa - two other projects of the Maharogi Sewa Samiti so I can finish this book. I promised Baba I would publish it in his lifetime. He scoffed at that possibility, and reminded me he would soon be ninety.

Vinoba Bhave said, when he inaugurated Baba Amte’s Forest of Joy - “Anandwan” - in June 1951, “New Ramayanas (epics) of service will be written here…” These past four days, I witnessed a miracle of epic proportions. And it was nothing short of a spiritual experience.

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MSS - Anandwan Eye Camp, December 2004

Number of Patients Examined: 3,500

Number of Patients Selected:610

Number of Surgeries(Dec 11-13):

Dr. Lahane: 236

Dr. Parekh: 175

Dr. Siddharth: 51

Dr. Soni: 20

Resident Doctors: 50

Total Number of Patients Operated: 532

Cost for One Cataract Operation (I Care, doctors & volunteers donated their services): Rs. 1000 ($25)

Cost of hosting the camp (MSS/Anandwan -(diesel, food, electricity, transportation, awareness campaign, follow-up, and pre-qualification):Rs. 600 per patient ($15)

Contact Information:

Maharogi Sewa Samiti

At and Post: ANANDWAN - 442914

Via: Warora, District: Chandrapur

Maharashtra, India

Phone: (91-7176) 282034/282425

Fax: (91-7176) 282134

Website: http://mss.niya.org

Email: mss@niya.org

I Care

25 Ebrahim Rehmatullah Road

Botawala Building,

Mumbai 400 003

Phone: (9122) 3754245/ 3741340/ 3740997

Website: http://www.icaremumbai.com [visit I Care’s website to learn how you can support their fantastic work. Also, see photos from all the eye camps they have done.]

The photos in this post are courtesy I Care.

Also look at I Care’s track record at http://www.icaremumbai.com/track_record.html

If you are based in the US, contact NIYA, at 919-696-4531 or email us at info@niya.org /Website: http://niya.org for more information.

© Neesha Mirchandani/Niya, http://niya.org/ Please do not reproduce or use images for commercial purposes without permission

J.J. Hospital statistics courtesy Dr. Ragini Parekh

July 14, 2007 in Seattle, WA, and February 29 -March 4, 2008 in Pune, India

As India rushes to dominate the global marketplace, will she take on her social challenges with comparable determination? For example, what will she do about her millions of orphan children? This remains to be seen. In the meantime, the onus has fallen on individuals and organizations that are quietly chipping away at systemic social problems in India. They are in the business of making a tangible impact on a day-to-day basis in the lives of ordinary people. They fight daunting statistics in the trenches, one human life at a time. While the politicians pontificate and plan photo-ops, they scrounge together limited resources and make it happen.

Welcome to SOFOSH

One shining example is from the IT hub of Pune, in the western state of Maharashtra, a hop-skip-and-jump from Mumbai (Bombay). Mrs. Abhyankar and her team run one of India’s most well respected social service organizations in this bustling city. It is affectionately called SOFOSH, an acronym for the somewhat long “Society for Friends of Sassoon Hospitals.” Mrs. Abhyankar gives me an overview of SOFOSH, “Though we do not receive any official government funding, we are located in the public Sassoon Hospitals where the poorest of the poor come for healthcare. We provide food to the neediest relatives of the patients in the hospital; we give prosthetic aids and free nutrition counseling to pregnant women; but of course, it is our work with children that is most recognized.”

She is referring to SOFOSH’s program focused on child care and adoption: Shreevatsa. Since 1973, Shreevatsa has facilitated over 2,400 adoptions (most of them domestic). It has cared for over 5,000 children on a temporary basis, including children of patients at Sassoon Hospital.At the moment, it has 65 children in its facility in the Sassoon hospital campus, and 25 in foster care in families in Pune.

Though we didn’t discuss the patient care side of SOFOSH’s activities at Sassoon Hospital in great detail, I got the sense that it is where the organization got its start, and continues to be important to its mission. If you live in Pune or visit it, and you have never walked the halls of Sassoon Hospital, I advise you to do so. It is an eye-opening experience. Volunteers from SOFOSH quietly help the families of the patients here in their time of crisis. Since 1964, they have rendered this valuable service in addition to their core function as an adoption agency. They also reach out to HIV patients and raise awareness about public health issues like tuberculosis and child care.

The Context for Shreevatsa

There is still a very strong stigma against unwed mothers. Without this stigma, Mrs. Abhyankar is convinced that many babies would be saved and pre-natal care would be better. When you hear of 13 year old girls delivering babies in shock (they don’t realize they are pregnant), it’s easy to get frustrated. Worse are the macro-level statistics: India has an estimated 12.4 million orphans but only 5,000 children are processed for adoption. Most of these orphans are not available for adoption because they have at least one living family member – but poverty, illness, or migration for work has made it impossible for them to live at home. A large number live on the streets or in institutions, or they shuttle from one relatives’ home to another. They often lack education, stability, and opportunity.

I wonder if India is leaving too much latent creative and economic potential on the table by not having a progressive strategy for its millions of orphans and street children. The government has done a few things right, for example, it has encouraged domestic adoption. Underfunded and overwhelmed, even well-intentioned government officials do not have the infrastructure and resources required to run a world-class child welfare system. Also, if it supports organizations like SOFOSH, perhaps they could expand their capacity to serve more children.

Due to a corruption scandal at another Pune-based orphanage, the public is skeptical about donating money, and with good reason. Mrs. Abhyankar agrees that one bad apple can make life difficult for other orphanages. So she felt that SOFOSH should do its best to be transparent and accountable. Fortunately, as I found out from talking to people in the community, SOFOSH’s record speaks for itself and its reputation over the decades has stayed intact. The biggest misconception that Puneites have about SOFOSH and specifically, Shreevatsa, its child care arm, is that it is government funded. Mrs. Abhyankar assures me this is not the case. “We survive entirely on donations. Fortunately, we have continued the work for almost 35 years based on this generosity.”

Mrs. Madhuri Abhyankar

When you meet Mrs. Madhuri Abhyankar, she embodies everything you’d expect from a passionate advocate for orphaned children of India — with one important exception — she’s not angry. Through her twenty-three years of service, she has made a meaningful impact (despite the depressing statistics) in the lives of more than three thousand orphans and that’s what she focuses on. But if you ask her about her achievements, she’ll prove to you that that in fact, she has benefited more than the children she has cared for. Mrs. Abhyankar gets a twinkle in her eye as she admits that she still wakes up every morning raring to go to work. She loves what she does. “When I got married in 1984 and moved from Mumbai to Pune, I joined SOFOSH. I had a Masters is Social Work.” She quipped, “After more than two decades, I can say I have really enjoyed every moment.” Raised by a mother who served as principal of a Bombay Municipal School, she volunteered at an orphanage from a young age. Apparently, her parents brought her up to live simply and give generously. When Mrs. Abhyankar joined SOFOSH, the workload was tremendous, and it was extremely challenging. But over time, the organization grew and hired more people.

Mrs. Abhyankar told me about the lost, abandoned, and abused children she has seen over the years – the preemies who literally have to fight for their lives, the special needs children who never get adopted, and babies left on doorsteps. One newborn was found floating in a plastic tub during a recent monsoon flood. “He was just born. Someone saw him floating… His whole body had turned blue…” Mrs. Abhyankar’s sadness was apparent but there was no cynicism. The horrors she has seen have not eroded her innate optimism. During this conversation, it became clear that in order be on the frontlines, one needed a huge reservoir of empathy but also a strong constitution. What makes her stick with it? “At the very core, I have to admit, I just love children,” said Mrs. Abhyankar. “They are completely innocent. And no matter what you put in, you get double or triple back.”

One of my discussions with Mrs. Abhyankar took place at the SOFOSH booth in the exhibit hall at the Brihan Maharashtra Mandal convention in Seattle, Washington, USA. Held once every two years, people who share a love for Marathi culture gather to celebrate it and meet each other. (My book, Wisdom Song about noted civil rights leader, Baba Amte, was launched at the conference). Mrs. Abhyankar is here to raise funds for a new home for the special needs children who do not get adopted, “the Tara Dadphale Center for special needs orphans.”

The Tara Home for Special Needs Orphans

“I know I can count on the parents of adopted children. It is their generosity that has kept us afloat all these years. But without any government support…” Madhuri Abhyankar’s voice trails off. “Who will provide for disabled children?” She’s hoping that Pune’s information technology companies will come forward and sponsor the monthly overhead of the new Tara Dadphale Center for special needs orphans. “All the children who come here have painful pasts. These children watch their peers get adopted, but because of their physical or mental challenges, they know they will never have the joy of family life.” Though Mrs. Abhyankar does not like the idea of institutionalizing these children, she does not have any alternatives. “One day in an institution for a child, is one day too many. But there is absolutely no other place for them to live so we created the Tara home.”

A passerby stops at the SOFOSH booth. Mrs. Abhyankar smiles and welcomes her visitor. Even though she has repeated it many hundred times, she eloquently describes the work of SOFOSH. The visitor picks up a brochure, thanks her and leaves. After more than a month of non-stop travel, Mrs. Abhyankar should be homesick and exhausted, but she perseveres, always that warm smile on her face. The convention is packed but people don’t have to enter the exhibit area in order to attend the main stage events. So the floor traffic is rather limited. Causes like SOFOSH compete with booksellers and jewelry vendors.

Abhyankar speaks admiringly of her committed team back in Pune without whom she would be unable to leave, and come to America on this tour. During this trip to the States, Mrs. Abhyankar has met grown-up children – she remembers when they came to Shreevatsa as babies. Now many of them want to volunteer at SOFOSH.

“Each adopted child is an ambassador for SOFOSH,” she said proudly. Mrs. Manisha Gore, a grand-parent of a newly adopted baby showed me photos of her grandson. “He’s only been in the family for two months or so, but we feel he has always been a part of us. He’s almost three years old…”

Mrs. Abhyankar says that nothing comes readymade. Make a plan and solve problems, she advises. Count your blessings. She’s grateful for everything, including donors who come by the booth and donate small amounts like $5 or $10 or buy a packet of bindis for a couple of bucks. Everything counts.

Mrs. Abhyankar says, “giving up a child for adoption is a confusing process for a young girl. Many of them don’t even understand what is happening.” One girl, after she delivered, kept asking Mrs. Abhyankar if she could go back home because she didn’t want to miss her exams. Many of these girls have been raped. One girl with mental illness kept changing her mind about whether she wanted to give up her child for adoption. SOFOSH offers counseling and support so girls can come to their own decision. For unwed mothers, issues of guilt and shame, and post-partum depression can also play a role. “Many of them don’t tell their fathers about the pregnancy. There are cases where the child is an incest child.” Abhyankar also recounted a story of a girl who accused her father of impregnating her but a genetic test proved her wrong. The family dramas, the complex inter-personal dynamics – these come with the territory at SOFOSH. “We see the best and the worst of human nature,” says Mrs. Abhyankar.

I asked what we can do to help. “Love your children,” Mrs. Abhyankar said simply. “Unconditionally. Many times, our love comes with conditions. Short, dark, slow, special needs… love your child. All of us have some purpose in life. Maybe we need to explore that purpose… make it more meaningful.”

Another visitor hovers near the booth. Mrs. Abhyankar sells a few bindis. Clearly, caring for the children is the easy part. Fundraising is a necessary function of what she must do to keep the work going. “We just have to present it to society and well-wishers and hope they will fund our new endeavor.” No sales pitch, no fancy powerpoint. She waits patiently till an interested passerby approaches, and then answers their questions. Mrs. Abhyankar advises prospective parents to think carefully before they adopt. “Ask yourself why do I want to adopt? Think about your career and how a child will affect it. But once you decide, the child must be your number one priority.” SOFOSH gives preference to domestic parents, then Indian parents living abroad and then foreign (non-Indian) parents. But Mrs. Abhyankar clarifies that this is not because any one of these parents is better than the other. From the child’s point of view, she feels it would be better to be closer to their own cultural setting.

As it gets closer to the time for the launch of my book Wisdom Song at the hands of Dr. Narendra Jadhav, Vice Chancellor of my alma-mater, Pune University, Mrs. Abhyankar said, “I think SOFOSH is part of my body. It’s part of me. My son would sometimes say, “I wish I was a Shreevatsa baby. Then my mom would take me to the doctor. Since we live in a joint family, I didn’t take always take him for his medical check-ups, but I took so many orphans from Shreevatsa – to the same doctor.”

Mrs. Abhyankar and the SOFOSH team in general remain largely unknown (even while Paris Hilton’s every move makes international headlines!).

Update: March 25, 2008

I just returned from India. I visited SOFOSH four times. I played with the kids. I met the staff. Many of the nurses have worked at SOFOSH for more than a decade. They are extremely dedicated to the children. Their work is challenging. I know I couldn’t do it. The office staff is equally dedicated. I realized on the third day, that while I gave a lot of importance to Mrs. Abhyankar in my piece, and rightly so, the staff that supports her also deserves a huge amount of the credit. She mentioned this during our interview in Seattle but I didn’t internalize it till I saw it in person. Two young women from SNDT, both volunteers, taught the kids sequential learning with great patience. A local technology company organized a magic show. I met an old friend of my family, Mrs. Tehmi Karbhari, who has volunteered at Shreevatsa/SOFOSH for many years. Every little bit counts. The older kids need to learn more English. They are fluent in Marathi but don’t have enough exposure to Hindi and English. They space is a bit limited and the building is old but the atmosphere is warm and inviting in spite of that.

AUDIO/VISUAL FROM SOFOSH

View the entire photo album of the SOFOSH team, volunteers, and group photos of the kids from my recent visit. (External Link to my Picasa Web Album)

William Widmer’s fantastic slide show and audio documentary on SOFOSH (including interviews with Mrs. Abhyankar and others).

http://www.widmerphoto.com/sofosh/index.html

Image to the left: A list of donation items needed at Shreevatsa

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April 2008:

I just received this announcement from Mrs. Abhyankar:

Dear All Friends,

Namaskar!

We are happy to inform you that 14th May 2008 is special day in the life of SOFOSH. Our dream is coming true. We will be having small inauguration function at 6.30 p.m. at SOFOSH DHADPHALE CENTRE, Pimple Gurav (TARA). Mr. Rahul Bajaj (Industrialist) will be the Chief Guest and Mr. Dilip Band (Commissioner) of Pimpri-Chinchwad) will inaugurate the Centre. You all are been so kind and helpful.

We humbly request to keep this evening for TARA and make it convenient to attend the function. We and our children will be waiting to take you around and show our newly built home. Your active support has made this possible.

Thanking you, Sincerely Yours, All at SOFOSH.

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SUPPORTING THE TARA HOME

I asked Mrs. Abhyankar how we can help. She broke down the funding needs for Tara this way: