Category Archives: Pre-Trip Training

For me, India is a country that is at once both close and far. I was born in India, retain a strong connection to Indian culture and cuisine, and still visit relatives there every few years. At the same time, I have spent the majority of my formative years in the United States and have always lived in middle class comfort during my summer trips to India. A big reason I chose this specific country was my desire to get to better know the “real” India outside of my comfort zone. As I embark on my summer project to Delhi, I will be entering the country for the first time on my own. I will be exploring a part of the country that I have never previously been exposed to and interacting with all kinds of people I would usually stay away from. My hope is for this experience to broaden my mind and allow me to see the bare realities of life in my home country. This will go a long way to helping me understand who I am and where I come from. This is the personal reason as to why I chose India for my fellowship placement.

As an aspiring future physician, I am constantly looking to learn about the intricacies of patient interaction and about the roadblocks that prevent effective provider patient interaction. The specific issue of drug rehabilitation in Delhi fits in well with these interests. This is mainly because the cultural stigma associated with drug use in Delhi means patients find it extremely difficult to admit their problem and seek help. The stigma also means many healthcare providers are unwilling to admit rehab patients or unaware of how to work with them. The sheer challenge of navigating this problem will provide me with an incredible opportunity to study provider patient interactions in challenging situations. This kind of in-depth, hands on look will teach me valuable lessons that I can take with me on my path to becoming a physician. This is why I chose the specific policy issue of drug abuse in India.

Overall, my pre-trip training has given me a great look at the background of India and the basics behind the drug addiction problem in Delhi. I feel like I will be going into my summer project with a solid understanding of what I will be facing.

For the community connection part of my pre-trip training, I had to speak with a member of my nonprofit organization who would be able to provide me with advice and context for my upcoming internship. I spoke with Miss Robin Young, who is director of programs at CFHI (Child Family Health International), and was in charge of organizing my Delhi trip in conjunction with my in-country non-profit SPYM (Society for Promotion of Youth and Masses). CFHI is a global health non-profit based in California that works to set up international service programs in a variety of countries worldwide. They have broad areas of focus in Global Health, Clinical Work, and Public Health. At the same time, they try to be flexible when deciding which programs to cover. As an example, if a specific need comes up at a specific time- such as a fight against a certain disease- they will then adjust their programs to meet that need. At any one time, CFHI runs 37 to 40 programs in 10 countries, all centered in Africa, Asia, and Latin America.

In terms of determining social issues/policies to address and finding organizations to connect with, there is a general model that CFHI follows. CFHI has local coordinators and contacts in their 10 countries, and when there is an issue to work on or a program to implement, the local coordinators will get CFHI in touch with the appropriate non-profit, hospital, or family practice. In my case, the issue of drug rehabilitation in India led the local Delhi coordinators to connect CFHI with SPYM, and that is how my project was formed. Miss Young referred to this as a “cadre of pre-receptors”(though in some cases the local coordinators might be part of a non-profit itself). In general, advocacy and policy work is not something CFHI does directly. However, the in-country partners often try and do advocacy work and implement policy change on their own, and an example is a palliative care initiative that was started through a CFHI partner in Trivandrum, India.

In regards to my role at the organization, the structure of CFHI programs is all about nesting short term internships into longer term partnerships and broader goals. I will be coming in with a couple of other interns, and we will all work together this summer. We will be implementing one phase of the project, and when we leave, CFHI’s partnership with SPYM will continue, with new interns and new projects, all working towards the same long-term goal of drug rehabilitation in Delhi. When I leave, I might not a direct worker for CFHI anymore, but I will be an advocate of the issue back in the United States as I share my experiences and lessons with those around me.

For the faculty connection part of my pre-trip training, I had to speak with a Rice faculty member with connections to Delhi who would be able to provide me with advice and context for my upcoming internship. I spoke with Dr. Divya Chaudhry, who teaches Hindi at Rice. Dr. Chaudhry was born and raised in Delhi, India, and spent her entire life there until coming to the United States for graduate school. Most of her family still resides in Delhi, and she still regularly visits them.

The main point I got out of my discussion with Dr. Chaudhry was a reinforcement of the notion that drug addiction and rehabilitation are extremely taboo subjects in both Delhi and in the majority of India. Dr. Chaudhry noted how the very notion of people using recreational drugs is almost unheard of amongst the middle class and educated population, even though the issue is prevalent in a large number of urban areas. She repeated how the cultural stigma on this subject is simply massive. Even when the concept of drug addiction is accepted, it is primarily viewed as something that affects grown men, with women and children not expected to be associated with the problem at all. The stigma also means there is a general lack of empathy and support for individuals who find themselves addicted. If they openly seek help, their family name will be shamed. This stems from the Indian notion of ‘log kya kahenge’ (what will people say), or the huge weight placed on the opinions of others in society. Due to the stigma, it will be very difficult to speak to others about drug rehabilitation during the course of my internship. I will keep these facts in mind and be sure all efforts to speak about the problem of drug addiction are done so with utmost care and consideration when I conduct my work this summer.

Dr. Chaudhry also gave me very useful tips on traveling and general cultural awareness while in Delhi. She noted how a proper distance must always be maintained between men and women in public, as this is a very important part of traditional Indian culture. A particularly interesting point was that the first coach of most metros in Delhi is specifically reserved for women- men should not enter this area. For other travel tips, she told me how it would be a good idea to use a metro to get from the suburbs to the city, and a rickshaw (a  common small Indian “taxi”) to get from there to the socioeconomically underprivileged areas where I would be working.  She also stated how the poverty and desperation I will witness while working with the low income population is likely to be overwhelming. She told me to stay wary of pickpockets and scammers, and advised me to not show my cell-phone in the open and carry as little money with me as possible. Finally, she mentioned the tendency of those in India to look after themselves and mistrust outsiders, which means I will have to be vigilant and on alert throughout my time in the country. I will be sure to take note of these tips so I can travel safely, work with minimal stress, and adjust to the cultural norms as I begin my project this summer.