Alert Alert!!

It's official: Swine Flu mania has gripped Hyderabad.  True, the first reported case of swine flu in India was in Andhra Pradesh earlier this summer.  But thankfully, no reported deaths in the state yet (although there was a controversial death earlier this summer, where the Telugu press wrote in shockingly huge red blinking letters across the screen: "swine flu death reported!!"...only to be rescinded the next day).

Everywhere I looked this summer, people were wearing surgical masks.  Drugstores reportedly sold out of them, so some enterprising street vendors came into the picture.  When I saw children jumping up and down, begging their parents with huge smiles to buy masks as though these masks were ice cream, I couldn't help but think of "Tipping Point" and the next big craze.  (see pictures above!!)

Of course, this isn't to belittle swine flu (and indeed, pregnant women appear to be particularly suceptible -- prompting many maternity hospitals around Hyderabad to rework their visitors' policy)... but it's just interesting that with all the public health issues plaguing the state (HIV/AIDS, for one, has reached WHO-defined pandemic levels here), the focus is on swine flu. 

You can't blame the media, for the public seems to be eating it up.  It just makes me wonder how media and "hype" can be used to draw wider attention to some of the more silent but deadly issues here.

The British are Coming!

Directors from the UK's National Health Service (NHS) are visiting LifeSpring this week.  The visit is run by the NHS Institute for Innovation and Improvement and its purpose -- as you can imagine from the title -- is to help spur innovation, both for NHS and for its leadership.

After taking a tour of our newest hospital in Chilkalguda with our head of Clinical Quality, the LifeSpring/NHS team gets down to business.  A few colleagues and I make fun of "development tourism" -- well-meaning but surface trips to see social enterprises "in action" in developing countries.  This trip is far from that.  I am impressed by how genuinely the group wishes to learn LifeSpring's best practices for delivering quality care in resource-constrained environments and apply these to their own programs.

At the same time, LifeSpring identifies key challenges we're facing in the realm of clinical quality improvement, creating a quality-driven culture, staff engagement, and IT.  On the first day, we discuss these with the folks from NHS at a high-level.  It's clear the next day that they've done their homework, for they come back with lots of practical, applicable ideas.  Among these is a performance and quality scorecard for our hospitals, which blends not only the key indicators of quality, but efficiency and financial performance as well.

When I first moved to India, the underlying assumption of development seemed to be: "What can the West bring to developing countries, by way of resources, ideas, and best practices?"  Western consultants came to developing countries to advise social enterprises on exactly this, and there seemed to be a clear line between teacher and learner.

What's so exciting about working in Indian healthcare in general and LifeSpring in particular is the growing recognition that Indian healthcare has something to teach the West about how to do things efficiently and affordably.  High quality, affordability, and patient-centered care are clearly central to the debates happening in the US about healthcare now -- and it's what LifeSpring's entire model and mission is around.  

And more than that, there's such a focus here on *doing* rather than just talking and debating.  As someone from the NHS said: "What an incredible opportunity to be working on this now, in a country like India that's growing so quickly and with so much unmet need that LifeSpring can tap into and serve."  Cheers to that!

Quote of the Day

Earlier this month, former Indian Health Secretary Prasanna Hota visited LifeSpring Hospital at Moula Ali -- the hospital he inaugurated almost four years ago.  The furthest thing from your stereotypical Indian bureaucrat, he regularly uses words like "rascal", graduated from Columbia Business School, enjoys discussing Locke, and bluntly speaks his mind in the most refreshing way.  During his tenure, he pushed through widespread reforms increasing accessibility to healthcare, especially in rural India.

During the middle of his talk to the LifeSpring staff, he turns to me and says:

"Time flies so quickly.  Before you know it, you'll blink and be 70, telling your grandchildren about all the LifeSpring Hospitals you helped open across India and the world."

That was at once one of the scariest and nicest thoughts I've heard in a while.

Spirituality and Business

Last night, I had dinner with a good friend and her fiance, a banker from London with a sharply analytical mind.  The talk turned to yoga and meditation, and he was completely incredulous that I did a 10-day Vipassana silent meditation shortly after I first moved to India.  Like many people who hear this, "I don't understand...so what exactly did you DO all day?" is a question that keeps cropping up in the same conversation -- amidst lots of laughter: "Seriously, I just sat in an ashram and meditated and thought."  They were shocked to hear that the silence was the easy part.  The hard part is being alone with your thoughts until they drive you so crazy that at some point, your mind just shuts off.  This is when the internal work and spiritual "cleansing" really gets started.

The conversation made me think about the intersection of spirituality and business -- or at least the possibility of the intersection of spirituality and business.  While that may sound like an oxymoron, I think it happens simply when you're passionate about what you do, and pursue it in a sincere and honest fashion.

It recalls a recent interview I read in Forbes India with the Dalai Lama:

Forbes: "Your Holiness, what would Buddha tell the world of business if he were in our midst today?"

The Dalai Lama laughs at the idea.  He is like an amused second grader who thinks every adult question is a fruitless exercise.  But in the next moment, the Monk takes over.  "Perhaps one thing," he says.  "Businesses must pursue their activities with humanity.  I think Buddha may insist that modern business be more altruistic and be truthful.  With truthfulness and honesty, you can be transparent.  Transparency is very important to build trust.

Forbes: "Your Holiness, how do you feed your own soul to keep the idea of Tibet alive?  Leaders in business are also required to promote ideas but faced with the smallest adversity, we simply give up."

"If I am involved in the business field, I may also give up," he says with a mischievous glint in his eyes.  Then the Monk returns.  "I think people carrying on with their work just for money, name or out of plain curiosity have a greater chance of giving up when faced with a small adversity.  If a scientist is at work for the benefit of humanity, then he will not give up.  So we need a larger sense of purpose to be able to draw from a larger source of inner strength."

I remember hearing the Dalai Lama speak in New York City, right before I left for India in 2007.  Above all and beyond anything he said (much of which was so spiritually above-my-head!), I was blown away by simply his being -- he personified such an aura of compassion, gratitude, and optimism that was contagious to everyone around.

It's a good reminder of what's really important when getting caught up in the inevitable grind of the day-to-day.

A legal resident!

Every time I think I know the process at the FRO, they change the rules.  

I arrive at 2pm as instructed last time, only to be told TODAY it opens at 3pm.  Pointing to the new "Open at 2pm" sign is a futile exercise, so I sit near the registration desk for the clerk to arrive from lunch.  Once he does, his desk is literally flanked with people, and I'm pushed around as passports from all nationalities are shoved into his face.  

The scene is unfolding with such intensity and raw emotion that it oddly brings to mind scenes of the Americans pulling out of 'Nam and the Vietnamese trying to be pulled into American choppers.  I laugh at myself at my ridiculously melodramatic mental parallels, but I've learned that amusing yourself is the only way to survive the FRO (a former roommate recommends just going drunk).

FOUR hours later with the sun starting to set, I'm still waiting to be called into the room next door.  As I complain to the clerk, he cooly replies, "This is India."  

There's nothing to say in response.

It's not all bad though; I have a good book and meet interesting people -- the German girl who's randomly spent time in Little Rock, Arkansas; students from Kenya and Vietnam coming here to study; and a young American with a strong southern drawl, here teaching Indians at call centers to speak with American accents.  His wife just delivered at an amazingly nice maternity hospital in Delhi, which I recently visited to learn more about the spectrum of maternal health in India.

While it's fascinating to learn about people's backgrounds and what they're doing here, we're all getting antsy and frustrated and bored.  I sit and wait and wait some more, contemplating the fine line between acceptance and complacency.  It's a delicate balance that I find myself constantly navigating and re-calibrating in India.  When do you just take a deep breath and let things go, and when do you speak out and insist things are done differently?

My thoughts are cut short, for I am finally called.  After more formalities, my waiting is finally rewarded.  I breathe a sigh of relief -- my three-month visa extension and residential process is now officially over!  

My co-workers think I should start a consultancy advising others on the visa process.  I think I may have a new career! (just kidding, LifeSpring ;)

Happy Diwali!

Over the weekend, Indian newspapers happily reported that Barack Obama is the first US President to observe Diwali.  He lit the White House diya while a Sanskrit scholar and Hindu priest chanted Asatoma Sadgamaya.

As an American living in India, I was really quite proud of the celebration of faiths exemplified by his Diwali wishes (which you can see here), where he talks about celebrating the triumph of good over evil and quotes Sanskrit verse: "lead us from falsehood to truth, from darkness to light."

Returning from Goa, it was so nice to see my inbox filled with Diwali wishes from just about everyone -- co-workers and friends here, of course -- but also random people I've met once in a conference, and the best surprise: Diwali wishes from many friends from home! -- many forwarding Obama's speech with remarks like: "I've never seen anything like this."

Diwali is a time of reflection and contemplation, which seems the perfect precursor to Thanksgiving up ahead...

I think I can get used to this seemingly never-ending celebrations and festivals!!

Goan Paradise

You can tell a lot about cities from its dogs.  Hyderabad's dogs are insecure and loiter in packs.  Delhi's dogs are highly aggressive and have something to prove.  Goa's dogs, by contrast, are friendly, welcoming, and laid-back.

There must be something in the air or in the water, for it hits us too.  My layer of daily frustrations start to instantly melt away amid the ubiquitous palm trees, warm tropical air, salty sea water of the Arabian Sea, refreshing pina coladas, and deliciously fresh seafood.  Oh, and did I mention the seafood? :)  From a culinary perspective, the four-day vacation can be seen as a 96-hour long fest, with king fish and pomfret and swordfish and shrimp and squid and mussels in white wine sauce and and and!!  It almost makes it worth it to live in landlocked Hyderabad to make weekends like this all the more incredible (almost).  It's already my fifth trip to Goa in two years, and I have a strong feeling I'll be back again soon! (with paradise 1.5 hours away by direct flight, can you blame me??)

Besides our incredible scuba adventure (see below), one of the most magical aspects of our long Goan weekend is being there during Diwali.

It's my first Diwali in India -- in many ways the highlight of festival season.  The Diwali holiday celebrates light over darkness, good over evil... It is also a time to pray to Lakshmi, the goddess of wealth (I find this confluence celebrating "good" as well as "wealth" fascinating).

Celebrations are already underway even before leaving Hyderabad.  The city is decorated in light; it looks like Christmas in the US, although about 50 degrees warmer.

We aren't sure how widely Diwali, a Hindu holiday, is celebrated in Goa, which was colonized by the Portuguese who left the Roman Catholic legacy.  But Goa doesn't disappoint.

Riding around Saturday night, we see candles lined outside houses and lights strewn and brightly shining.  All through the night, fireworks light up the beach and waterfront.  Absolutely magical.

The rest of the weekend is just as incredible.  Ajey our rockstar scuba instructor (last picture above, on our dive boat) keeps us busy with scuba certification, but after class, it's time to go out and explore.  

We lounge at beach shacks along the shore and dance in the sand.  Not a bad way to spend a Monday night!

In what's beginning to exemplify Goa for me, Tyler and I spend our last day exploring on the motorcycle (with helmets on, Mom!!), riding along winding roads lined with palm trees and lush greenery, punctuated by brightly colored colonial houses and white-washed beautiful churches.  We find a relatively hidden beach and jump into the Arabian Sea, before finding a picture-perfect beach shack for pina coladas, bloody marys, and fresh seafood nearby.

Turns out Goa ain't so bad.

----

PS: For anyone planning a trip soon, some recommendations and favorites:

Lodging: Silk Cotton Resort

Diving: Dive Goa

Eating: Brittos in Baga Beach

Diving Adventures

Underwater in the Arabian Sea.

Tyler looks at me and crosses his hand over his throat -- the universal diving sign for "out of air."  He reaches for my alternate regulator and replaces the fluorescent yellow reg for his, as we slowly ascend and reach the surface of the sea.

Not to worry though -- this is only a drill (unlike the time I really ran out of oxygen diving in the Galapagos Islands -- a story for another time!)  We work through dozens more underwater drills like this, such as recovering a lost regulator, filling our masks with water and subsequently clearing it, underwater navigation, and probably my favorite -- the controlled emergency ascent, where you raise your arm like Superman while swimming to the surface, singing "AHHH" along the way.

We are in Goa to become certified open water scuba divers, and it's an absolute blast.  Our teacher is Ajey Patel, who has logged over 1100 dives and owns and runs Dive Goa (which I'd wholeheartedly recommend to anyone!!)  He's incredibly competent, confident, intellectually curious and smart...we feel safe under his care and have fun the whole way.

After drills in the controlled safety of a pool (conveniently in the same resort/B&B we stay at), we quickly move onto diving in the open sea.  We do four dives over the course of two days, all from a small dive boat that picks us up from a nearby beach and takes us to dive sites named things like Bounty Bay and The Jetty.

After putting together our diving equipment on the boat, we receive a brief of the dive site and learn one of the most fun tricks -- falling backwards from one side of the boat and flipping into the water below (2nd picture!)...before donning our scuba gear that's thrown into the water after us.

Descending under the water is always a trip; there's something exhilarating about your field of vision moving from the water's surface to below... while there's something relaxing about hearing your breath through your regulator and seeing all the resulting bubbles around you.

Goa is known to have poor visibility, which ironically becomes a great place to learn, as it leads to increased confidence underwater.  And despite visibility ranging from 2-6 meters, we still see tons of sea life: coral gardens, eels, schools of trigger fish, sergeant majors (because of their stripes!), lion fish (see pic below) and even a jellyfish! (full disclosure though: the jellyfish was dead, but still pretty!)

By far the hardest skill to master is buoyancy control -- in other words, actually staying at the depth you want to stay at during the dive.  Tyler and I would signal down, and we'd go down down down CRASH into the rocky bottom below... Or point up and ascend up up up until we'd almost have to be physically pulled down so we wouldn't actually surface.

But hey, it's a start, and a good one at that!  It's amazing how steep the learning curve is and how confident we already feel on our fourth dive compared to our first.

And best of all, we're now certified scuba divers!  Our next underwater adventure awaits... here we come, El Nido, Philippines!

Looking Within

In yoga this morning, we are led through a meditation where we are forced to think through our fears.  We are asked to keep gathering more and more fears and worries in our heads (which gives me the WORST headache ever, seriously).

With our heads sufficiently filled with worries big and small, the facilitator begins counting backwards from ten to one... at one, your BIGGEST fear is supposed to come up.  Of course, all I feel is anxiety during the whole countdown... "Oh no, hurry up!!  We're already on 4... now 3!  What's my PERFECT worst fear??"

Ah, so maybe this is why I need yoga... :)

Ah HYD...

From the City that Never Sleeps back to "Gypsy" Hills.  Frank Sinatra had it all wrong though... "If you can make it here, you'll make it (drum, drum) ANYWHERE" is incredibly more applicable to India than New York, which is so efficient that my 3-month visa ordeal in India was solved in one day in NYC...complete with an apology for making me wait ten minutes upon pick-up and an email follow-up requesting customer feedback!

But of course, India wouldn't be nearly as fun if everything worked out exactly as you expected.  Case in point: I head (yet again!) to the Foreigners Registration Office this morning to register on my glorious new visa.  By now, I'm feeling rather self-assured and confident that I know the drill -- SO confident, in fact, that on the way I email our incoming Acumen Fellow instructions and advice for registering once she arrives.  At the FRO, a sign in giant letters warns that foreigners are ***ONLY*** allowed between the hours of 10:30am and 12:30pm, and I'm there exactly at 10.29am... only to be told that I must return at 2pm to complete my registration.  Huh??  And to top it off, they actually mean TOMORROW at 2pm...So much for my premature self-assuredness! :)

By now, I've learned to laugh at this (kindda).  After all, you come to be prepared for all sorts of hurdles around registration and visa.  What still continues to shock me, though, are things that "don't work" that defy all logic and reality.

Case in point: technology.  Clearly a strength of India and Hyderabad, with all its IT and tech companies.  In fact, when I was back in NY last week, I was laughing at how 1990s I was without a cell phone and internet... trying to find virtually non-existent internet cafes and making calls on phone booths -- remembering like an old granny how "when I was a little girl, there was a phone booth on EVERY block!"  (In fact, I remember practicing case study questions as a college senior such as: How many pay phones are there in New York City?  Answer in 2009: 5.  And I've made calls on all of them :)

But I digress... In India (as I suppose, everywhere), there are things you expect NOT to work, and there are things you expect to work.  Internet and technology is something I expect to work.  Mind you, not reliable internet, but logical internet.  Some samplings of my recent experiences that defy logic and are "fascinating" on good days and "ARG!!! -- why doesn't anything here WORK?!?!" on bad days:

(1) When my MacBook is plugged in for internet (as opposed to wireless), the ONLY websites that work are Google related... Google works, gmail works, Blogger and Picassa work... but when I click on any other site (e.g. a link found on Google), it says "You are not connected to Internet."  This happens regardless of where I plug in!  Tyler and I joke that I have a Google-only laptop.  Seriously though, that's just WEIRD.

(2) I can't go on certain sites at work (like the FRO site!), and this is NOT due to security -- which I've triple-checked with IT and also called our vendor.  Even when I bypass work internet and use a data card, I *still* can't access those sites, while friends in other locations can.  The only explanation I was given yesterday is this is due to Airtel, which is like hearing Verizon randomly doesn't let you call ONE number out of millions (OH, and don't even get me started on the phone companies here! ;)

(3) Emails get sent out from my work address and are received by SOME people and not others... even though other emails reach those same people on the same day.

Odd I tell you.  My yoga teacher (and very good friend) advises that I stop focusing on what's wrong because I'm bound to find it (as if on cue, at that instant a car begins honking its horn for what feels like an eternity!).  She instead reminds me to appreciate and give gratitude for everything good around me.  And really, that's what this blog is all about.

But once in a while, you just have to vent! :)

Good Morning Hyderabad!

Watching the sun rise at my apartment's terrace... As I'm learning, getting up at 6am for yoga does have certain benefits!  In a weird way, the view of Banjara Hills below reminds me a bit of San Francisco will all the buildings atop hills -- but as I write this I can almost see my west coast friends cringing and saying I've been away too long!  My favorite part of our view is the mosque in the foreground, whose amazingly loud call to prayer infiltrates our entire apartment and sounds wonderfully exotic and romantic on I-love-India days...and a little less so on I-hate-India days.

Central Park South & Broadway

Even though my apartment is rented out, it still feels like home sweet home (especially napping in the building's common area in my unsuccessful attempt to ward off jet lag) ... I suppose staying on Indian Standard Time has its benefits for a short one-week trip!

Waiting for the F Train

Or: Reason #76 I love NYC.

A little bit of India in NYC

Fall in New York is just about perfect... cool, crisp weather; Yankees in the playoffs; leaves starting to turn amazing shades of amber, orange, and yellow... And of course getting to spend time with my family and friends.

And lest Hyderabad starts to feel too far away, a little reminder on Park Avenue:

Back Home in NY

I left The Home so long ago now
that I would not recognize my own face.
I constructed the Boat of My Life
and I set out
into the open sea
waving to all who knew
that the seas would give me
everything I could handle
and everything I could not
and yet they waved, and I set out
into the open sea
in the Boat of My Life:
built from Soul, crafted by Heart
and with great innocence I pushed off
into the open sea
and have been away from my Home
so long now that I would not recognize my own face
but I know that Home--
Home
remembers me.

"Long at Sea", Em Claire