Experiencing IndiaJune 4, 2012 | Alexander, PSY, CWY, India, Rmkm
It is the end of my first month in India and the beginning of greater personal responsibility following this morning’s departure of a very helpful Canadian intern (Jenna) who arrived at RMKM one month before Michelle (a fellow University of Ottawa intern) and I.
Jenna showed us the campus, introduced us to the students and employees, shared valuable advice, and made the transition from Canada to India much smoother than it would have been without her. Now it is time to see if we can make it on our own after what felt like a very short first month.
India has been exciting at times and disconcerting at times but my experiences have always been worthwhile and valuable.
The RMKM campus where Michelle and I are staying is a school for disabled children as well as a university for students studying to be special educators. When we arrived at the school, we learned that summer break had just begun and that the children were on holiday for the months of May and June (the first two months of our internship). Fortunately, RMKM runs a number of off-campus programs in addition to the school, including a Targeted Intervention (TI) program for 533 injecting drug users in the nearby city of Ajmer where Michelle and I have been working since we arrived. Transportation into Ajmer and the language barrier created a few obstacles for us in our first week or so, but we have overcome these issues for the most part and have had a very successful first month at RMKM’s IDUs Office.
RMKM’s TI program for injecting drug users (supported by the Rajasthan State AIDS Control Society [RSACS]) is nothing short of impressive. It adheres to standards introduced by UNAIDS involving outreach work and counseling, peer education, medical assistance, and the provision of new needles/syringes and condoms to target populations. In fact, IDU TI programs in Rajasthan such as the one in Ajmer are used as models for TI programs in other Indian states. The everyday performance of my co-workers when interacting with the IDUs (outreach workers visit IDU “hot spots”in the Ajmer district to provide new injection/safe sex materials and counseling, and many IDUs visit the Drop in Centre at the office to watch a film or get some sleep) closely reflects the kind of counsellor-patient relations my psychology professors advocate for. They are kind, nonjudgmental, and persuasive rather than overbearing and invasive. They share their lunch with visitors to the Drop in Centre, spend time with them at the office throughout the day, and consistently and reliably visit them where they convene throughout the Ajmer district to provide support. They effectively access a large proportion of the target population by networking with IDUs who have social influence (“Peer Educators”) who can help reduce or eliminate their peers’ high risk behaviour. In addition, our co-workers are very successful at convincing members of High Risk Groups (HRGs) to accompany them to Integrated Counselling and Testing Centres run by NACO and RSACS to be tested for HIV.
They have also helped reduce the number of risks HRGs are exposed to by encouraging them to opt for drugs that are less harmful than drugs that are injected. Some of the HRGs I spoke to smoke rather than inject drugs to reduce harm, and others express interest in alternate drug options. However, HRGs’ options are limited in Ajmer because the Opioid Substitution Therapy (OST) that is available in other Indian cities as a prescribed oral alternative to injecting drugs is not yet available in Ajmer.
My living conditions at RMKM are far better than I expected. I have my own bedroom with a bathroom and a powerful fan (a “cooler”), and I always have access to filtered drinking water. Our meals are prepared for us and snacks are available throughout the day. The campus itself is just outside a small village, and it is surrounded by a stone wall with a gate. It is very hot here, often hovering around 40 degrees, but I am rarely exposed to direct sunlight so the heat hasn’t really bothered me. Even when I choose to sit in the sun, I am almost immediately instructed by one of my peers or co-workers to sit in the shade, and they persist in telling me to move until I do.
The cultural differences that I have experienced thus far have been a challenge at times but never unbearable. As mentioned above, Michelle and I faced some issues regarding transportation and language barriers. To get to work during the first week of our internship we took a number of different modes of transportation and were always accompanied by an RMKM employee, but beginning the second week we were responsible for getting to work ourselves by bus each day. At first we got a little bit lost and felt considerable stress because we had to take 3 or 4 different buses (depending on how long we wanted to walk) and could never communicate with bus drivers about where we were headed. Also, rickshaw drivers would constantly tell us we were on the wrong bus and that we needed to get off just so we would take their rickshaw instead.
Fortunately we managed to secure our route after the first few days and although rickshaw drivers still bother us from time to time, we have found ways to deal with it and we no longer have much trouble getting to work.
The language barrier has not been much of a problem on campus at RMKM because well-understood communication is not so important when you are playing games or just eating meals together. Communication difficulties at work on the other hand can be somewhat problematic. On my first day, I thought that the language barrier might actually make work impossible. Since the main activities surrounding the IT program involve communication with the HRGs, it isn’t easy for Michelle and I to help discuss issues with IDUs or convince them to get tested for HIV. However, we are able to have fragmented conversations with these individuals and ask questions through our co-workers which has proven to be somewhat effective. Our co-workers try to teach us Hindi throughout the day, but for the most part we speak English with them since our Hindi skills are not as developed as their English skills.
In the next few weeks I will be making a transition to an entirely different work setting. I am excited for some new experiences but I will miss my co-workers at the IDUs Office who have been so kind and who have made my first month in India very memorable.