Creative Solutions in Resource-Poor Settings

I have a post on creative solutions on my global health blog, from back when I was learning about these things in a classroom. But yesterday, on our first site visit in Jaipur to the NGOFXB, I was able to see it in action.

The creativity of FXB's interventions blew us out of the water. We've heard of using hair salons as points of disseminating health messages, because people go there habitually and spend at least 30 minutes waiting and being tended to. FXB designed a project to educate barbers (with male clientele) to teach their clients about HIV/AIDS and to distribute condoms to them. They have reached roughly 100 barbershops this way. They have distributed stickers with an FXB phone number and are receiving many calls about condoms. The condoms are advertised as free, which unfailingly attracts Indians, according Dr. Gupta, the director FXB.

Another project that the NGO has started grew out of the founder's love for children. The founder is Countess Alvina, a French woman who lost her son Francois (for whom the NGO is named) in an airplane accident. He was a rescue pilot and was flying over Mali on a mission when he died. Alvina is the primary funder for FXB now. Dr. Gupta says that one day, she asked him to take her to see street children. He took her to an orphanage. She was unsatisfied. So he took her to the railway station, where the street children really were. She befriended the kids and devised surveys to collect information on their lives. Most of the kids are runaways, and they come to the stations to find work. The most common work is collecting plastic waterbottles on the trains and in the station. Each one can be sold for 50-75 paise, which is less than one rupee. It's like dividing up one U.S. cent.

Countess Alvina wanted to teach these children about hygiene, and give them some informal education. She and Dr. Gupta set up health camps in the railway station, and one by one, children would come and receive care and instruction. They received nail trimmings and haircuts. They learned how to brush their teeth. They were given coloring books and crayons--Dr. Gupta says the railway kids loved to color. They also received regular checkups at these health camps. FXB worked with the childrens' schedule; after all, they were at the railway station to work.

At first, FXB met with some opposition. The railway police saw these homeless children as the cause of petty crime in the station. They also viewed the children as criminals, since they were squatting at the station and entered the trains without tickets. They would beat the children, too, blaming them for any crime that occurred. But with time and persistence, this obstacle was overcome.

To help the children with hygiene, Dr. Gupta contacted 5-star hotels in Jaipur to get used hand towels and soaps at no cost. 5-star hotels replace their soaps with each new guest, and a lot of soap is thus wasted. He showed us the towels and soaps and sure enough, they were from a top resort in the area. I marveled at this; what a great idea! In his own bathroom at the FXB office, I saw that Dr. Gupta himself uses these used soaps.

Other services for the children include field trips to the zoo, puppet shows, and screenings of fun, educational DVDs on HIV/AIDS.

Apart from the site visit to FXB, yesterday we got a comprehensive lecture on the Indian health care system from Dr. R. S. Goyal, professor and dean of IIHMR. He also gave us a tour of the campus, and an overview of the research and educational opportunities at the institute. It was interesting. IIHMR has a beautiful campus (pictures to follow), and the hospitality is astounding (upon arriving to the meeting hall yesterday morning, we were all presented with IIHMR computer bags, pens and notebooks). The campus also has a gym, a grass tennis court (I wanna play!), a swimming pool, and all the amenities you can think of. It also has an intriguing art collection. I have to admit to being slightly suspicious when I see such a high-maintenance public health institution--does this place really benefit everyone? It's possible...

At night, Dr. Goyal invited us to a Rajasthani theme park! The park is set up as a typical Rajasthani village. We rode an elephant and a camel (I got my wish!), and saw a lot of other performers dance and do amazing tricks. Emma rightly pointed out that some of these people should try out for Cirque du Soleil. Although as Sej said, there was a lot of child labor going on at the park. A lot of the performers were children, dancing or performing for hours. I don't know what their economic status is, but it just doesn't seem right. We all had an amazing time, though. By the time we reached home, it was about 11:30. Long day!