the weekly pick me up.

This has been one of those weeks where I’ve definitely needed a weekly pick me up… so here’s to you friends, things that have kept me going, smiling, and pulling through.

I thought this was a brilliant idea. Here’s two of my favorites.

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This made me stop and pause this week. The stories in this TIME cover were really something. To think that some of those first responders on 9/11 could be involved in such an integral way in the construction of the new world trade center, to remember just how far our country has come… #thetopofamerica #resilience

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This song really rung true for me this week.

This struck me as a brilliant idea.

This made my week. Sometimes, just sometimes your friends, family, and neighbors (#ilovethesouth) drive/fly/bus up to see ya… and when they do, when in Cambridge, you take them to Zinneken’s. #foodie #noshame #prioritiesplease

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These words really rung true this week.

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And this is what I learned.

Through it all, when things get tough, really tough, look for the fighters – the ones who, through it all, keep on fighting for you. They’re the keepers.

Lots of love for this week ahead – may you enjoy the sunshineeee! Even if it only lasts for just a little while :)

xo Inesha

 

 

Back in town

It’s a crazy set of life circumstances that will take you from the rooms of a Palace to the standing section of a bus swerving through the Sierra Madre in the span of just a few days–but there I was, myself part and parcel of the crazy. Stepping off the plane in Tuxtla yesterday, it felt good to have returned to Chiapas. It was a world away from the week I just spent in Europe, but it was familiar and welcoming nonetheless. I was coming back to something after all–the doctors, my host family, and the unfinished work that Partners in Health is dedicated to each and every day.

As the taxi sped away from the airport, the driver said that he could take me to the bus terminal (I still had a good 3 hours to go before reaching my final destination) or we could just “catch a bus” that was passing by. I nodded sleepily–sure, that sounded fine. And then, not minutes later, the driver whipped his head around and the car followed–got one! He sped in front of a passing bus, honked twice, and before I knew it I was watching my suitcase get hauled into the aisle of a big, white, rickety vehicle in the middle of a Chiapanecan highway. As I got on myself, I realized that there was not a vacant seat to be found. Uhoh, three hours of standing while the bus took wild turns around mountains bends would be a challenge I hadn’t anticipated. Fortunately, within a few minutes a nice young man soon offered up his seat, no doubt having witnessed the expressions of terror flashing across my face at every turn. I was grateful for his and everyone else’s kindness as they ogled this girl who was clearly at least a little bit foreign and could probably use their help. The amount of pure human-to-human kindness here never ceases to amaze me. And so, that was that. After some 15 hours of traveling, I was in my last 3 hour stretch. Almost there….

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it’s good to be back :)

¡hasta pronto!

The Undergraduate in the Room: on Ophelia Dahl & Ken Himmelman’s Visit to Chiapas

IMG_5163Members of the Compañeros En Salud team walk back after a patient visit in the community of Soledad

Ken said something that day that struck me, “It’s interesting, but I’ve found that students only know what they really majored in when they look back on their experience in college.” 

Looking at the delicious bowl of deep brown mole and the seemingly bottomless pile of tortillas before me, I mulled over his words. After visiting a patient with a local community health worker, we had just broken for lunch in Soledad, a gem of a community tucked in the cradle of the Sierra Madre Mountains of Chiapas. Ken Himmelman, the Chief Program Officer for Partners in Health (PIH), and Ophelia Dahl, co-founder and Executive Director of PIH, were both visiting one of the Compañeros En Salud (CES) clinics here. Though I had spoken with Ophelia before on her visits to Harvard, I had never met Ken. Like me, he was someone who had recently been very much immersed in the undergraduate world in his former job as Dean of Admissions and Financial Aid at Bennington College and had since translated those experiences into his passion for healthcare delivery. As the only undergraduate in the room, his words resonated particularly with me.

IMG_5159A Compañeros En Salud community health worker listens and provides advice as a patient describes the localized pain she is feeling

“A ver.”  Let’s see, says the doctor. I have heard this phrase many times during my time in Chiapas, and it’s the phrase that came to mind as I thought back on my experiences as a Harvard undergraduate who is participating in the inaugural Global Health Equity Option (GHEO) Scholars program as a student, researcher, and volunteer with CES. As we talked over lunch, Ken pushed me to think about what this experience might mean for my future and asked me how I hoped it would impact my education and career after graduation. Having been surrounded by doctors for most of my time here, I’ll admit that the fact that I am not yet trained in the delivery of clinical services came to mind as something that has been particularly salient.

Let me explain.

In working with PIH’s sister organization for the past month, I have come to realize just how grateful I am for my inexperience. After all, this is what has granted me the greatest opportunity to learn. I am free to experience life in its many rich and diverse forms here–from walking with my host mother to sell milpa (the leaves of the corn plant) around the community, to observing visiting dermatologists interact with local patients, to helping my host brother with his English homework. I have had the opportunity to know and love this community both within and outside the walls of the clinic. This is the freedom of the undergraduate experience, and it exists here just as much as it does in Harvard Yard or at Bennington. As students, we not only have the chance to choose our course of study, but too to shift in and out of various roles since we do not have an obligation to any one.

As an aspiring physician I will one day have an obligation to my patients, but first I would hope to be their friends in the same way that the CES social service year physicians are here. My inexperience has helped me in this regard, too, for it is what has cushioned my falls through every cultural gaffe and left me warmly in the hands of people who are willing to form those relationships with a Sri Lankan-American college student who, as I’ve been told, could also easily be part Mexican. In the course of an average day in the community of Honduras, I will have spent a morning observing consultations with the social service year physician who works in the local clinic, visiting the cafetal (coffee field) with my host father, and playing fútbol with my host sister’s team on an elevated field that is far more beautiful than any I have seen in the United States. These are not just the experiences of an undergraduate, but too of a young woman who desires more than anything to know and love the people who have welcomed her into their lives.

So, I couldn’t answer Ken’s question. Well, at least not fully. In truth, I’m still figuring out my answer, but I could appreciate what he had said about many students only truly understanding what they “majored” in after leaving college and looking back on the way in which their courses and life experiences shaped one another. As part of the GHEO Scholars Program, I am continuing to take my classes via videoconference with my Harvard professors while I spend my days working with PIH and breathing in the air of communities that truly are the small wonders of the Sierra Madre. With one foot in both worlds, being here has taught me about the critical junction where school meets life.

“Give it one more try,” I urged Ophelia as we both stood at the traditional stone hearth with the masa (corn dough) and the nifty silver machine for pressing tortillas before us. This was before lunch, and after making a few tortillas myself, I had asked Ophelia if she wanted to learn how to tortillar. Her first attempt had ended much like my own, crumpled on the hearth as the dough split unceremoniously like a dancer experiencing her first fall. But Ophelia kept her cheery attitude and I reassured her that achieving that seemingly perfect full moon shape is no easy feat for those of us who are new to the Chiapanecan culinary arts.

IMG_4833The traditional masa dough used to make tortillas

“I bet you didn’t think you’d learn how to make tortillas when you went to Harvard!”

I looked up to see Ken smiling broadly as he observed my attempts to teach Ophelia. I laughed as I flipped another tortilla on the hearth. That was certainly true. But then again, I suppose I will only truly know all that I have learned here after my semester abroad with CES is over and I have taken the time to look in the rearview mirror. I realized that this must be what Ophelia and Ken were doing too–in taking the time to visit the projects that began under the auspice of PIH many years ago, they were looking back on what had been achieved in order to learn how things could be made even better in the future. Just like the process of delivering healthcare in some of the most resource-constrained regions of the world, the process of learning as an undergraduate is far more complex and iterative than can be described under the umbrella of one “major” alone. Ken had helped me realize that.

And with that, I took a final softly browned full moon off the hearth and added it to the pile.

It was time to eat.

 
*The postings on this site are my own and don’t necessarily represent PIH’s positions or opinions.

From Brussels to Barcelona: a crazy kind of wonderful

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In what has to be one of my favorite parks: Parc Guell

There aren’t that many words I could aptly use to describe the Harvard World Model United Nations (MUN) team–or perhaps there are too many. As we bid one of our members goodbye at the airport in Barcelona, I could begin to grasp what this week has meant to me. On the one hand, maybe it’s not hard for a group of 20 odd 20-somethings who are traveling to a foreign country and designing an international Model United Nations conference to bond, but on the other, the variety of experiences and back stories each of us individually brought to this year’s World MUN made for an unlikely combination. My teammates between Boston, Brussels, and Barcelona are people whom I would most likely not have met at Harvard otherwise.

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The team at La Sagrada Familia in Barcelona

And sure, I was flabbergasted at times as I heard a mix of languages from French to Dutch to German filling the air around me, or just downright confused as I tried to navigate new streets in a foreign city without the luxury of google maps loading on my wifi-less phone, but at the end of the day, I remembered that it’s all about the people, not the place. The people that I lugged boxes upon boxes of materials into a palace with, the ones that I stayed up all night with before showing up in our committee rooms on time the next morning, the ones I shared the dance floor with, and the ones I joined to cross oceans and policy gaps in the span of one week–these are the people of WorldMUN 2014.

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I wrote in my previous post that I had participated in Model UN in both middle and high school, but even serving on Secretariat during my junior and senior years back then cannot compare to the experience that was this conference. I emerged extremely proud of my delegates in INTERPOL (the International Criminal Police Organization) and the work they did to combat organ trafficking in committee. After all, the students are the reason we run this conference, and as I looked around my committee room and saw the delegate from Pakistan in fervent discussion with the delegate from Spain or the interactions between students from France and Venezuela, I felt blessed to have a smattering of perspectives from around the world represented in our room–they couldn’t have known how much they were teaching me even as I wielded the gavel as their chair.

This was also a week when I wore many hats.

From being team mom when the boys forgot to tie their shoelaces (yes, it still happens) or needed some urging as we left one meeting for another,

To being the waitress as the bewildered staff in Barcelona didn’t know what to do with a crowd of 20 at a tapas restaurant, requiring me to whip out my Spanish and my organizing skills,

To being tour guide as we navigated the streets of one of Spain’s most beautiful cities in order to see La Sagrada Familia and Guadí’s village,

To being the head of INTERPOL as I worked with my assistant chairs from MUN Society Belgium to direct the best committee we could,

To being roommate, sister, friend and more than anything else,

A new and fearless Harvard WorldMUN-er.

WorldMUN is truly an experience unlike any other, and if I could wear that hat again, I would do it in a heartbeat.

And now, with spring break having ended, I’m headed back to Boston with the team before I return to the Sierra Madre and Mexico!

Be part of the story — WorldMUN 2014

Here we go. Mexico –> Boston –> Brussels.

“In Brussels, we ask: why do things simply when you can make them complicated?” Laughs resounded as the opening speaker finished her remarks in the auditorium of the Bozar theatre in Brussels, Belgium. It was true, Brussels is known for its many different tiers and levels of governance over the years, despite it being such a small country. This week, we would be simulating the work of the United Nations right here in a city at the crossroads of Europe–

this was Harvard WorldMUN 2014.

On the one hand, it was very strange to be sitting once again in a very familiar place while being in a wholly foreign country. I first participated in Model United Nations in middle school and continued throughout high school, but it has been a long time since I have sat with my fellow chairs, secretariat, and delegates at the opening ceremony of a conference like this one. And I have certainly never attended one of this size (Harvard World Model United Nations has well over 1,000 participants from around the world). But to back here wearing my old Model UN hat feels incredible. It’s an activity that is easy to fall in love with–not only because of its unique mission of bringing students together to discuss issues of international concern, but too because of its promise of conferences that are part-classroom, part-design space, and full-camaraderie.

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As Herman Van Rompuy, the President of the European Council, stepped up to the podium to give the keynote address, the room fell silent. I couldn’t help but think that Inesha would have loved to be there too, listening to the words of such an important figure in European politics, especially considering the ongoing conflict regarding Crimea. For an American like myself, Van Rompuy’s description of the relationship between different European delegations was one that I hadn’t heard before. He said that “Europe can be derided at times as a Florence Nightingale” in that the continent is not a soft power, but does command soft powers. “We don’t just send nurses and nutritionists…”  he said, highlighting the variety of resources at the Council’s disposal. If negotiation is truly an art form as Van Rompuy believes it to be, then he said that the United Nations is not just a diplomatic body between nations, but too helps to build greater understanding between the people within them.

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A second address was given by Olivier De Schutter, U.N. Special Rapporteur on the Right to Food, who spoke about the Sustainable Development Goals–the next installment that is being discussed as a follow-up to the Millennium Development Goals which expire in 2015. He came to the end of his address to a truly international audience of students, professors, advisers, and esteemed guests at the opening ceremony with this short story:

Imagine that there is a small boy with a bird in his hands. He asks a woman near him: “Is this bird alive or dead?”

If she says “alive,” then he will squeeze the bird and it will die. If she says “dead,” then he will open his hands and set the bird free.

Either way, the woman would be wrong.

So what is the answer to the boy’s query? The woman says to the child: “The answer is in your hands.

Hence the theme of Harvard World Model United Nations 2014:

Be part of the story.

The end of coffee?

I have now returned to the good ol’ USA after spending over one month in Mexico. In many ways it feels surreal to be back on my campus as if no time has passed, though the people, the colors, and certainly the weather has changed since I was last here. One very tangible piece of Chiapas that I have brought back with me, though, is the ever-famous coffee that has been grown for decades by the families of the community that I have been fortunate to call home over these past weeks. As I appreciate the fruits of their labor, I wanted to take a moment to post a reflection on a topic that has come up in many a conversation as the coffee farmers of the Sierra Madre region (and around the world) consider the fate of their crops and their livelihoods in the coming years. I penned the following before leaving my host family’s home in the community of Honduras.

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La roya. It may roll off the tongue, but the ease of this word’s pronunciation belies a far more malignant truth no matter how beautiful the Spanish that is spoken here. I have been studying and working in Chiapas, Mexico for several weeks now, soaking in as much as I can of the breathtaking Sierra Madre mountain range during the core of what is both my junior spring of college and my term as a Global Health in Equity Option (GHEO) Scholar. It is also here in Chiapas, a region famous for its natural resources, that local campesinos are caught in turmoil over the diminishing returns of their state’s many coffee farms.

Moises has first-hand experience with the coffee farms of Chiapas. “Fui un tostador,” (I was a coffee toaster) he began as we sat in a small upstairs room of the Compañeros En Salud (CES) office. He seemed happy to have left that job behind, but memories of the process that it entailed had forever been ingrained within him.

Small-scale farmers and tostadores like Moises primarily produce Arabica coffee, a variety that is particularly well-suited to the high altitudes of the Sierra. But rising global temperatures and fluctuations in rainfall have put productivity levels in peril in recent years. Enter, la roya. This local term for “Coffee Leaf Rust” describes a fungal blight that has wiped out a significant amount of the worldwide coffee crop, adding insult to injury as farmers in Chiapas now doubly face the pressures of decreased output and falling global coffee prices.

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The familiar sight of coffee seeds left out to dry by families in the Sierra Madre

While companies like Starbucks and Green Mountain Coffee have begun taking action to prepare for the effects of diminishing coffee production worldwide, it is not corporate America that I was thinking about as Moises concluded his explanation. “It affects all the communities,” he stated matter-of-factly, glancing towards the shadows now lengthening across the Mexican landscape outside. I thought back to a conversation I had recently had with an American medical resident who had come to work with CES. He had just concluded his first week working at the health clinic in Honduras. During his stay with a host family, he had learned that some of the farmers were trying to enter the aquaculture business by installing Tilapia farms in their backyards. But this was not the typical response–most families have little idea how they will cope when la roya claims the remainder of their coffee crop in one to two years. “¿Quién sabe? No tenemos otro recurso…” (Who knows? We don’t have another resource…) is the most common response I have received when asking my neighbors and friends in Honduras about their plans for the future. As I have come to realize, these doubts and pressures are intrinsic to their daily lived experiences.

I may have come to Chiapas with the perspective of a pre-med student interested in healthcare delivery, but I know too that the economic pressures faced by patients in their daily lives are inextricable from the challenges faced by physicians in the examining room. After all, these pressures often lead to the complications that ultimately force doctors with limited resources to focus on curative rather than preventive medicine. In communities like Honduras, healthcare remains free, but food certainly is not. As I spend my time studying and working in the communities here, the long-term health implications of falling income levels in regions where poverty is already endemic have been unfolding before my eyes. What medical conditions should CES anticipate treating in higher frequency in the coming years as the effects of la roya become even more widespread? Will the healthcare system’s response to conditions like malnutrition seem like a proximate solution to the more fundamental problem of parents’ inability to put food on the table?

The struggle to grapple with the relationship between the fight against poverty and the one for the provision of healthcare is not new.

I can remember my professor, Dr. Paul Farmer, leading the first in-depth discussion I had had on the topic in a Harvard classroom during my sophomore year. Touted as the “father of social medicine,” Farmer is known for his advocacy of a “preferential option for the poor” in healthcare based on the idea that it is the poor who differentially face the consequences of ill health due to their inability to access adequate food, water, and medical services (among others). So, in that case, where to focus our efforts? In his latest book, In the Company of the Poor: Conversations with Dr. Paul Farmer and Fr. Gustavo Gutiérrez, Farmer writes,

where we can intervene through medicine and public health, we have a way of saying, ‘We might not be undoing poverty by making sure we have high-quality medical care, but once we get this specific manifestation of poverty out of our body, that will leave you free to fight on against poverty.

CES’s core mission is to provide high quality medical care to the poor of the Sierra Madre. While I hope that the government and other public sector agencies will help to provide economic relief in response to la roya by making initiatives such as the provision of microloans to farmers a priority, this is not a burden that CES can take on in and of itself. Instead, as Farmer says, the organization demonstrates that the provision of medical care is an inherent part of the fight against poverty.

Confirmación

Obispo. Cuaresma. hortaliza. rezar.

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Waking up to a house full of women is nothing new for me. After all, it’s four to one in my house. As I walked into the kitchen with my jarra (jug) to fill water for a bath, a familiar chorus of good mornings greeted me from various points in the room. Julissa and Doña Lori were at the hearth making tortillas, abuelita was washing dishes, and little Fernanda was being her usual mischevious self :)

Ishani, qué vas a hacer hoy?” (Ishani, what are you going to do today?) That was Julissa’s voice, coming shyly from near her mother’s side. Her dad had told me the night before that it was her big confirmation today at the Catholic Church. There would be people from all over the community and neighboring ones coming for the occasion.

Well…” I drew out my pause just a bit as I filled the jug. “I thought I’d come to your confirmation. It’s your big day, isn’t it?” I said sheepishly.

A broad smile spread over Julissa’s face. “Yes, it is!” she replied. I knew that expression because I had seen it on my own 15-year-old sister’s face a million times. I wouldn’t miss her big day for the world.

***

And there she was, wearing an elegant white dress with sandals to match. She looked beautiful.

Piling into the car, we headed to the church for her confirmation in the nearby community of Buenos Aires just a few minutes away. “I’m nervous,” she whispered to me as we sat crammed in the back of the green truck.

Being a little nervous is a good thing,” I replied. She seemed to think about that for a moment, and then settling into her thoughts, turned her head towards the window and stared at the Sierra passing by.

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