Uncivil Hospital

John, Anjali and I take a relaxed late night walk back to Jayesh-bhai's after treating ourselves to orange ice candy (Indian English for popsicle) near Subhash bridge. Halfway home we stop to sit street side on an impressively-sized gas pipe section on either side of which slum folk are prepping for bed on plastic sheets and blankets spread out on the dirt. Anjali strikes up a lively conversation with an older woman while a collection of scooter and motorcycle drivers buzz in from the road to cluster around the odd assemblage. Thirty yards distant, from the shadowed depths of the street side encampment, a man motions feverishly for me to approach. I have become accustomed to ignoring such invitations as nuisance quiz sessions as to country of origin, good name, father's name and so on. I pretend not to have seen the man and look blankly to the opposite side of Ring Road where sundry wallahs are still peddling tea, tobacco packs and sugarcane juice from their carts. As I swing my head back to where Anjali's dialog remains the center of attention I catch sight of the man crab-walking his way toward me heavily favoring one leg. He cradles a wood crutch in the depression formed between thighs and torso. Now there can be no disguising that I have seen him. He takes a breather to motion me hither once more and I notice for the first time that he has a bloody shirt wrapped about the right thigh of the leg not in use. Holding my attention he starts to peel back the shirt to reveal a large ruddy area where the skin is missing. I frantically motion for him to keep the makeshift bandage in place and turn to John and Anjali.

"Hey you guys, I think this guy's hurt real badly. We're probably going to have to take him to a hospital." Anjali and John look to where the man is still eagerly displaying the top portion of what appears to be a massive wound. A quick discussion ensues. I offer to take the man to the hospital myself, but Anjali points out there will almost certainly be language barriers and offers to come along. We all are carrying multiple bags. The three of us, our baggage and the man are unlikely to fit into a single rickshaw--certainly not without risking further damage to his leg. Securing two rickshaws seems out of the question at this hour, so we determine we should hurry to Jayesh-bhai's, drop our belongings off before the house is locked for the evening, and then return to hunt for a rickshaw. Our plan is shared with the man who has made it streetside and Anjali asks that he stay put until we come back.

Parvati, Jayesh-bhai's adoptive eighteen year old, is watching one the many overly dramatic Indian serials when we arrive. Countless reaction shots heavy with see-saw zooming effects are utilized to heighten the impact of stiffly-delivered soap dialog. We brief Parvati on the mission, but she politely declines our invitation to come along and instead assists in filling water bottles and stashing luggage before we head back out.

Murti's Law: Exhaust spewing rickshaws will hound your every step when you want to walk and are no where to be found when you need a ride. Back on the main road we try to hail a rickshaw on the emptying streets, but are spurned by the few that speed to unknown destinations fat with fares. We head up the road to where a lonely rickshaw sits decommissioned for the night. The driver is prodded from his nearby cot and we make our pitch for conveyance. He is receptive until he sees the bandaged leg of our companion and then explains that the rickshaw cannot be used for injured persons and only an ambulance will do. You know you're in for a long night when you are jilted by a rickshaw-wala with an empty vehicle. When we finally succeed in hailing a rickshaw on the road we decide on a new tact and obscure our companion from the driver's view. Anjali asks for the nearest hospital and the driver assures her that he knows the way. John sits up front with the driver and I, then our injured friend and finally Anjali carefully stuff in the back taking care not to make contact with the injured leg. No sooner than we start out and Kishan makes an odd sound, scrunches his body and I feel something wet hit my exposed leg. When I look over to him he is adjusting the bandage and grinning broadly. Anjali looks over to me smiling. "What was that?" I shake my head side to side, resigned to having been exposed to unknown fluid number 101. Chalk it up to just one of the occupational hazards of being a "do-gooder."

After several left turns that complete the sides of a square it becomes apparent our driver is lost despite his good-natured assertions to the contrary. He slows the rickshaw to a crawl and asks for directions from pedestrians who give conflicting instructions. Eventually I spot the sign of the hospital in the distance and point it out to the riskshaw-wala who is relieved to be drop the pretense of navigational expertise. A squadron of police loiter about their jeeps at the hospital's entrance and one steps forward to ask Anjali what our business is at the institution. From the way the police are settled it appears they have been there for hours--a couple sleep in the back of one jeep with their legs crossed and resting on the front seat. We show Ashok's injury and they begin peppering him with questions which reveal the injury is over a year old. The policemen tell us they can't be involved with his case because of the time lapse. "This is a private hospital," a round-faced officer with thick moustache says, "Who is going to pay for the work on his leg?" When I indicate my willingness he says the hospital will only try to take advantage of us and charge far beyond whatever the work costs. He recommends, in a way that suggest we have no choice, that we head to the public hospital across the river.

When it becomes clear the police will not avail their vehicle for the new destination we pack ourselves into the rickshaw once more and have directions explicitly communicated to the driver before heading out. The streets are almost completely empty now and are rickshaw is embarrasingly loud in the unusually serene context--a lonely survivor of a post-apacalyptic Ahmedabad sputtering through uncharacteristically fresh air. I sing a filmy song along with the radio and put my arm around Kishan who harmonizes and momentarily becomes downright giddy. Anjali leans over and tells me she thinks our hospital-bound friend is quite toasted. We buzz past walls replete with Victoria underwear advertisements that look like they haven't been updated since independence. The color scheme and implementation give the appearance of a mammoth, laterally-oriented Warhol installation. These stand in stark contrast to saucily bold billboards hawking Extreme briefs with a nearly naked couple engaged in foreplay. The "x" in "extreme" serves double duty heading the vertically oriented "x-rated." Once we cross the Sabarmati a couple of bhangi (sweepers) are the only signs of life before we arrive at the campus of Civil Hospital Ahmedabad.

A couple of plumpish guards armed with rifles man the door to the emergency ward and peruse our party of four with obvious bemusement. In retrospect, it would have behooved us had the guards denied us entry to the hospital at this point. Inside my eyes are immediately drawn to what appears to be an unattached thumb complete with bloody entrails just in front of the operating room doors. Closer inspection reveals that it is a blood stained wrap of a digit that is no more in residence but has left a gauze littered pool in its wake. Three yards beyond a dog lies dead tired or just plain dead. To the right we are beckoned to a caged reception area by three inmates manning a single dirt-stained PC. While one questions Kishan from a reclined plastic yard chair, another sits atop the counter and enters the necessary bureaucratic bunk with handless stubs. We are asked to pay a fifty rupee entrance fee and it is impossible to tell if it is a legit fee or simply the cost of having the trio direct us to the next destination. We are waved up the hallway around a corner to where a girl is screaming uncontrollably on top a hard metal gurney that could pass as a realistic prop in a 19th century period piece. Her family wheels her up the hallway with no staff in attendance as far as I can tell. I desperately want to offer her some comfort, but am afraid the appearance of a white person may only increase her anxiety. We wait in front of a desk as two frowning staffers decide where to send Kishan. Finally it is determined we should go to the other side of the hospital and a wheelchair with three working wheels is produced for our use. For it to function at all it has to be held in a perpetual wheelie--no problem as this is my natural inclination when pushing a wheelchair anyway. The wheelchair, like the gurney, is made entirely of metal with no cushioning for butt, back or arms. It appears to have been painted read at one time and soldering repairs are visible at the joints. We squeak past sleeping patients to either side that are stretched out on sheets or simply the floor itself. Carefully we negotiate the chair over bumps and down an unlit corridor which leads to a littered outdoor passage and finally to our ward.

Three soiled and blood-stained cots are lined up outside the x-ray room. A turbaned man contorts his body in pain on the middle bed while a disinterested staffer stares blankly at his clipboard. With our appearance a crowd of security personnel, doctors and miscellaneous staff quickly forms around us and we fill them in on Kishan's status. The doctors only half listen to our briefing before leveling a barrage of questions Kishan's way. The questioning turns into lecturing, taunting and then spiteful attacks during which time no effort is made to look at the wound or offer any succor. I step in to ask the main doc if we should take Kishan somewhere else. The question is successful in interrupting the inquisition and the doctor informs us that x-rays will need to be taken before anything else can be done.

"Don't you want to see the wound first?" I say, "I don't think there are any broken bones. He just has a large amount of missing skin." The doctor says that it is standard operating procedure for everyone coming on the ward to have x-rays taken before being examined. I try again, "Can't you take just a quick look at his leg before x-raying?" I am assured that this is not possible. "The x-ray will show everything," the doctor assures me, "Then we can decide what needs to be done."

The doctor is a thin man in his late forties and wears a dress shirt, tie and pants, but no white overcoat as if he is off duty. Like so many Amhedabadis in positions of authority he maintains a well-groomed moustache. Something about his manner strongly suggests he is an actor playing the role of a doctor rather than an actual physician. The hospital itself has the appearance of a low-budget set designed for afternoon soaps that hasn't been cleaned during the off season. Over the course of the night I find myself waiting for the doctor to turn to me and deliver the hackneyed, "I am not a doctor, I just play one on television." Even the staff mills about waiting for an unseen director to call them into action before tending with intensity to any of the moaning wounded.

I pull Anjali aside while we wait for the x-ray room to become available. "Why were they giving Kishan the ninth degree? It's like they don't even care about his injury."

"I know. One of the guys that was grilling him evidently is an ex-policeman who recognized Kishan because he busted him for drinking about a year ago," Anjali explains, "He could tell that Kishan is drunk and evidently no one who is intoxicated is allowed in the hospital. He was threatening to bust him."

The x-ray room is the cover of a retro sci-fi pulp in three dimensions--all that's missing is the catchy teaser, "X-Rayed Into Submission." Kishan is made to leave his crude wooden crutch outside the room and crab walk over to the table for his x-ray. The machine's operator is concerned the crutch may contain some hidden metal. Too many Ian Fleming novels or errant radiative doses have evidently taken their toll. While we wait for the film to be processed John decides he should have his long troublesome shoulder x-rayed and heads back to the main counter to register as a patient. Kishan's alcohol-induced positivity is beginning to wear off and he shows signs of wanting to bolt. Anjali explains the importance of sticking around to have his leg examined and reminds him that it was he who approached us for help; if he takes off now it would all be for naught. An hour passes before a technician appears bearing the x-ray film. He sticks the plates onto a wall mounted light box and studies them briefly before announcing, "There are no broken bones here." His tone suggests that he is suspicious that someone has played a trick on him.

"We didn't think there were any broken bones. Our friend could have told you that himself. He has a massive surface wound that needs to be tended to," I offer unapologetically.

The technician returns to studying the plates. "There is some trauma to the surface here," he says pointing to a slightly darker patch along the border of the thigh. "We will have to take a look at his leg." The original plain-clothes doc is called back to offer his assessment. He wastes no time in confirming the technicians diagnosis. "We will need to have a look at the leg. There seems to be some disruption to the skin layer." Thank heaven for x-rays.

The doctor and two nurses assume positions around Kishan's cot and he is asked to remove the shirt that is serving as a bandage. I stand bedside transfixed by the unveiling. I need to see clearly now the affliction that set the night into motion from the forgotten recesses of a street side slum. The wound is massive. Essentially the entire outside portion of his right thigh has no skin whatsoever. The leg is cocked permanently at an obtuse angle due to the scarring of tissue near the knee joint. The two orange ice candies are starting a slow tango in my stomach and I have a brief sensation of the room simultaneously constricting and becoming remote. I am still staring at the vast expanse of exposed inner leg anatomy. I decide to sit behind the growing crowd of gawkers against an anonymous wall. Feeling somewhat better I return to find the doctor instructing the nurse to wrap gauze around Kishan's thigh. The gauze is set on the soiled sheet to be cut. Kishan's thigh hasn't been drained, disinfected, dried or even dabbed. The gauze is simply used to take the place of the shirt. I am too dumbfounded and woozy to protest. The doctor hypothesizes to Anjali that it is only due to the perpetually high concentration of alcohol in Kishan's blood that he wasn't dead long ago. "The alcohol in the blood sterilized the wound," he explains, "Medically there can be no other explanation for his surviving like this." If Anjali's face were on the Vegas strip it would be a forty-foot, flashing neon-colored marquee: "NOT BUYING IT!" The doctor continues theorizing in Gujarati unfazed by her obvious skepticism. Later Anjali tells me she thinks that he started making up medical terms to try to keep her convinced of his expertise. The doctor concludes his diagnosis by declaring that Kishan has been brought to the wrong ward and should be returned to emergency. "Why didn't someone tell us that before the x-rays were taken?" I protest.

"He must go to emergency to have this kind of wound treated. He doesn't have any broken bones."

We return in disbelief with our rickety wheelchair to the front entrance where an emergency room doc has just emerged from the operating room. We hand him the previous doc's notes and after a cursory reading he tells Kishan to sit on the floor not five feet from the bloody thumb wrap. He is made to unwrap the wound once more and again a crowd forms to take in the spectacle. The emergency room doc wastes no time in his assessment, scribbling notes while he talks. "He will be needing plastic surgery and you need to take him back to the ward you brought him from." Before we can ask any questions the doctor retreats back through the swinging operating room doors while a staffer re-wraps Kishan's leg with the same gauze which was lying on the visibly dirt-covered floor where the dog lay earlier.

The first doc strikes a decidedly exculpatory tenor when we return. It is evident he overheard my comments on the lack of cleanliness in the hospital during our first visit to his ward. He puts his arm around my shoulder after Kishan is re-deposited on a cot and tells me I should bring a film crew to the hospital to document the filth. "It is not sanitary here. How can anyone get well in such conditions? Everyone should know about that this is the state of their public hospital. You should come back here and show the people how to clean." The doctor reviews the ER doc's notes and informs us that Kishan must stay in the hospital for at least one week. Kishan wants to leave now. Clearly the thought of weathering the taunts of the hospital staff and going without the comforts of his wife and alcohol is not sitting well with him. John reappears proudly wielding the freshly-developed x-rays of his shoulder. After getting Kishan's promise that he won't take off without us, Anjali and I go with John to have the x-rays read by a specialist deep within the bowels of the tentacled building. "These indicate there is absolutely nothing wrong," the x-ray analyst announces much to John's disappointment, "Everything is in order." I propose a bright spot on one sheet might be a long forgotten bullet to no one's amusement.

Back on the ward Kishan has become insistent that we take him home. Whatever high he had enjoyed from imbibing illegal hootch is now completely gone. His brow is permanently furrowed and he's unresponsive when asked what he will do about his leg if it's not treated now. Eventually we strike a deal: he will see Jayesh-bhai's doctor the following morning if we take him home to spend the night. One last stroll with the wheelchair cocked at an thirty degree angle past families sleeping in the hallway, past a dog that has usurped the former's spot, past the unmolested bloody thumb wrap and finally into the relative cool of the night air. A rickshaw driver is unceremoniously roused from limousine dreams to port us back to our homes.

At Jayesh-bhai's Parvati, incredibly, has waited up for us and listens raptly as we relate our latest adventure. On the television a doctor emerges from the operating room to pronounce the dire status of an injured patient and the camera throbs on the slack-jawed disbelief of each family member in turn.

Stopping by Tekra on a Sweaty Evening

I am thinking the woman has leprosy, but never having seen anyone with leprosy before, am not sure. She wears a black scarf and Ray Charles-style sunglasses and peers about aimlessly while sitting with her back against the wall at Manav Sadna. The teenage girl sitting next to her smiles amusedly at my antics with the young regulars to the school, but resists my invitations for her to join in the fun. She whispers in the ear of the woman with the badly disfigured face, causing her to nod either in understanding or agreement.

I try to remember the scene in Papillon with the lepers living in the South American swamps outside the prison. Is leprosy contagious? Didn't I read something about leprosy not being contagious? If it isn't contagious why are there still leper colonies? I can't think of any other disease where people are given primary identification (i.e. leper) courtesy of the afflication. I believe it was in a documentary I saw that lepers lose digits not as a direct result of the disease, but rather due of the loss of sensation in extremities which made it possible for rats to chew off fingers and toes. Remind me to look that up on the internet later.

I kneel next to the girl (taking care to approach from the far side of the woman) and ask in broken Hindi if she needs anything. Both her and the woman respond simultaneously and I am unable to decipher any familiar words. I indicate with an elaborate series of arm and hand gesticulations that I will get someone to act as translator and then return. After getting promises from several potential translators that never pan out, I grab Jagat-bhai and pull him in front of the pair. The girl smiles and talks freely with Jagat-bhai who has a knack of putting people at ease.

Meena and Anandi, her older sister, haven't eaten for several days. Anandi's two children are at home and also hungry. I study Anandi's face more closely. Her forehead is glistening and smooth. Her nose is similarly shiny, with only vestigial nostrils. Her lips are permanently peeled back from her teeth, stuck in an endless grimace. What I took to be the toll of leprosy, it turns out, is the result of an acid attack by her husband some four years ago. The acid burned Anandi's eyes from their sockets leaving her in the care of Meena, who was compelled to drop out of school as a result. Primary care for the children, evidently, also fell to Meena.

I ask Jagat-bhai what Meena and Anandi have come to Manav Sadna for and if I can help them in any way. He says they are simply hungry and hoping for a little food. I relate their woeful tale to Parol and, after some time, she arranges for a plate of rice and broth for the two to share. When the food arrives it has been nearly an hour and a half since I first noticed them. I am frustrated at the amount of time it has taken to address their simple request. After they are finished eating I take their plate to wash it in the dish pit behind the ashram. The floor leading to the dish pit is red hot and burns the bottoms of my feet. I goose step on toe tips to a precarious balance in a small patch of shade near the spigot. Images of the acid attack keep playing themselves out in my mind as the water timpanis off the brilliantly shining metal ware. Below me, the Sabarmati river stretches barren to the south and north, save for a handful of silty water patches that refuse to evaporate even under the intense scrutiny of the mid-afternoon sun. I find my eyes welling with tears time and time again.

I offer to take the sisters grocery shopping, but am told that it would be better to provide them with some basic supplies from the Manav Sadna kitchen. An hour passes in chasing down kitchen staff, phone consultations and serial miscommunication. The entire time the sisters remain virtually motionless and without complaint. The girl returns my apologetic entreaties for them to wait just a bit more with a simple reassuring smile. Odd that I should be the one in need of comfort--and patience. Only after another hour elapses am I able to secure a bag of rice and some cooking oil for the unflappable pair. Arrangements are made to meet them in the evening at Manav Sadna's project in the Tekra and then visit their home.

Rampur no Tekra is Gujarat's largest slum, occupying the rolling stretch of land across the road from Gandhi Ashram and Manav Sadna. To get there you must cross a serene, sparsely-treed ravine, roughly divided in two equal parts by a fast flowing creek. From a distance the area appears to be an attractive respite to the crowded areas to either side, but a simple inspiration betrays an almost overwhelming stench of human excrement. The creek, it turns out, is composed entirely of raw sewage flowing furiously from the Tekra. Wild pig families grunt and wiggle in barely-contained delight literally up (and down) shit creek. Across a wood-plank bridge and up a slight dusty rise more than one hundred thousand people live in a claustrophobic collection of simple dwellings and shanties. Each residence generally shares walls with neighbors on three sides and entryways face out on a labyrinth of impossibly narrow, tiled passages that invite the outsider to get utterly lost. It is a world onto itself, fashioned from mud, brick, mortar and corrogated metal.

I arrive in the Tekra just before five and follow a stream of children headed to the project for the night's special meal. The grounds at the project are completely covered with young children patiently awaiting the dinner which is being served by Manav Sadna staff members. Nearly five hundred slum kids are organized into rows, shoulder-to-shoulder and cross-legged. I am beckoned into the office and a short while later Meena enters leading her sister by the hand. Two children cautiously follow and are introduced as Anandi's children. Dipika is bright and smiling while Ulkesh seeks the shelter of Meena's kameez and self-consiously avoids eye contact. He occupies himself with a small plastic train engine. A pancake-sized patch of his skull is shiny and hairless, the misfortunate result of being next to his mother at the time of the acid attack.

Viren-bhai, the co-founder of Manav Sadna, is the next to arrive and is introduced to the family. As the family relates their story once more, it is difficult not to be swept away by waves of emotion. At one point I ask Meena what her favorite game is and she looks at me with obvious confusion. Through Viren-bhai she explains that she is tending to her sister and her family around the clock and has time for nothing else. She must lead her sister by the hand whenever she wants to go out or visit the toilet. When I look at Meena with transparent pity, she breaks out the comforting smile again. Hang in there big guy.

After the meal, Dipika insists on collecting my plate for washing and Meena smiles her approval, while carrying her own plate and Anandi's. We head for their home following a serpentine route that squeezes my modest backpack at several narrow constrictions. The Tekra is a population density chart's exponentially-exploded extreme come to life in three dimensions and myriad pungent smells. On the far side of the slum we arrive at the familiy's home which is really a doorless 6x8 room carelessly appended to the vast sprawl behind it. Just outside, a smallish temple bearing an uncanny resemblance to a pair of red tipped breasts thrusts itself boldly skyward--an easy to remember landmark. The family's worldly possessions are few: a pile of bedding in one corner, a couple of dilapidated trunks opposite and a simple shrine in the recess of the outside wall. Light pokes in here and there between gaps in the mortar. A curious crowd grows just outside the door and eventually pushes inside making for standing room only, then squeezing room only. Viren-bhai makes note of basic cooking implements that the family should possess and then suggests we make a hasty exit before the family is too inconvenienced by the burgeoning mass of onlookers.

A couple of days later I call Viren-bhai to find out if the supplies for the family are ready yet. He says everything is in place although he would still like to take me up on my offer to buy some more substantial items. "A little something happened at the prayer meeting the morning," he begins in a tone that makes me instantly uneasy. "The lady confessed that she lied about how many children are in her care."

"Oh, really?"

"No, it's nothing bad. It was a good thing for everyone. She became very emotional during the bhajan and afterward she said she didn't want anything from us. She was so appreciative of everything we had done, but her neighbors had counciled her to lie about how many children she had and she had listened to them. Now she didn't want anything more bad to happen after all that has happened to her, so she just wanted the truth to be told."

"So how many children are there? Is Meena really her sister?"

"Yeah, yeah. She just had said there were three kids when really there are only two staying with her."

"Including Meena?"

"No, three if you count her. Actually I don't know. There is a child or two with the father also. Evidently Jagat-bhai knows the father from a long time back, because he stole his motorcycle and the police were looking for him."

I am thoroughly confused now which is the norm for my stay in India. Viren-bhai asks me to come over around noon so the supplies can be transported to the family's house (or should I say room? or room-house, as in city-state?) and we can finish shopping for the remaining items.

I scooter over baking asphalt to Manav Sadna and find the exuberant Meena sitting behind the main building hard at work. She, along with four or five other slum children, are making paper bags from old newspapers. Dipika sits nearby playing with scraps of paper and the tools that aren't in use. Meena takes seven bags that have been crisply folded and glued and then uses a cardboard template to mark four hole positions along the top edge. She lines a metal punch over the marks and hammers it sharply to cut through the multiple layers of paper. Brass-colored hole reinforcements (my terminology) are then inserted and given a whack to flatten into place. Lastly the pile of bags is taken in front of the building where two lengths of cord are knotted in the holes on each side to form attractive handles. She will get an extremely modest income from the morning's work, but her sense of pride is palpable.

Meena takes me to sit with Anandi who is resting inside under the fans. She is happy to hear my voice and chuckles when Meena explains once more what a character I am. The three of us share lunch from the same plate and Meena gives me pointers as to the finer aspects of dining by hand--work the subji (vegetables) into the rice until a modest ball is formed and then back thumb it into your mouth. Meena is too excited to sit for long knowing that an expedition to their house is in the offing and ducks out after only a few mouthfuls to rinse her hands.

After lunch two burlap bags of donated cooking supplies are loaded into a Sumo along with the family and five others from Manav Sadna. At our first stop a couple of large steel cylindrical containers for grain are purchased after Viren-bhai haggles the price down. Immediately after the purchase the shopkeeper engraves the largest of the drums with the family's name using a fine electric drill as a stylus. The next store over we get sugar and some cooking spices. Meena is all smiles when we clamber back in the Sumo and head for the Tekra. Anandi confirms that none of them have travelled in a personal vehicle before--just rickshaws and buses. By the time we disembark from the Sumo, unload all of the supplies and make our way to the families house, a good sized audience has formed. When four or five of us enter their room, along with the family, a few strangers and the booty, it begins to resemble a college phone-booth stuffing stunt with arms, heads and legs hopelessly intertwined. With lots of shuffling and rotating in place we manage to conduct a little prayer in front of the shrine after Meena ceremoniously lights some incense.

Almost a week passes before John and I are able to make time to visit the Tekra again. We hop into a rickshaw just before nine and request Gandhi Ashram as the destination. Experience has shown that asking for the Tekra causes too much confusion. It's as if the template for "Tekra" simply does not exist in the Rickshaw-wala's mind if the passengers are not Indian. The pronunciation can be dead on, but the driver simply won't understand. Why would a white person want to go to the mammoth slum? Just prior to the ashram we indicate for the driver to take the side road leading to the Tekra. He is dumbfounded and tries, even then, to change to yet another road that has the potential to lead to more comfortable environs, but we manage to re-direct him once more to the Tekra.

Darkness has largely fallen by the time we reach Meena and Anandi's home which makes it a little easier for us to travel in semi-anonymity. Even so, by the time we are seated on the cot outside their room nearly twenty strangers have followed to see what's going on. Mahesh, a local in his early twenties, takes on the role of constable managing the crowd and noise level and seems to have earned the respect of the Tekrites. Meena is ecstatic to see us and shakes her palm skyward and holds her head at an angle as if to ask, "Where you been?" Anandi feels about for my hand and I have her take first my wrist and then John's, which sports a bracelet, so she can recognize us by way of a finger-extended hand shake. Anandi's grandmother sits up from her resting position on the cot in front of the home and instructs us to sit.

Lakshmi, a teenaged girl I met on my first visit to the Tekra some seven weeks earlier, appears and I am reminded of my promise to purchase her a pair of sandals. Awkwardly tall, she stands head and shoulders above the other children and sports a perpetual smile on her attractively pimpled, dimpled and freckled face. When I offer to take her shopping the following day a slew of other kids request to be treated to footwear as well. Whereas Lakshmi is quiet (in fact I never hear her speak at all) the other children jostle and elbow for a chance at the potential freebie. It is a vivid illustration of the ongoing tension that permeates every transaction with the materially impoverished. If you give something to one person then a crush of people demanding similar consideration will appear out of nowhere. Even in the absence of a crowd, a number of arguments have been fashioned that suggest giving of this sort is not in the best interest of either party: if you reward begging than there is a diminished desire to work; if you give unilaterally, and without some deeper connection, the relationship is immediately imbalanced--giver and taker; if you give to one, then you are compelled to give to all; anything given without "earning" will not be truly appreciated. The list goes on, ad infinitum. The rather obvious downside to all of these objections is that they can be conveniently employed to simply enter a state of non-giving, likely a more injurious and less-evolved condition. Involved solutions have been crafted in the developmental sector, but are rendered impractical in situations involving time constraints or simple one-time encounters.

Jayesh-bhai has developed a interesting compromise. When beggars approach he will pat kids on the head, ask names, and then proceed to clip nails and comb hair while lecturing on the importance of personal hygiene, sanitation and resisting the temptation to beg. When he completes administering one of his mini-makeovers, he rewards the child with a "chocolate" (cover-all term for candy) and affectionately sends him on his way. Repeat offenders are invited to Manav Sadna for a meal, play, work or even schooling. Even armed with techniques such as this, it is still possible to find oneself encountering a child braving the blistering streets barefoot and what to do? All the arguments go out the door and you act spontaneously from the heart for better or worse.

(Meanwhile, back in the Tekra) John and I present the watermelon we have brought, which diminishes the hue and cry for sandals, and commission Meena to carve it for those gathered. She becomes pleasantly frustrated as John continues to redistribute the pieces offered to him. Soni, the family's adolescent goat, comes over to investigate the recent arrivals and I greet her with a soft head butt, before stroking her exceptionally long, pied ears and scratching between her horn buds. Meena demonstrates later a fist to the forehead technique that Soni seems to accept if not enjoy.

Meena produces an incredibly effective hand fan that is comprised of a wire-rimmed cloth whirled about a foot-long rod. She expertly whips it into high-gear producing a considerable cooling effect. If you have never been hand-fanned, trust me, it is the stuff of complete indulgence. I'm supposed to be doing the hard-core service thing in the slummiest of slums and instead I am supping on watermelon and reclining on a cot in carefree luxury. Welcome to India. Dipika and others take their turn keeping us cool. Not wanting to be left out of the fun, a game develops whereby John and I trick the fanners out of their prop and enthusiastically redirect the air flow which brings laughter but a seeming inability on their part to fully enjoy being on the receiving end.

John and I are asked where we will spend the night and I point to the ground and reply in Hindi, "Here only," to the dropped-jaw delight of Meena and family. When our intent is confirmed, Meena protests that our staying on the ground level will create too much of a crowd and leave us vulnerable to an onslaught of mosquitos. Despite our counter-protests a spot is prepared on the tailor's roof for us--one of the few concrete roofs in the Tekra. I indicate with a raised pinky that I have to visit the toilet before bedding down and am escorted by a flock of children some hundred yards along the perimeter of the slums to the public facilities which are remarkably clean considering the locality. The front is manned by a trio of cell-phone equipped teenagers who divert me into their office to wash my hands with soap when I have finished in the stall. On the way homeward an old woman motions me over to her cot where she is prone. She props herself up to show me her forearm which features an unnatural angle and a consensus is reached that it has been fractured. With the debacle of my last late night visit to Civil Hospital still fresh in my mind, I promise to see her again the following day .

Old blankets are spread out on the roof and Meena and a few friends gather to play the two hand games I have introduced, including thumb wrestling ("Ek-Do-Tin-Char-I declare a thumb war") and the hand-slapping reaction challenge. Meena presses for some new games, but I am at a loss to recall any and as such underscore a previous mental note--"Learn More Games." I suggest we meditate for five minutes before bed and all present agree. Eyes are shut and legs folded accordingly and a remarkably quiet sit ensues that floats by effortlessly on a rare, supernal breeze. The quietude is all the more remarkable considering a number of the participants are still in single digits years. Ultimately, John, Mahesh and I stay rooftop while the others descend. The night passes mosquito free underneath the few stars powerful enough to penetrate the light pollution of the surrounding city.

In the morning Meena insists on preparing tea before we depart and I am able to communicate that John and I won't have milk--the justification for which is distilled by the laughter inducing, "We love cows." It is gratifying to see her family making full use of the metalware that we gave them, though they continue to use sticks and a few bricks piled in a corner for their stove. Evidently the kerosene-powered burner that was purchased is not being used due to the cost of fuel which cannot be accommodated by their meager budget. A balloon is produced while the chai and sweet pancakes are being prepared and a handful of children join John and I in tapping it back and forth. It is a serene moment that if captured on video would make for an award-winning documentary short. The balloon moves animatedly, influenced by a complex confluence of breezes and rising warm air. When it climbs its way onto the corrugated metal rooftops, Dipika and her friend nimbly ascend ajar doors and brick outcroppings to retrieve it. Early morning stove smoke ambles sweetly down the narrow alley toward us and splits the sun's rays into a hundred and one shafts. The balloon, backlit by the nascent light, dances with the smoke in the passageway producing an overall effect straight from a fantastic children's book.

We returned to the Tekra late in the afternoon zigzagging across its width to the astonished stares and smiles of locals. In the hope of avoiding some of the inevitable germy goo that one accrues with hand shaking, John and I experiment with pointing fingers, ka-pow, ka-pow style followed by a friendly tap on the shoulder. Despite our best efforts some are intent on the Western-style greeting and succeed in grabbing a hand and inquiring by rote, "Hallo, how are you? What is you name?"

We arrive on the west side of the slum and find Meena running errands near her home. We explain our mission and she recruits some children from nearby to help us locate the woman with the fractured forearm. Our haphazard route involves more weaving in and out of alleys, scrunching one way or the other to allow goats, cows and pedestrians passage. Heads are stuck into homes and inquiries are made refining our search until finally we are told curtly by a frazzled mother that the woman in question has left for her sister's and won't be back anytime soon. Next I try to locate Lakshmi intent on fulfilling my promise of purchasing sandals for her without causing a riot in the process. No luck as another unruly crowd forms and I am forced once more to postpone the gift.

Back at Meena's she asks if we will spend the night again and I explain that we will be going to Jayesh-bhai's instead as John is feeling unwell. I invite her family to come along with us. At first Meena is unsure whether I am serious and tilts her head first one way and then the next, waiting for me to crack a smile or reveal that the offer is in jest. "It's only fair. We slept here last night and now we would like your family to spend the night at our place." Meena equivocates but eventually agrees that one day soon they will slumber at Jayesh-bhai's. I make her promise and it is sealed with yet another hand shake. The final order of business is what to do about dinner and Meena insists we stay and I immediately acquiesce. In discussing what to prepare we come to the realization that we share a passion for bindhi masala, so a short trek to the sabzi-wallah is organized and a couple of kilos of the good stuff are procured. Meena and Mahesh collaborate to make a sensational dish and the fan is produced again leading to another pampered evening.

The next time I talk to Jayesh-bhai I express my desire to treat the family to a day of careless frivolity and ask if there is an appropriate venue. He immediately tells me to invite them to spend the night at his house (oops, done that already). But this is another story for another day and I have promises to keep and miles to go before I sleep. Miles to go before I sleep.