My journey for three months with Project Hope began with two boring days driving to Arizona. After I arrived in Phoenix (the temperature was 105°F) I read the instructions for my trip to India (I thought I had read them several times, but apparently I had only printed them). I discovered that I needed a visa! And antimalarial medicine! I completed my online application for an e-visa and contacted my primary care provider in Ozark who sent a prescription for doxycycline (antimalarial) to Hawaii (my next stop).

With my e-visa approved, but only for 30 days — I could renew it in India (or so I thought) — I left for Honolulu.

I spent five days in Hawaii, and while I was there, I attended church at St. Andrew’s Episcopal Cathedral. I went to the 8 a.m. service which is mainly in Hawaiian. It was a special service remembering Prince Albert’s (son of Queen Emma and King Kamehameha) baptism. Because in 1862 the four year old prince had become an honorary member of a fire fighting company, the Honolulu Fire Department was there in uniform and with a fire truck. Hawaii’s governor and first lady were also at the service as well as black gowned descendants of Hawaiian royalty. The school my three daughters attended while we lived in Hawaii, St. Andrew’s Priory, is on the same property as the cathedral so I took a few pictures for them.

All too soon my time in Hawaii was over, and I was up early for my flight. I had a quick walk around Waikiki to say aloha to Oahu and then went to the airport. I was flying China Eastern Airlines to Shanghai and was the only Caucasian passenger. The seat next to me was empty so I enjoyed good food, my Kindle, and some sleep during my ten-hour flight. I had to get a one day visa just to spend eight hours in the airport. I walked a lot during my layover.

My flight to Delhi was almost all men. After we landed I slept in one of few comfortable chairs in the airport. My Kindle continued to supply me with great reading material and I found some tea and pastries when the food court opened at 4:30 a.m. Although there was an earlier flight directly from Delhi to Vijayawada (my final destination), Expedia had booked me through Hyderabad. That added ten hours to my trip. Hyderabad airport had terrible food but there was diet Coke available. There were many heavily veiled women including one with thick black gloves to coordinate with her total body black covering. I watched with interest as she gave her husband money and apparently told him to go buy some food for the children (which he did). Another stereotype slightly damaged! Airport security was now segregated by sexes with full body pat down for everyone. Other than being a very long trip (over 40 hours from Honolulu) it was not a bad experience. There were at least two meals on each leg of the trip and vegetarian options on all.

My destination was definitely not a tourist attraction. On my last two flights I was asked if I were on the right plane. From Shanghai on, I was the only non-Indian passenger.

Vijayawada airport is tiny. I was supposed to be met on arrival. However, my pick up was 90 minutes late. I was beginning to be concerned – it was getting dark and the airport closed after my Air India plane returned to Hyderabad – when my ride with two nurses and a driver arrived. The hour-long ride to the hospital showed that the most important car accessory in India is the horn. The traffic was crazy. Buses, people, motorcycles, three wheeled motorized carts, bicycles and cars. All was chaos but everyone survived. I was housed in the hospital’s “staff quarters.” My room was basic but clean. I had a private bath and shower. The shower was a bucket and small pitcher but I had hot water.

The next day I learned three important things:

1. The tea was great – just like chai latte.
2. I was wrong about the visa. It could not be extended. I would have to leave the country and reapply for a new visa. That was not an option since any country near India also requires a visa so I would have to leave India for home in 30 days.
3. Although the doctors and nurses were taught in English and the hospital officially used English, actually everything was done in Telugu. Even the people who spoke English reasonably well had difficulty understanding me because my American accented English was very different to the Telugu accented English they heard in school.

Hospital

They wanted to assign volunteers to the area in which they were currently working. However, they had no concept of Case Management – arranging for patient care after hospital discharge — In India that is a family responsibility. In fact, unless it is an emergency, patients are not admitted to the hospital without a family member (or neighbor or someone) to care for them. That care giver goes to the pharmacy to buy the medications and supplies the patient needs, provides meals and in general cares for the patient. Some of the hospital wards are 60 beds with only one or two nurses. Family assistance is required. Often entire families stay at the hospital for the totality of the patient’s stay. There are always people sleeping in the hallways. At night the hallways are crowded with families sleeping.

Nurses rotate through three shifts: 8 am – 2:30 p.m., 2 p.m. – 8:30 p.m. and 8 p.m. – 8:30 a.m. Transportation (or lack of transportation) is the reason for the arrangement of the shifts.

There is no way for nurses to get to or from the hospital at 11 p.m. If it safe to do so, nurses are allowed to sleep during the overnight shift.

The hospital and associated medical and nursing schools were started by Indian doctors originally from that area of India, who had practiced in the United States. The hospital offered a wide range of services including open heart surgeries and renal transplants. Since I had experience in the Post Anesthesia Care Unit (PACU – the recovery room) I was assigned there. One of the highlights was attending a nurses’ conference on Stress Management. At the end of the two day program, a yoga master was introduced. After a brief lecture, he led 250 nurses to a large room where we lay on the floor and “relaxed.”

Church

One of PACU nurses was the wife of a pastor of a Christian church. Vimala asked if I would attend the church and (I thought) she asked if I would pray for them. Of course, I agreed. Later I learned that I had agreed to preach at the Shalem Evangelical Church. I also learned that I should wear white to church. Santhi, the PACU charge nurse, took me shopping for white church clothes and a sari.

That Sunday at the church and I was nervous at the beginning. The congregation was Telugu speaking so everything I said was translated by the pastor. Any Bible verse mentioned was immediately located in their Bibles. The women covered their heads. Men and women sat on opposite sides of the small church. The service was over three hours long and filled with lots of music and enthusiastic singing. Communion in the form of dense bread and a sweet liquid was given to all. Everyone was so gracious and encouraging. It was a wonderful experience.

Hindu Worship

In the room across the hall from me was a doctor from Calcutta who was at the hospital to administer tests to the medical students. He was visiting a temple and asked if I would like to go too. The visit was interesting and very confusing. We had to be barefoot. I received a tap on the head with a silver vase, sweet water and a handful of spicy cooked rice. I later learned that food – often rice and small yellow chick peas – is often associated with Hindu worship. The hospital had a temple across from the main lobby and a small shrine in one of the hallways. I often noticed hospital personnel stopping for a few minutes in front of the shrine. It is common for families to have shrines in their homes. At first I thought I had caught a man just coming out of a shower – he had just a towel wrapped around his waist. Later I learned that Hindu men often pray wearing only a prayer towel.

There is a trinity of gods in the Hindu belief: Shiva the destroyer, Vishnu the preserver and Brahma the creator (The total number of gods in the Hindu pantheon is difficult to pin down, varying from three to 33 million).

I knew September 17 was a holiday for some reason, but I could not understand the reason for the holiday. I learned from Wikipedia that it was Ganesh Chaturthi, the festival of the elephant headed god. A temporary shrine to Ganesh was constructed in the hospital lobby. At first the elephant face was covered in newspaper. The priest / monk/ Hindu altar guild member(!?) uncovered the face, dressed the statue in cloth and flowers, poured a sack of rice at feet of Ganesh, then added more flowers and some fruit. All this took about one hour. People came and watched and prayed at the shrine. Within a day the fruit was gone and flowers had wilted. The statue was supposed to remain in place for 10 days However, after three days the statue was moved with great ceremony. There were fireworks, bands, loud speakers, and much dancing as the statue was moved via tractor to the canal where it was “drowned.” Every small community had its own celebration. It was an amazing cultural experience. I danced, was pelted with pink powder (my hair was still pink on my return to the US), had my hands painted with henna and had a wonderful time.

During the four weeks at the hospital I discovered:

• Banana juice is wonderful!
• There is life without toilet paper.
• Plain yogurt with salt is not my idea of great dessert.
• Putting on a sari is very complex.
• Hawaii is not crowded. India is crowded!
• One issue I had never considered – how to keep monkeys from stealing the food you are preparing for dinner.
• How to drink from a plastic water bottle without my lips touching the bottle (because the bottles are reused multiple times!)
• Both the rules of cricket and the Hindu beliefs are too complicated for an ordinary human to comprehend.
• Many Hindus also pray to Jesus.
• Doxycycline for malaria prevention is hard to take. Every morning I was reminded of morning sickness.
• My laptop allowed me to listen to the St Louis Cardinals games. The 10.5 hour time difference did make catching all the action almost impossible.
• “Had your breakfast?” seems to be a greeting similar to “how are you?” Or perhaps everyone was worried that I was starving.
• In India after a woman gives birth, she gets 84 days paid maternity leave.
• Everyone eats with their hands. Apparently I was incompetent at this task. Someone usually gave me a spoon after a few minutes.
• Transportation is normally by three wheeled motorized cart. There was a bench for three passengers. One trip I took carried 11 passengers. It was crowded! Another method of traveling was by motorcycle. I rode as the fourth rider on one. Not necessarily safe but fun.
• As India is a former member of the British Commonwealth, residents refer to nurses as “sisters”, elevators as “lifts” and lab coats as “aprons”. I was “madame” and the nurses stood up when I came into the room.
• The only person I saw during my days in Mangalagiri who was lighter skinned than me was an albino Indian man. I got used to stares everywhere I went.
• I nearly caused a riot in a girls’ orphanage when I brought out bottles of bubbles for the girls.
• This is a middle-class home (wife is a nurse, husband an accountant): a two room apartment – one bedroom with a double bed for the couple, nine year old daughter and six year old son, squat toilet, no hot water, no oven, no refrigerator, dishes and clothes were washed outside, a motorcycle, and lots of beautiful saris.

Soon it was 22 September, my last full day in the hospital. Time had gone by so fast. I really was not ready to leave but I had to.

During my brief stay my work accomplishments were:

• I observed both the PACU (Post Anesthesia Care Unit) and the step-down Post-Op ward. For each unit I wrote up my findings and submitted them to the hospital administration.
• I participated in an EKG class taught by the hospital nursing educator. Later I developed student worksheets for identifying various cardiac rhythms.
• I created information papers on the ACLS (Advanced Cardiac Life Support) medications.

These papers will be used as the hospital develops an ACLS certification class for the ICU and PACU nurses.

In the afternoon the PACU nurses dressed me in my sari. I had absolutely no idea how to do it myself. The nurses were really amazed at that I had no experience with a sari.

Dressed like, but not looking like a native resident of India, I made the rounds to say goodbye to the hospital executives. PACU had a party for me complete with a gift of a replica of a Hindu temple and a cake. Apologies were made because my name was spelled wrong on the cake but no one noticed that the cake read “Happy birthday July”. It was the first real dessert I had tasted in over four weeks, and it was very good.

Next I went to a gathering of the head nurses of the hospital who had prepared a farewell gathering for me. There were speeches and refreshments. I was presented with a beautiful cloth (apparently the giving of a cloth is an Indian tradition). One of the comments I heard several times during the good-byes is that it is amazing how long (how old) Americans keep working. Apparently by the time someone in India is my age, he or she spends their days in bed having children and grandchildren wait on them.

I left clothes including my white church outfit which was now permanently pink and Project Hope t-shirts with the staff. I gave the last of my bubbles to a boy waiting somewhat patiently outside the OBGYN ward and presented an 11-year-old girl hospitalized for electrical burns with a small bottle of hand lotion.

Early on 23 September I was packed and ready to go. Santhi (the PACU charge nurse) and her husband accompanied me to Vijayawada airport from which I left for a two-hour flight to Delhi.

At Delhi airport I was met by a tour guide and driver, and was delivered to my five-star hotel. I had gone from Spartan living to the lap of luxury. After a lunch of Thai curry (I needed a change from Indian) I had a brow threading, facial and scheduled a hot stone massage for later. There was a fourth floor outdoor pool that overlooks the city and several trendy looking bars. However, I did have time for some culture. I toured the National Museum. There were lots and lots of statues of Hindu gods. Santhi and her husband had given me a print out of what was essentially “Hindu for Dummies”. I planned to study it and then go over the multiple pictures I took at the museum. Hopefully I would be able to link a picture with a god. I also walked around India Gate, the giant memorial for soldiers killed during World War II. Back at the hotel the doorbell for my hotel room rang! It was a bellman who asked if I wanted the turn down service. I declined. Too much luxury too fast might be harmful.

The 75-minute hot stone massage was awesome. And there was fresh fruit in my room! My supper was two bananas and two apples. I did not try walking or running outside the hotel now that I was in a big city. The traffic was unbelievable, and I was lucky not to get run over because I couldn’t figure out which way to look when crossing a street (they drive on the left). I checked out the television stations. The listing identified programs in English, Hindi, Punjabi, Spanish, French, German, Arabic, Chinese, Korean and … Australian!

The next day I traveled to Agra – home of the Taj Mahal. The trip took almost four hours and was interrupted only by a 45 minute stop with a man shouting and claiming my driver had hit his car. Somehow it was resolved without involving the police and we continued on our way. We passed a restaurant advertising ‘multi-cuisine pesto bar”. I was sorry we couldn’t stop. We passed a fresh meat market – the goats were waiting at the door to be selected for dinner. I was becoming more vegetarian every day.

The trip took me through rural India for the first time. There were grass huts that I think were for storing crops, not for housing, but I could not be sure. I think I glimpsed an even deeper level of poverty than I had seen previously.

Nevertheless, I proceeded on to my next five-star hotel where one of the many services offered was “astrologer available on request.” Compared to the Western tourists I saw, I was dressed like a very poor country relative or a missionary. I had no other clothes except those I wore in Mangalagiri which is much more restrictive in acceptable fashion than are the cities of Delhi and Agra.

I visited the Taj Mahal. As expected, it was awesome. A few facts:

• It was built in the seventeenth century by Shah Jahan as a tomb for his favorite wife who died at age 39 after her fourteenth pregnancy.
• He had planned a matching black Taj Mahal for his tomb but that did not happen because the Shah was jailed by his son during the last eight years of his life.
• The scripts on the front of the building are chapters from the Koran. They are not painted but are made of precious stones.
• The exterior is cleaned with layers of Pakistani mud which is rinsed with distilled water.
• The entire building is an amazing work of symmetry and detail – all completed without the aid of a computer.
• One of the most popular places to have a picture taken is at the “Lady Di” bench, the location where Princess Diana sat and viewed the Taj Mahal when she visited.

One of the newest attractions I visited was the Swaminarayan Akshardham, a ten year old temple which includes boat rides, movie theaters and displays promoting a vegetarian diet. The focus was an 11 foot high gold covered statue of the holy man Swaminarayan. Also on the 100 acre campus (because of the importance of the elephant in Hindu culture and India’s history) are carvings of 148 life sized elephants. Even though I injured several toes walking into recessed lighting (you have to be barefoot in a temple) it was a great experience.

I finished my time in India with visits to the Red Fort and Agra Fort, both planned by Shah Jahan who designed the Taj Mahal. I also visited a carpet factory and, of course, bought a knotted wool carpet. Hopefully it will go well with the silk carpet I bought in China. I rode in a bicycle rickshaw through the streets of Old Delhi (it was terrifying – so crowded!) and visited the site of Gandhi’s death – he was killed by a fellow Hindu who disagreed with his policy of allowing Muslims to live in India.

I spent my final hours packing and repacking and leaving clothes in my hotel room (hoping that someone could use them and that I would be under the 50 pound weight limit on luggage). At last I was ready for my 15-hour flight from Delhi to Newark, NJ then on to Phoenix and finally a 1,300 mile drive back to Missouri.

I was not certain what my next adventure would be, but I did know that my first priority at home would be to do something about my fluorescent pink-orange hair. Even though it was a reminder of a great time in India, it just wasn’t my style.

This article was originally published as a series of posts on Julia’s personal Facebook account.

Julia Taylor attends Christ Episcopal Church, Springfield, Missouri