by Dave Prager
5. http://economictimes.indiatimes.com/News/News-By-Industry/Cons-Products/Liquor/India-tops-Diageos-growth-markets-in-H2/articleshow/4127158.cms
6. http://www.mg.co.za/article/2006-03-03-battle-for-theworlds-largest-whisky-market-india
6
Health: That Which Didn’t Kill Us
Both the Hindustan Times and the Times of India kept a running tally of how many people were killed each year by Delhi’s Blueline, the rickety private buses that swept up and spat out and ran over commuters in every corner of the city. Despite the noise with which they prowled the streets—one could hear them coming a quartermile away—they still managed to pounce on an astounding number of victims. At least 115 people were killed by Blueline buses in 2008.1
The Blueline’s grim numbers grew entirely out of two economic incentives: first, because each bus was privately owned, the driver’s salary was wholly dependant on how many fares he picked up. And second, because each bus was privately owned, every bus was in direct competition with every other bus on the route. The faster a driver drove, the more competitors he passed, the more passengers he picked up, and the more money he made.
Which is why the last thing a Blueline driver ever wanted to do was come to a stop. Every decision was made with the intent of keeping the bus in motion. He slowed at the bus stop just enough so debarking passengers could jump off, and then picked up speed even while passengers were running alongside the bus, grabbing the iron handholds, and swinging themselves through the door as the conductor screamed at them to hurry. The driver would already have shifted gears by the time the last passenger was dragged inside by his fellow riders; dust would spew at any stragglers running after the bus as he bulldozed back into traffic.
Making the economic incentives worse was the fact that Blueline buses were not typically driven by their owners. Instead, most drivers rented their buses from a small cabal of owners for three or four thousand rupees a day plus the cost of repairs.2 With passengers usually paying less than fifteen rupees a ride, drivers had to pick up a few hundred people before they could even begin to consider buying lunch, much less investing in upkeep. So their brakes squealed, their headlights didn’t work, their tires were balding and patchy, and old vomit stains marred the windowsills where riders couldn’t bear the motion or the heat. (With no air-conditioning, Bluelines were only cool when moving fast enough to generate a breeze.) Some Blueline buses were so poorly maintained that their side panels had rusted through. Because of the economics, the driver had no incentive to tell an owner when maintenance was required, lest the owner make him pay for it; and the owner had no idea when the wheels were about to fall off because he was never out driving it. Preventive maintenance was not in either party’s economic interest.
So the driver barreled down the street with one hand on the wheel and the other triggering the horn (the one part of the bus that was kept in good repair), invoking Ganesh for luck and Lakshmi for money and every other god in the pantheon for keeping families on scooters out of their way. But with an estimated 2,2003 Blueline buses careening across Delhi, it’s no wonder the newspapers seemed to be printing the same article every couple of days: a bus killed a pedestrian, the driver tried to flee, an angry mob beat him, the police impounded the bus, the driver was jailed, and the owner of the bus bore no responsibility. Or perhaps the driver escaped, in which case the mob found its release in setting fire to the bus.
After the Delhi government pledged to replace the Blueline with modern, city-run buses, the newspapers reported that the cartel of “powerful people” who owned the majority of the Blueline buses weren’t going to let the city cut them out of the transit racket quite so easily. Which set the stage for a clash between public interest and private profit, during which time the rupees would keep pouring in, the owners would keep getting their cut, and the newspapers would keep having gruesome subjects to write about.
All of which is to say that we had other threats to worry about in Delhi beyond our fear of being attacked by monkeys.
Monkey attacks, incidentally, were a realistic fear. Nine days before we boarded our plane in New York, Delhi’s deputy mayor was knocked off his terrace and killed while battling a horde of wild rhesus macaques.4 Fortunately, we never saw any monkeys in our neighborhood, although there were plenty in other parts of the city. And while we still worried a bit about an out-of-control bus smashing into our third-story living room—with the Blueline, you never know—it quickly became apparent that our biggest concern would be our health.
This went beyond the inevitable cases of Delhi Belly. Jenny and I got sick far more than we had in the US, and we got sick far less once we moved on to Singapore. It’s possible that our bodies were particularly weak after a lifetime of American pampering, but it’s more likely that Delhi was too extreme an environment for us. The pollution, the dust, the sanitary conditions, the cold, the heat, the exhausting commutes, and the long working hours were more than our immune systems could handle. On completion of our first six months in Delhi, we gathered up all the medicine we’d accumulated in the preceding 180 days for a photo shoot. There were seven half-empty bottles of syrup, eighteen packets of pills, a small number of powder sachets and some mosquito cream—and that was just all the medicine we had left over. Just before we left Delhi for good, we donated three full plastic bags of surplus medicine to the charity hospital our doctor had opened, which was probably funded by all the consultation fees we’d paid him.
Our ailments were usually minor: colds, coughs, sore throats, headaches, stomach problems. But we also endured worse. Drug-resistant bacteria are a growing problem in India, where antibiotics have been both overprescribed (doctors administer them when they’re not needed) and underutilized (patients don’t finish the full course of medication). Those two conditions breed bacteria that laugh in the face of ciprofloxacin and eat amoxicillin for breakfast. One newspaper quoted a study estimating that antibiotics accounted for forty to eighty percent of the drugs prescribed in India, “mostly when not required.”5 One day, when I went to work with a sore throat (it was my own fault—I should have known better than to breathe while standing by the side of the road), one colleague suggested I see my doctor. “I had a hoarse throat,” he told me, “and my doctor advised me antibiotics for my tummy.”
All of which may explain why one infection Jenny suffered was so resistant to oral antibiotics that she ended up requiring three separate cycles of powerful antibiotics that could only be delivered by injection. The poor girl had to go to the emergency room clinic to receive her shots once a day for three sets of five days each. That’s fifteen total injections.
But doctors alone can’t shoulder the blame, because it was extremely easy to get pills without prescription. There were a number of times one of us went to the pharmacy only to realize that we’d left the prescription at home. So we simply told the pharmacist which medication we required, assuring them that we really did have a prescription. Nobody ever questioned us; each time, they happily packed the medication along with their card for future home delivery. The customer is always right, even when the customer is lying to score prescription meds.
This is the exact opposite of the crowded drugstores in New York City, where the customer was the last thing on the employee’s mind, and where we considered ourselves lucky to get a scowl out of the cashier because that meant he’d noticed us at all. In a New York City pharmacy, getting medication was often a day-long ordeal: we’d spend twenty minutes waiting in line to drop off the prescription in the morning, knowing that in five or six hours we’d have to stand in line for another twenty minutes to pick up the pills. Delhi was far more efficient. We’d pass our prescription to the pharmacist, who would return a few minutes later with a week’s worth of antibiotics, painkillers and vitamins all costing around 150 rupees. Even the prescription paper itself was more user-friendly here—it always had at least six different phone numbers for the doctor on it, giving us the comfort that we could always reach him on his
mobile, at his home, at his office, at his other office and, presumably, his two favorite restaurants.
On the off chance that a pharmacy denied our request for prescriptionless medication, we could always just walk to the next one. There were at least four we could choose from in Hauz Khas market. Nearest to our house was one whose red sign read simply “Chemist,” along with some Hindi lettering presumably proclaiming the same. It was a dark cave inside, and the long, narrow counter was the only thing preventing the pill packets that were strewn about its shelves from spilling into the aisle, out of the door and drowning all of Hauz Khas market in a flood of Ranbaxy-stamped foil. Just a few doors down was Religare Wellness, a bright and airy pharmacy chain that employed modern inventory control techniques like labeled containers and alphabetical order. We sometimes felt guilty for patronizing a chain store over locally owned shops like Chemist (and its competitor on the other side of Religare, called “Popular Chemist”); but Chemist and Popular Chemist both had doorways that were narrow and forbidding, front windows so cluttered that no light could enter inside, and countermen who would spend minutes hunting up and down their stores to locate the products we asked for. Religare was more organized and more inviting; and in a country called the “capital of counterfeit drugs,”6 it was also much more reassuring that the pills they handed us in the little brown paper bags weren’t actually candycoated rat droppings.
Once we realized how often we’d be sick, we prepared ourselves for everything. We never traveled outside of Delhi without a bag full of remedies for headaches, stomach aches, diarrhea, constipation, heartburn, coughs, colds, allergies, sunburns, cuts, blisters, dry eyes and more. We needed to plan ahead because we never knew when we’d be unable to find a pharmacy, or when we’d be unsure of what to do with the medicine once we found one. (We learned the latter lesson on the train back from Jaipur, when Jenny drank an ounce of cough medicine that was meant to be dispensed in millilitres. Her ride home was a hallucinatory experience amplified by windowsill cockroaches and 1970s Hindi music played over the train’s loudspeaker that, well, she actually quite enjoyed.)
But despite our preparations, we were still hit by ailments we never anticipated. Like my ear infection, for example, which began as a minor sensitivity to loud noise and conveniently transformed into uncontrollable pain exactly an hour before our plane to Chennai was scheduled to depart. The popping and pressure during the flight was miserable. We landed around 11 p.m. and went straight to one of Chennai’s private hospitals, where the emergency room attendant looked at our luggage, listened to my complaint, and coldly informed me that I was suffering from “jet lag.” Over the next three weeks in south India, my “jet lag” would force us to supplement the Lonely Planet’s suggested itinerary with visits to a second hospital in Chennai, and then other hospitals in Madurai, Kochi and Kovalam.
(Although I must admit that the visit to the doctor in Kovalam was as much to ask about the heat rash I’d developed as it was for my ear pain. We’d been taking cheap local buses all over the south, and the confluence of sweaty skin, vinyl seats, and lack of circulating air were the perfect recipe for heat rash—to say nothing of when the bus would get crowded and my shoulder would be buried six inches deep in the rump of the woman standing in the aisle next to me.)
Our numerous health issues did not go unnoticed by our friends, co-workers and even Ganga, each of whom suggested their own family remedies to supplement our faith in Western medicine. After that so-called single-malt Scotch induced what was diagnosed as “severe food poisoning” (an inadequate label for a stomach that’s acting like an industrial-speed blender), it was suggested that I eat nothing but boiled eggs, mashed potatoes and khichri, a bland rice and lentils dish that was meant to be easy for my hyperactive stomach to digest. My mother would have advised bananas, rice, applesauce and toast, which follows on the same principles: for a stomach conducting its own version of the revolt of 1857, bland is good.
Many of the remedies people recommended transcended our two cultures, like that of gargling salt water for a sore throat. Others came as a surprise to us. One day, when complaining of a backache and dreaming of a massage, Jenny was advised by everyone in her office to simply sit in the sun. That made sense, though she’d never thought of it—after all, heat relaxes muscles—and suddenly Jenny understood why so many old folks in the residential neighborhood where she worked spent their mornings sitting in the sun, reading the newspaper and watching the maids shake out the bed sheets. And while I ignored that one co-worker’s suggestion of antibiotics for my sore throat, Ganga alleviated it by brewing up her recipe for ginger tea: she boiled raw ginger for about twenty minutes, then added a teabag and several spoonfuls of sugar. Suddenly, I could talk again, and Ganga’s remedy has joined chicken soup in our pantheon of homemade cures.
Some of the remedies we were exposed to totally baffled us. When Jenny fainted at the mehndi ceremony for my co-worker Pankaj’s sister—too much heat, not enough food—Pankaj’s father rushed over, whipped off Jenny’s shoes, and began violently rubbing her feet. We were later assured that rubbing one’s feet was supposed to get one’s blood circulating, but that’s not something we practice in the States. So Jenny, finding herself on the floor with everyone standing above her and staring, was as freaked out by the foot rub as she was about fainting.
We attempted to aid our exhausted immune systems by keeping fit. And despite the fact that our blood flowed creamy white with Ganga’s raita, we didn’t gain any more weight in Delhi once we started using the exercise bike we’d bought. (We’d tried the gyms, but they were too expensive, too inconvenient, and had too many macho men in designer tracksuits puffing their chests while staring at Jenny.) I also supplemented the bike with periodic runs in nearby Gulmohar Park. I’d jog down the dirt path, through the grounds of the centuries-old stone mosque just twenty meters from our flat, past the elderly guard who never returned my smile no matter how many times I gave one to him, and then carefully through the Hauz Khas Apartments and into the park. I’d gasp my way for a couple of laps around the park’s perimeter while dodging errant cricket balls, admiring the orchids growing along the path, and waggling my finger at the ten-year-olds sneaking cigarettes near the park’s stone ruins.
If it was evening, the park would be filled with people walking: mothers, fathers, children and aunties all trying to reduce their prosperous midsections one slow lap at a time. Many of my colleagues told me to forget running and to forget the exercise bike because morning or evening walks were the sole key to healthy living. And they weren’t alone. “In my opinion,” wrote Mahatma Gandhi, “a brisk walk in the open is the best form of exercise.” A few laps around the local park, Murali assured me, along with some healthy hawking and spitting, were all he needed to make up for all the cigarettes he smoked every day.
We didn’t take their advice. And the fact that I gained fifteen pounds after we sold the bike tells me that our exercise routine had been effective. However, their advice did benefit us in one unexpected way: it taught us how to get autorickshaw drivers off our backs.
Jenny and I did enjoy walking, but not for exercise. Rather, we liked to sightsee on foot. But every time we’d walk down the street in a tourist area—the sidewalks near Lodhi Gardens, or anywhere around the Red Fort or India Gate—one auto after another would pull up next to us and demand to take us to our destination. Not a single driver would believe us when we told them we were “just walking”; they’d putter slowly along to match our pace, interpreting our refusals as bargaining ploys.
“Where do you want to go?” They’d always ask, leaning out of their autos and patting the passenger seat behind them.
“Nowhere!” we’d reply cheerfully.
“Where are you going? I’ll take you there!”
“That’s OK. We’re just walking,” we’d say, still with a smile.
“Where are you walking? Come with me, very good price.”
“No,” we’d say, our smiles fading. “We just w
ant to walk!”
“Please, I take you!”
“No! For the love of all that is holy, no!”
It was a terrible nuisance. Nothing worked, not even walking against traffic in hopes that they couldn’t sidle along next to us—they’d just park their autos and nag us on foot, or putter alongside us while dodging oncoming cars. We hated getting angry at the drivers, but we’d find ourselves snapping at them the moment they pulled up. It was exactly the kind of loutish tourist behavior we deplore, but there was nothing we could say to them that would communicate our simple desire to walk.
Until we guessed the one phrase that drivers actually took at face value. The words came to us serendipitously one day in Jaipur, where the drivers were even more persistent than in Delhi. “Where do you want to go?” one auto driver after another demanded of us. Our response up until then—“We prefer to walk”—had gotten us nowhere. So this time, I tried something new: “We’re just getting exercise.”
The auto driver grunted knowingly and drove off. And so did every other driver we tried this line on. Thanks to Gandhi, we finally found a way to walk in peace.
My parents were flying back home from their visit to Delhi when the Mumbai terrorists struck. Which was lucky, because if they had opted for their tour company’s extended package, they would have been in The Oberoi in Mumbai on the very night the attacks began.
As for us, safe in Delhi, we experienced the Mumbai attacks as two agonizing days and nights of staring at the news, checking the Internet, and watching our colleagues at work grow angrier and angrier—not just at the terrorists, but at the government. They were fed up that the government was unable to protect its people. After all, that year had already seen bombings in Jaipur, Bangalore, Ahmedabad and, a month-and-a-half prior to the Mumbai attacks, in Delhi itself.
