SPAN's Jan/Feb 2013 issue by SPAN magazine

JANUARY/FEBRUARY 2013 Rs. 20

“”What’s With the Gleeks? Travel Like a

Local Spice it up With

Samosas

RICHARD VOGEL © AP-WWP STEVE HELBER © AP-WWP

MATT YORK © AP-WWP

Left: Adriana Leiss and her daughters replace burned out light bulbs on their 1965 Chevy pick-up truck decorated for Christmas at their house in Los Angeles, California.

Right: Visitors take photos in front of homes decorated with thousands of holiday lights in Richmond, Virginia.

Above: Christmas lights stretch across the street on Natal Circle in Mesa, Arizona.

Holiday Lights The National Christmas Tree

Official White House Photo by LAWRENCE JACKSON

http://www.thenationaltree.org

President Barack Obama, First Lady Michelle Obama and daughters, Malia and Sasha, participate in the lighting of the National Christmas Tree in Washington, D.C.

January/February 2013

A LETTER FROM THE

PUBLISHER

Apps

Photographs © Getty Images/ WebMD/ iTriage, LLC/Tactonic Systems, LLC/iSonea

Keeping Healthy While Staying Mobile By Howard Cincotta

Sun, Not Soda

By Michael Gallant

Partnerships for Good Health By Carrie Loewenthal Massey

Using Technology to Improve India’s Health Care

Partnering Overseas to Battle Malaria

Courtesy DESIRE Society

By Michael Gallant

Seeing is Believing By Paromita Pain

Clean Up Your Act

By Anne Walls

Social Development

By Steve Fox

Transforming Lives By Kimberly Gyatso

From the Local’s Eye View By Carrie Loewenthal Massey

n the fast-evolving world of mobile phones, the features which grab the most attention are the cool games and entertainment apps. But your phone can help you do a lot more than play Angry Birds, watch the latest movie trailer or stay connected on social networks. You can also get information on how to stay fit, monitor your blood pressure, check the calories of a handful of cookies and even monitor your sleep patterns. There are more than 40,000 health apps available for Android and iPhones and according to a marketing research firm, more than 240 million users worldwide were expected to download a mobile health app in 2012. The utility of mobile phones in the health sector is not limited to apps. Innovative entrepreneurs are using them to train health workers to collect and track patient information as well as demonstrate health care practices with audio and video. Continuing our practice of providing information you can use, we bring you some expert advice on the healthy choices you can make to avoid getting diabetes, how you can save yourself from malaria and how you can stay clean and healthy at home and at work. We round off our health package with a look at U.S.India partnerships in this field. American and Indian government agencies, researchers, entrepreneurs and educational institutions are collaborating on scores of projects to develop better treatment methods, train health workers and share knowledge. While we have featured only a couple of these, this area of cooperation will continue to expand in the coming years. Recently, the SPAN editorial staff invited a group of college students to talk about the key themes for the magazine in 2013. A lot of ideas were discussed and there were energetic debates on a number of topics. This focus group discussion showed us that along with lighter topics there is also great interest in reading about policy issues, topics that have a bearing on the U.S.-India relationship and about things that influence our present, and shape our future. While you will see a number of these ideas reflected in our upcoming editions, I encourage you to continue this dialogue with us. Please tell us what topics interest you and what you would like to see in SPAN. Write to us at editorspan@state.gov

V O LU M E L I V N U M B E R 1

Indian American Doctors: Then and Now By Anne Walls

How to Respond if Placed on the Waiting List By Don Martin and Wesley Teter

Art Director Hemant Bhatnagar Deputy Art Directors Qasim Raza, Shah Faisal Khan Web Manager Chetna Khera Production/Circulation Manager Alok Kaushik Printing Assistant Manish Gandhi Research Services Bureau of International Information Programs, The American Library Front cover: Illustration by Hemant Bhatnagar. Photographs © Getty Images Published by the Public Affairs Section, American Center, 24 Kasturba Gandhi Marg, New Delhi 110001 (phone: 23472000), on behalf of the U.S. Embassy, New Delhi. Printed at Thomson Press India Limited, 18/35, Delhi Mathura Road, Faridabad, Haryana 121007. Opinions expressed in this 52-page magazine do not necessarily reflect the views or policies of the U.S. Government.

http://span.state.gov For notification of new content, write to:

ezinespan@state.gov

Travel

Articles with a star may be reprinted with permission. Those without a star are copyrighted and may not be reprinted. Contact SPAN at 011-23472135 or editorspan@state.gov

Uncle Sam-osa By Jane Varner Malhotra

A Cappella on the Rise By Jane Varner Malhotra

Food

JANE VARNER MALHOTRA

Publisher Walter T. Douglas Editor in Chief Adele E. Ruppe Editor Deepanjali Kakati Associate Editor Richa Varma Hindi Editor Giriraj Agarwal Urdu Editor Syed Sulaiman Akhtar Copy Editor Shah Md. Tahsin Usmani Editorial Assistant Yugesh Mathur

Want to keep track of your health with a mobile phone? Here’s how. Keeping

Healthy While

Staying

Mobile Illustration by HEMANT BHATNAGAR/Photographs © Getty Images

By HOWARD CINCOTTA

2 JANUARY/FEBRUARY 2013

his app tracks one of your health’s most vital numbers—systolic and diastolic blood pressure. BPMonitor displays all the information in colorful graphic charts for easy interpretation over shorter or longer time periods. Blood pressure can be measured in metric or U.S./British units. The app allows you to e-mail reports to doctors or other medical professionals.

$0.99 for iPhone. Android version under development.

Courtesy Taconic Systems, LLC

Blood pressure

BP Monitor

BPMonitor http://www.taconicsys.com/ app/bpmonitor-lite

iPhone download

here may not be a mobile app for everything, but it can certainly feel that way. Health and fitness are no exception, with more than 40,000 health apps for Android and iPhones, according to Mashable, a popular news Web site. Many are free; others have prices ranging from $.99 to $2.99. According to Research2Guidance, a market research firm, more than 240 million users worldwide were expected to download a mobile health app in 2012.

That is good news, but it does raise a question: How can you pick the ones that actually deliver what they promise—especially since many apps claiming to cure specific medical conditions are probably fraudulent? (See sidebar on page 5). Here is a selection of some top-rated mobile health and fitness apps that have been reviewed by medical experts at Time magazine, Scientific American and the Web site iMedicalApps.

To share articles go to http://span.state.gov JANUARY/FEBRUARY 2013 3

APPS

http://goo.gl/J9GEA

lucose Buddy is a tool for helping manage diabetes. Users can enter http://www.glucosebuddy.com data concerning their glucose levels, carbohydrate intake, activity level and insulin dosage. All these data http://goo.gl/gzFz7 can be displayed in a variety of formats and graphic charts to see trends—and then adjust diet, exer- http://goo.gl/pHM91 cise and medications to better manage blood sugar levels. According to its site, the app has had more than 13 million logs uploaded.

Android download iPhone download

Free. Android and iPhone.

Lose It! Free. Android and iPhone.

http://loseit.com

Courtesy FitNow, Inc.

he weight loss program Lose It! recently won the U.S. Surgeon General’s challenge as the best mobile phone app in the fitness/physical activity category. “Lose It! helps users make healthy choices by setting a clear calorie budget, by permitting users to track their fitness and activity level, and by providing them insight into their nutrition,” says a description on a page dedicated to the challenge. Lose It! features a simple interface that provides access to an extensive database of foods and activities, recipes, nutrition information and a barcode scanner. You can also connect with friends and family, earn “badges” to reward success, generate progress reports, and share your information on Facebook and Twitter. According to its Web site, Lose It! users have lost more than 14 million pounds so far.

Fitness

Illustration by QASIM RAZA/Photographs © Getty Images

Glucose Buddy

Courtesy SkyHealth, LLC

Diabetes control

Glucose Buddy

Cure Acne?

There’s No App for That!

Fooducate http://www.fooducate.com

iPhone download http://goo.gl/aBT73

Android phone download

Courtesy Fooducate, Ltd.

http://goo.gl/tpImk

Free. Android and iPhone.

and

Food nutrition

Food ucate

ith the Fooducate app, you can simply scan any of more than 200,000 barcoded items in grocery stores to get complete nutrition information without having to read a single label. Fooducate uses a formula to assign each food a health grade from A to D. The rating incorporates food factors that consumers often overlook, such as preservatives, additives, high fructose corn syrup and other sugars, food colorings and serving sizes. Users can also save a history of their product scans and share them with others.

t a time when mobile phone apps are all the rage, it is hardly surprising that many people might fall for claims that health apps can actually treat such medical conditions as acne, persistent ringing in the ears or depression triggered by seasonal change. They can’t. Take AcneApp, previously sold through iTunes for the iPhone at $1.99. The app company stated that when the cellphone was pressed against the face, the app’s blue light would improve skin condition. “False,” said the U.S. Federal Trade Commission, which forced AcneApp and a similar product to be removed from the market. In a recent study, the New England Center for Investigative Reporting at Boston University reviewed approximately 1,500 paid health apps, and found that many claimed to be able to treat different illnesses. Several used either cellphone lights, sounds or vibrations as treatment methods—none of which could possibly work as advertised. Some apps are potentially dangerous, according to the New England Center’s findings. The Cardiac Stress Test, for example, sold in a $3 Android version, directed users to perform 30 squats in less than a minute, then enter their heart rate into the app’s calculator to determine if they were healthy enough for vigorous exercise. This could give someone a false sense of security, says Satish Misra, a physician and managing editor

with the iMedicalApps Web site. Determining someone’s cardiac health takes much more than just looking at heart rates, he notes. A number of mobile apps exploit the deeply human capacity for wishful thinking. One such app claims to cure everything from toothache to insomnia by playing the sound of running water. Other apps offer quick fixes for everything from flabby abs to alcoholism, and even relief from pain, says The Washington Post. None of these apps, needless to say, has the slightest scientific foundation. Mobile apps can empower individuals with information, even provide diagnostic and planning tools. But they aren’t magic. —H.C.

Sleep Cycle Sleep Time

Free. Android and iPhone. AsthmaSense Courtesy iSonea

http://www.isoneamed.com

Android download http://goo.gl/k2rOG

iPhone download http://goo.gl/9548B

WebMD WebMD, a health information Web site, offers a variety of mobile applications.

WebMD http://www.webmd.com

Mobile apps page http://www.webmd.com/ mobile

WebMD

hese are among a number of apps that take advantage of the smartphone’s accelerometer to track your movements and identify whether you are in deep or light sleep. During a preset wake-up time, the phone will determine when you are in your lightest sleep phase—and wake you with gentle sounds or music. The result: you will tend to wake up feeling more rested, since you haven’t been jolted out of a deep sleep. Both apps can provide you with a graphic display of your sleep patterns.

sthmaSense is a tool for recording asthma symptoms and severity along with medication use. You first create a user profile, then enter such information as the medicines you are taking, measurement reminders, special rescue drugs and other data. By holding the phone vertically, users can see data as a standard word entry. According to iMedical Apps, one of AsthmaSense’s best features is the ability to record when a user is experiencing symptoms, including a “wheeze rate” percentage. The goal is to manage medications properly, but also help users recognize when their asthma is uncontrolled.

Asthma control

AsthmaSense

Health theheart.org

App

Comprehensive health information with features like a symptom checker, listing of different medical conditions, drug and treatment database, emergency and first aid and a pill identification tool.

One of the leading sources of information for the latest in cardiology and cardiovascular research.

WebMD

Baby

Android and iPhone.

Designed to keep you and your family fully informed—and to help keep your baby healthy.

Download page

Free.

Free. http://www.webmd.com/ webmdapp

Android and iPhone.

Download page http://www.webmd.com/ webmdbabyapp 6 JANUARY/FEBRUARY 2013

Free. iPhone only. Download (iTunes) http://goo.gl/8QWTD

Android download http://goo.gl/RCwem

Sleep Cycle iPhone download http://goo.gl/zBfBG

hen you suddenly become sick, you need quick answers to two urgent questions: “What’s wrong, and how should I be treated?” iTriage, developed by emergency physicians, tries to answer those questions by helping to identify symptoms in different ways. One is by clicking on the body part of a threedimensional male or female figure and then choosing from a dropdown menu of possible medical problems. The alternative is to search through extensive listings of symptoms. iTriage also offers the option of integrating your medical records with the application. According to its Web site, iTriage has been downloaded more than 7 million times.

information

Free.

WebMD

Android, iPhone and iPad.

Pain Coach

http://www.webmd.com/ webmdpaincoachapp

Mobile phone download

https://www.itriagehealth.com

https://www.itriagehealth.com/ mobile

Courtesy iTriage, LLC

Free. iPhone only. Download page

iTriage

Courtesy WebMD

Allows you to monitor your pain level on a scale of 1 to 10, together with treatments, mood and more. As the app states, “There isn’t an easy fix for chronic pain, but if you know what triggers to avoid and what treatments really work, you can manage your pain more effectively.”

Medical emergency

Sleep Time

Sleep management

Courtesy Azumio Courtesy Maciek Drejak Labs

Free for Android. $0.99 for iPhone.

iTriage

Howard Cincotta is a U.S. State Department writer and editor.

JANUARY/FEBRUARY 2013

Sun, Not So By MICHAEL GALLANT

You may not realize it, but simple choices about what you eat and where you spend your time can protect you from

diabetes.

D r. Sarfraz Zaidi doesn’t like stress, sugar and starchy foods—and with good reason. According to the California-based diabetes expert, too much of any one can be deadly. “Poor choices when it comes to eating, a lack of exercise, and too much stress are three of the factors that are leading to a diabetes epidemic amongst young people in the United States, in India, and pretty much everywhere,” says Dr. Zaidi, an American endocrinologist, author and public speaker, whose parents hail from New Delhi. And, says the doctor, many young people who put themselves at risk of contracting diabetes are not even aware that they are doing it. Diabetes is a chronic disease that affects millions of people around the world. Left untreat-

ed, diabetics have higher amounts of sugar in their blood because their bodies cannot properly produce or use insulin, a hormone that controls how cells react to sugar. Patients may suffer from different types of diabetes, but they all can lead to major health problems if they are not treated properly. Type 1 diabetes is a condition in which the body produces little or no insulin. “You have to take insulin in the form of insulin shots or an insulin pump to survive,” says Dr. Zaidi. “It usually affects children and teenagers, but can occasionally strike a grown-up as well. It is an autoimmune disorder—your immune system starts to attack and kill your own insulin producing cells.”

According to the World Health Organization, the number of p 8 JANUARY/FEBRUARY 2013

Photographs ÂŠ Getty Images

oda!

http://ndep.nih.gov/publications/ PublicationDetail.aspx?PubId=72

Check Your Risk for Developing Type 2 Diabetes

Go Online

More than 50 Ways to Prevent Diabetes

http://www.cdc.gov/Features/ DiabetesAlert/

Vitamin D deficiency and Type 2 diabetes http://www.ncbi.nlm.nih.gov/pubmed/ 20065337

National Diabetes Information Clearinghouse

f people with diabetes around the world will

increase to at least 300 million

by 2025.

To share articles go to http://span.state.gov JANUARY/FEBRUARY 2013 9

DIABETES

http://diabetes.niddk.nih.gov/dm/ pubs/statistics/

(Continued on page 13.)

Courtesy American Diabetes Association

Type 2 diabetes, on the other hand, occurs when the body’s cells become resistant to the action of insulin. “It typically used to affect grown-ups, but now it is affecting more and more teenagers,” says the doctor. The good news? By making smart and informed choices, the risks of getting the disease can be reduced. Eating right—specifically, staying away from excessive amounts of sugar and carbohydrates—is a key factor in avoiding Type 2 diabetes. “Especially in Indian culture, people eat both rice and bread at the same time, which is not good for people at risk for developing diabetes,” says the doctor. “Vegetables, lentils, beans, nuts and most fruits are great to eat, and a little bread is fine, but get rid of the rice, and don’t drink soda— even if it says ‘zero calories.’ They still add artificial sweeteners and sugar

Simple definition of Type 1 and Type 2 diabetes: Diabetes is a chronic disease that occurs when the pancreas does not produce enough insulin—Type 1 diabetes—or when the body cannot effectively use the insulin it produces, known as Type 2. Insulin’s job is to help the body manage blood sugar by transporting the sugar in your bloodstream to your cells to be used as fuel.

10 JANUARY/FEBRUARY 2013

Eating a healthy diet with lots of fruits and vegetables, and staying away from excessively sugary foods and drinks, can help people avoid Type 2 diabetes.

Photographs © Getty Images

Solutions

Risk factors •High sugar and high carbohydrate diet. •Lack of exercise. •Lack of sun and vitamin D. •Stress. •Obesity.

• Eat more vegetables, fruits and proteins and less refined carbohydrates and sugars— especially processed sugary foods like soda, candy and juices. • Get outside, get some sun and exercise. • Do what it takes to relax. • Consult with your doctor and get on the right vitamins or medication, if necessary. Learn more from online sites like www.mayoclinic.com/ health/diabetes/DS01121

“

Stress increases the amount of a chemical called cortisol, which is linked to the increase in blood sugar. So making time to relax is very important. JANUARY/FEBRUARY 2013

n recent years, India has seen an enormous increase in diabetes patients, says Dr. Bernhard Weigl, principal investigator for Point-of-Care Diagnostics for Global Health at PATH in Seattle, Washington. With that increase has come an unexpected challenge: How can doctors test for diabetes quickly, effectively and affordably? “The most common way is to take someone’s blood while they are fasting and test for glucose levels,” says Dr. Weigl. “But that means that if someone comes in to see a doctor with symptoms, they have to come back again for the test having fasted beforehand. It adds cost, and a lot of people just don’t come back. When you’re trying to deal with such a widespread disease, this is a big problem.” Luckily, by collaborating with fellow experts in India, the doctor may have found a solution. While participating in a workshop in Hyderabad, in 2008, Dr. Weigl met Dr. V. Mohan, an Indian diabetes specialist, and the two became research partners. Funded by the Indian and American govern-

Indo-U.S. Collaborative Program on Low-Cost Medical Devices www.nibib.nih.gov/FundingMain/ IndoUSCollab#Weigl_

American Diabetes Association Photographs © Getty Images

http://www.diabetes.org/

12 JANUARY/FEBRUARY 2013

ments, their team has been working to bring a new technology to India, one that quickly and effectively tests patients for diabetes using nothing more than a beam of light. “The device shines a light into your underarm and then measures the natural fluorescence that comes back from the skin,” says Dr. Weigl. “The light that comes back helps determine the amount of a chemical called AGE, or advanced glycation endproducts, which corresponds to diabetes risk. It’s fast and non-invasive, like using a blood pressure cuff.” As of the writing of this article, the device is in evaluation in Chennai, under the direction of Dr. Mohan at the Madras Diabetes Research Foundation. “The machine is still relatively expensive, but because it’s quick and you don’t use any disposable materials—all you do is put your arm on it—on a per-test basis, it’s very cheap,” says Dr. Weigl. “We believe that the machines could be a great solution throughout India, and in other countries as well.” —M.G.

Courtesy Dr. Bernhard Weigl

Shining a Light on Diabetes

Above: Dr. Bernhard Weigl.

MARGIE M. BARNES © AP-WWP/The Telegraph/The News-Democrat and the Post-Dispatch Out

substitutes, and all of them are bad for your health.” The doctor also recommends choosing fresh fruit over fruit juices, which are often spiked with extra sugar. “This is a good diet for everyone,” Dr. Zaidi continues, especially for pre-diabetics and diabetics, and can help them control their blood sugar level.” The doctor also points out that a sedentary lifestyle, where people spend too much time watching TV, typing and texting, can increase the risk of diabetes. “Our lifestyle is changing, especially in the urban population in India,” he says. “Instead of spending time outdoors playing sports, young people are hooked on video games and spending time on the Internet. It’s a rapid change happening in India and the lack of exercise makes insulin resistance worse.” Stress is another risk factor for diabetes that Dr. Zaidi warns against. “People in India, in their 20s, 30s and 40s are getting heart attacks and angioplasties,” he says. “Some of them are very physically active and take control of their diet, but if you are too stressed out, stress can literally kill you.” The doctor encourages everyone to take time to relax, meditate or do anything else that can lower stress. “I’ve seen my diabetic patients go on vacation with no cell phones,” he says. “They come back and their blood sugar is perfectly fine. Stress increases the amount of a chemical called cortisol, which is linked to the increase in blood sugar—so making time to relax is very important.” One risk factor for diabetes that might come as a surprise? Not getting enough sun. “Vitamin D is a hormone and its receptors are on almost every organ in

Courtesy Dr. Sarfraz Zaidi

Above: Dr. Sarfraz Zaidi. Right: Supporters at the annual Walk to Stop Diabetes at Southern Illinois University in Edwardsville.

A sedentary lifestyle can increase the risk of diabetes. the body,” says Dr. Zaidi. “It’s extremely important to our overall health, and can also help prevent diabetes. The main natural source of Vitamin D is [the] sun,” he continues. Since many people do not spend enough time outside, Dr. Zaidi encourages many of his patients to consider Vitamin D supplements. Even if you already have either type of diabetes, there are many proactive ways to manage the disease, reduce your risk of complications, and still live a vibrant life, says Dr. Zaidi. He recommends five steps, in order of importance: “Nothing will work if you don’t change your diet,” affirms the doctor, “and you have to find

time to exercise as well. Stress management is also crucial, as is taking the right vitamins and being on the right medications. People think that if you are on a drug, the medicine will take care of everything—not true! You should take all of these five steps.” The doctor’s final advice? “Life and health are all about balance, so don’t lose your perspective or get lost in today’s high pace[d] life,” he says. “Always try to remember what is truly important!” Michael Gallant is the founder and chief executive officer of Gallant Music. He lives in New York City.

To share articles go to http://span.state.gov JANUARY/FEBRUARY 2013 13

ps alth l e h gi ity he a m i D mun liver com kers de e in wor ent car ng the e pati ges usi d mobil villa rnet an oncept Inte nes, a c pho wn as . kno

h t l a -he

Using Technology to Improve

India’

By STEVE FOX

“

ou are young, brilliant, well-educated, technologically-hip and deeply aware that billions of people around the world suffer from ill health linked to poverty. What should you do with your

We're not willing to settle for giving up what's important and interesting just for monetary rewards, and after a point there’s not much that you really need. —Dr. Vikram Sheel Kumar

life? If you are the founders and employees of Dimagi, a software consultancy headquartered in Cambridge, Massachusetts, you utilize innovative technology to improve the health and quality of life for some of those people. Noting that life expectancy in the United States is about twice that of poor nations, Dr. Vikram Sheel Kumar, co-founder and chief medical

Photographs courtesy Dimagi

a’s Health Care

officer of Dimagi, puts it this way: “We live two lives for every one life in many developing countries. At Dimagi, we’ve chosen to live our first life giving back.” One place where Dimagi, a Hindi word that translates roughly as “smart,” is giving back is India, where the firm’s innovative CommCare software is widely used within the Accredited Social Health Activist (ASHA) program. CommCare, which Dimagi created as an open-source program—meaning other organizations can freely access it—helps community health

workers deliver patient care in villages using the Internet and mobile phones, a concept known as m-health. With CommCare, which utilizes multimedia to engage villagers, ASHAs can collect and track patient information, manage individual cases over time, and demonstrate appropriate health care practices with audio and video clips. Already used to help treat a variety of health issues such as maternal health, malaria, TB, AIDS and malnutrition, CommCare will now be expanded across India under a grant from the United States Agency for International To share articles go to http://span.state.gov JANUARY/FEBRUARY 2013 15

TECHNOLOGY

Left: Checklists and educational videos help users learn about child care among other things.

Jonathan Jackson, co-founder and chief executive officer of Dimagi.

Dimagi has partnered with nongovernmental organizations, public health organizations, research institutions and governments in 28 countries. Dimagi http://www.dimagi.com

http://www.commcarehq.org/

mHealth http://www.hrsa.gov/healthit/ mhealth.html

Go Online

CommCare

Development (USAID). More than 750,000 ASHAs have been trained and sent into the field under India’s National Rural Health Mission, which has largely achieved its objective of deploying “one ASHA for every village.” But challenges remain, which is where Dimagi and CommCare come in. “India has very unique challenges,” Dr. Kumar says. “On one hand, India has one of the best community health networks in the world, with mandated health care workers...who touch every village. So the policy is way out in front. The problem is more in the execution, because the health workers are not always trained as well as they might be, so they may not know what to do, and supervision in the field is difficult. At Dimagi, we look at that and say, ‘Technology could have a very strong role in making this better.’ ” Dimagi has partnered with nongovernmental organizations, public health organizations, research institutions and governments in 28 countries. In India, CommCare is being used by 15 partners operating in nine states. The private firm is structured as what is called a “benefit corporation,” meaning that it puts social goals ahead of profits, and says its mission “is to integrate innovative technology into global public and private services in order to improve human health and wellbeing.” “We’re not willing to settle for giving up what’s important and interesting just for monetary rewards, and after a point there’s not much that you really need. I ride a bicycle. We all take small salaries,”

Photographs courtesy Dimagi

Dr. Kumar says. Although Dimagi will remain focused on the developing world, Dr. Kumar notes that m-health is really a global imperative. “No country in the world has enough skilled health care professionals for the future, so every country has to figure out ways to move away from relying on overworked, constrained physicians,” he says. Steve Fox is a freelance writer, former newspaper publisher and reporter based in Ventura, California.

Top: Accredited Social Health Activists or ASHAs receive training on how to use Dimagi’s CommCare Web app and mobile phone interface in Saharsa, Bihar. Above and right: Mobile phones increase the confidence of the health activists, while engaging their clients in learning more about health care.

With CommCare, which utilizes multimedia to engage villagers, health activists can collect and track patient information, manage individual cases over time, and demonstrate appropriate health care

practices with audio and video clips. JANUARY/FEBRUARY 2013

S Bringing a

Change Interview with a Vision Entrepreneur.

pectacles might be his business but Keerti Bhushan Pradhan is very grateful for India’s vast mobile phone network. “It is the small keys on the mobile phone that often convince people in the rural areas that they need glasses,” he says. As a health care management expert, Pradhan shares some startling statistics about eye health in the country. “Out of nearly 300 million people who need spectacles, only 40 million have access to eye care and glasses. The rest of the population is either unaware that their

sold my first pair of spectacles in December 2006 to Narsimha Reddy from my village,” says Rama Devi. “I was not nervous as I was used to selling consumer products as a Shakti Entrepreneur. The only inhibition I had was that I was not a doctor.” The Shakti Programme helps women in rural India set up small businesses. She wondered if patients would trust and accept her recommendations. That was nearly seven years ago. Today, Devi, coordinator of Shadnagar unit near Hyderabad, is among VisionSpring’s longest serving members. She started working in her village, Kalwakurthy, but moved to Shadnagar in 2010 when VisionSpring’s mobile optical stores were established there. She also trains team members. “I was a tailor in a sari business and also a Hindustan Unilever Shakti member when a Vision Entrepreneur explained the model to me,” she says. “Initially, I was very doubtful if I would be able to sell the spectacles. I went to school till class 12 and then I got married. I had no medical background at all.” But the idea intrigued her. “The training and VisionSpring’s approach to help rural people made me accept the offer,” she says, adding that they were given a four-day training course on how to identify people with near-vision problems like presbyopia. She was also taught about the concept of refraction by a VisionSpring optometrist. “The training was a mix of classroom and field training,” she says. “The refraction training has really helped me conduct detailed eye checkups.” She is proud of the certificate she has received as part of her training. As a Vision Entrepreneur, her salary varies based on the number of glasses she is able to sell. http://www.visionspring.org/ She is motivated to stay on because as “someone from a village in Andhra Pradesh, I am aware of the problems faced by people with vision problems and VisionSpring has created an opportunity for me to serve them.” —PP.P. http://visionspring.tumblr.com/USAID

VisionSpring

USAID’s Development Innovation Ventures invests in VisionSpring

Rama Devi

Go Online

failing eye sight needs attention or they simply can’t afford to buy eyeglasses,” he says. “Yet, a simple pair [of] reading...glasses can immediately increase productivity by 35 percent.” Pradhan, who is the India director of New York-based VisionSpring, knows he has a chance to help change these statistics. VisionSpring ensures the ready availability of affordable eye glasses to help people in India and other developing countries like Guatemala, El Salvador, Nicaragua, Bangladesh and South Africa to maintain healthy vision. Funded by foundations, corporations and individual donors, VisionSpring has been working in India since 2005, with headquarters in Hyderabad. It also supports partners in Bihar, Andhra Pradesh, Uttar Pradesh and New Delhi.

Increasing reach VisionSpring’s early work involved training local people to become Vision Entrepreneurs, conduct outreach and sell quality, low cost eyeglasses in their communities.

Seeing By PAROMITA PAIN

“Extensive pilot studies conducted before we launched showed that it would be easier to reach the local people if the entrepreneurs came from their midst,” says Pradhan. “The program has been modified significantly to serve our target audiences effectively.” VisionSpring now holds eye camps where a team of optometrists and Vision Entrepreneurs conduct eye tests and assign spectacles. Patients take their prescriptions and get their glasses within minutes. Customers who need more complex care or treatment are given referrals to a VisionSpring optometrist or a partner eye health institution. The door-to-door visits by Vision Entrepreneurs still continue, where they remind customers about dates and tim-

“

Out of nearly

300 million people who need spectacles, only

40 million have access to eye care and glasses.

Photographs courtesy VisionSpring

”

Keerti Bhushan Pradhan (right), VisionSpring India country director, with clients at a VisionSpring camp.

g is Believing were not able to see the insects that were eating their produce. After purchasing eyeglasses from VisionSpring, reading stories to their grandchildren is once again a nightly tradition. The brothers have also had a healthy crop this year. It is stories like these that inspire Pradhan. “I have years of experience in the field of eye care. Earlier, as a management person, I was doing very complex projects like setting up surgical centers for hospitals,” he says. “Today, I am stunned by the difference a simple idea can make.”

ENTREPRENEURSHIP

ings of eye camps. Over 20 vision campaigns are conducted every month. “There is no rigorous selection process,” says Pradhan. “Anyone interested can work with us. The only thing we try and ensure is that they...stay with us for a while because it takes time and effort to train them.” VisionSpring’s eye glasses are readymade products provided to the entrepreneurs at subsidized rates, which then are sold at prices ranging between Rs. 150 and Rs. 250. For customers like Toti and Omprakash, whose declining vision had started taking a toll on their business, purchasing glasses from VisionSpring was an easy decision. The brothers are farmers, but during the last season they

Paromita Pain is a currently doing her M.A. in specialized journalism from the Annenberg School of Communication, University of Southern California. To share articles go to http://span.state.gov

JANUARY/FEBRUARY 2013

Five ways to keep your environment clean (and keep yourself healthy). By ANNE WALLS

CleanUp Your

Act

ou know how they say that cleanliness is next to godliness? That old adage may need to be updated for the new millennium to read “cleanliness is next to healthiness.” Here are five easy and effective ways to make sure your home and office stay clean, which means you, and your loved ones, stay healthy.

Dirty dishes = dirty

SINK You may be shocked to know how much bacteria stays in your sink even after you have washed those dinner dishes. Germs that breed in the sink can get on your hands, your sponges or scrub brush, or— worse—your food. Clean

your sink with a mixture of bleach and Photographs © Getty Images

water once a day—and make sure it goes down the drain. The germs will, too!

Go Online 7 Simple Ways to Stay Healthier at Work http://goo.gl/R89v5 22

Tips for food safety http://www.cdc.gov/foodsafety/ prevention.html

TOOTHBRUSH high and dry

Not only does your toothbrush need to dry out after use, but it also needs to be kept well clear of your toilet. This may seem elementary, but did you know flushing the toilet sends germs floating around the bathroom for up to two hours afterward?

The best place for a toothbrush is a cupboard, where it can air out and be protected. Keep that toothbrush out of sight—and the germs out of mind.

Where the hands go, germs follow

Think of how many things your hands touch each day. Now think about the things that everyone in your household also touches: we are talking about

doorknobs, light switches, computer keyboards (both at home and at office), and that almighty remote control. Cleaning these frequently-touched items even more frequently is a smart move on your part…and helps your family’s and co-workers’ health.

Sing Happy Birthday…

twice Sure, you are vigilant about

keeping yourself healthy by washing your hands frequently. But here’s the thing: putting a squirt of soap on your palm and quickly swiping your hands under the faucet is not enough. You need to lather up and

rub your hands together for the length of

time it takes you to sing Happy Birthday twice, about 20 seconds. Then your next birthday will be happy and healthy indeed.

Dump

stagnant water

Everyone knows to use mosquito spray and netting around bedding areas to avoid attracting mosquitoes, who can spread dengue fever and malaria. But did you know mosquitoes lay thousands of eggs in stagnant water, including the many places in the home that hold water like flower vases, pet water dishes and fish tanks? Change the water

in these containers at least once a week to help prevent diseases, and wash them thoroughly. That way you will show those mosquitoes they are not invited into your home! Anne Walls is a writer and filmmaker based in Los Angeles, California.

To share articles go to http://span.state.gov JANUARY/FEBRUARY 2013 23

HEALTH AND HYGIENE

Keep your

A guide to authentic travel in American cities.

From the

’ Local s Eye View

By CARRIE LOEWENTHAL MASSEY

24 JANUARY/FEBRUARY 2013

Part of the appeal of traveling to a new city is, of course, the tourist attractions. You don’t go to Paris without seeing the Eiffel Tower, and a trip to Sydney demands a commemorative picture at the Opera House. But every city has its backbeat, too—the more subtle rhythm the locals follow as they carry out their daily lives. To get the true flavor of a place it helps to walk in the locals’ shoes; only then will your experience be authentic. Read on for a guide to the residents’ favorites in four great American cities. These spots may not make the popular travel guides and some may be off the beaten path. But one A couple walks thing’s for sure: they are through Boston in worth the trip. Massachusetts.

CONNIE M IL

LER

Massachusetts

Boston

The Freedom Trail www.thefreedomtrail.org

Cambridge Office of Tourism www.cambridge-usa.org

Located on the northwest end of the city, Allston-Brighton encompasses the Boston College campus Cambridge to Russell House Tavern in Harvard and is home to students and young Gittes and Maiorana agree that this Square for drinks and $1 oysters after professionals. Though it is outside of separate city, connected to Boston by 11 p.m. If it is music you seek, both downtown, resident Emily Gittes bridge over the Charles River, is a Gittes and Maiorana recommend The says the area is very accessible. must-visit for cuisine, nightlife and Middle East, a restaurant and night“Wherever you go, everything’s con- general ambience. Home to many club with up to four floors of differnected in Boston,” she adds. educational institutions, including ent music each night. Gittes, 24, loves the AllstonHarvard University and Brighton neighborhood for its Massachusetts Institute of And beyond… plethora of cheap eats and hang-out Technology, Cambridge boasts a Other neighborhoods to explore spots. Among them, she recomdiverse population of international include Little Italy and the South mends Eagle’s Deli, which has students and young people, along End, says Gittes, while Maiorana rec“everything you can think of ” on its with a high concentration of quality ommends a waterfront meal in menu, she says, and Yamato Indian restaurants, says Maiorana. Charlestown, complete with breathJapanese restaurant for an all-youWhile in Cambridge, be sure to taking views of the city. can-eat sushi experience. Former check out Davis Square, which is Just one other bit of advice from Brighton resident Dan Maiorana, 25, technically in neighboring Gittes: “I recommend coming in the recommends Devlin’s for “live jazz, Somerville, for shops, cafés and art. summer or the spring. The locals tend good food and drinks.” At night, Gittes recommends heading to hibernate in the winter.” To share articles go to http://span.state.gov JANUARY/FEBRUARY 2013 25

TRAVEL

Allston-Brighton

Above: Russell House Tavern at Harvard Square in Cambridge. Right: Quincy Market in downtown Boston is part of the Freedom Trail.

ou can learn a lot about American history with a walk on the Freedom Trail through Boston. Relive the history of the American Revolution on this 4kilometer route. But in between history lessons, you can also get a drink or a bite to eat somewhere a Bostonian of 2013 would frequent. Here is the lowdown on happening neighborhoods and local hotspots.

Eats, drinks and nights out on the town

Thompson has several other must-eats for visitors to his city: Willie Mae’s Scotch House for the “best fried chicken in New Orleans,” Emeril’s Delmonico “when you want to spend a little extra for the service, atmosphere and food,” and Elizabeth’s for weekend brunch complete with “their signature praline bacon, The real New Orleans spicy Bloody Mary’s and the “New Orleans neighborduck waffle.” Riegel would hoods are said to be a add Delachaise wine bar and ‘checkerboard’—that is, the restaurant, and Bacchanal, dynamics can change dramatwhich allows you to bring your ically from block to block,” own wine and includes outdoor says Riegel. The best way to dining with live music. travel from one place to The local hotspot for music, another, she says, is by hopdancing and nightlife is ping on the historic streetclear—Frenchmen, cars, which cost less than $2 Frenchmen, Frenchmen, says per ride. A few areas not to Thompson. Frenchmen Street miss, according to is filled with clubs that are free Thompson, include Marigny, of cover charges, serve good Bywater, Mid-City, Lower food and drinks, “and all they Garden District and Uptown. ask is for you to tip the musiIn Riegel’s neighborhood, cians if you are enjoying the Uptown, visitors can enjoy a music!” Thompson says. His walk through “amazing” favorites include Maison, The Audubon Park or take a stroll Spotted Cat Music Club, The down Magazine Street, “a Three Muses and Apple Barrel. long street with a ton of restaurants, boutiques, vintage shops [and] antique stores,” she says. Tulane University is also in the area. For dinner in Uptown, Riegel www.neworleansonline.com and Thompson agree that Jacques-Imo’s is worth the wait for its “absolutely deliwww.frenchquarter.com cious food including a must-

French Quarter

New Orleans Streetcars

New Orleans

26 JANUARY/FEBRUARY 2013

Courtesy Tulan e Public Relati ons

have shrimp and alligator cheesecake....”

Louisiana

Above: Skaters at Audubon Park in New Orleans. Right: Mardi Gras celebration in a New Orleans neighborhood.

BART EVERSO N

ew Orleans will always have its claim to fame: the French Quarter. Home to Mardi Gras celebrations and funfilled Bourbon Street, the French Quarter is a destination worth exploring, say residents Jessica Riegel and Chris Thompson, both 23. Yet, they implore would-be visitors not to miss what Thompson calls “the real New Orleans.”

“

New Orleans neighborhoods

are said to be a ‘checkerboard’—that is, the dynamics can change dramatically from block to block.

”

The best way to travel from one place to another is by hopping on the historic streetcars,

which cost less than $2 per ride.

TonyTheTiger at en.wikipedia

Above: People at Bourbon Street in New Orleans. Right: A New Orleans streetcar.

LIESL MATTHIE S

ÂŠ Getty Imag es

Above: A boy at the Space Needle in Seattle. Right: An aerial view of Gas Works Park. Far right: A paraglider practices his technique utilizing the winter winds in the dunes near the shore of Golden Gardens Park.

Seattle

Washington

JOE MABEL

he largest city in America’s everWhen the rain comes green-covered Pacific Northwest, Rain can certainly factor into a visit to Seattle is a haven for the outdoorsy Seattle, but fear not, because excellent and artsy alike. For residents Emily indoor entertainment options abound. For Doherty and Dick McKibbin, both food, Doherty recommends some “amaz26, its charms accommodate its climate ing” vegetarian fare at Café Flora, Sutra of mild, temperate summers and equaland In The Bowl Bistro, which is in her ly mild, though quite wet, winters. neighborhood—the young, vibrant and diverse Capitol Hill. Also nearby, Annapurna offers an authentic taste of The great outdoors India, Nepal and Tibet. And for fresh Seattle has several parks that offer local catch, head to The Walrus and the different perks to the out-of-town visiCarpenter for oysters, mussels and more. tor. Cal Anderson Park, which Doherty In between meals, travelers can treat counts as her favorite, includes a wadthemselves to copious chocolate samples on ing pool, oversized chessboards, promethe Theo chocolate factory tour, a bargain at nades and is “right near tons of restau$6. For a pricier but truly memorable experants,” she says. Gas Works Park prorience, visitors can learn to create art glass vides spectacular city views, while during an intro class at Seattle Glassblowing Golden Gardens in the Ballard neighStudio, says Doherty, a glassblower herself. borhood, which McKibbin recommends When it comes to music, check out the exploring, offers lookouts on the sur“gorgeous” Paramount Theater, Showbox rounding Puget Sound and Olympic or Can Can, which brings “great live Mountains. shows from music to burlesque acts— It is this surrounding geology that think tiny Moulin Rouge but done via sets Seattle apart from other cities, and Seattle,” says Doherty. If you need a within it visitors can enjoy “any activity great date spot, try the Knee High one can dream of…camping, hiking, Stocking Company, a “speakeasy type bar sailing, boating, etc.,” says McKibbin. where you have to ring the doorbell to There is music out there, too: two-andget in,” she says. Or, catch an independa-half hours east of the city sits The ent film at the Harvard Exit Theatre, one Gorge Amphitheater, an outdoor venue of the oldest movie theaters in America. Doherty says is “to die for.”

Seattle’s parks www.seattle.gov/parks

Theo chocolate factory https://www.theochocolate.com

Seattle Glassblowing Studio www.seattleglassblowing.com

The Paramount Studio http://stgpresents.org/paramount

JANUARY/FEBRUARY 2013

San Francisco JON SULLIVA

N /pdphoto.or

California

Above: The Palace of Fine Arts in San Franciscoâ&#x20AC;&#x2122;s Marina district. Right: A car moves down Lombard Street, the crookedest street in the world.

30 JANUARY/FEBRUARY 2013

bout 1,300 kilometers south of rises and you find yourself still in the And in the daylight… Seattle lies the City by the area, Martinez recommends Curbside Just go for a walk. Bay, San Francisco. Famous Café for a breakfast of “amazing “You can walk from block to block in part for its rolling hills, French toast.” and find yourself surrounded by totalmajestic bridges and Across town in the Mission, there ly different people and cultures,” says Lombard Street—the crookedest street is a more “laid back vibe,” says Martinez. “San Francisco never gets in the world—San Francisco has tons Martinez, with “a bunch of people boring.” of hidden gems, ranging from lesserbar hopping.” But before they hit the known lookout points to corner cafés. bars, they are likely sampling some of the authentic Mexican and Central http://www.sfgov.org American food that pervades the Adventures at Lands End area. Spots to try for Mexican include At the city’s western limit (the Pacific Ocean) is a park called Lands Papalote, Tacolicious and Gracias Madre for a vegan spin on the clasEnd that offers hiking trails, paths to http://www.sftravel.com/ sics. For Peruvian food served tapas Ocean Beach and a memorial to the lomabardcrookedstreet.html style, Martinez says Limon is “simply USS San Francisco, a decorated batdelicious.” tle ship from World War II. “It’s one of the best views of the Carrie Loewenthal Massey is a New Below: The corner of Haight and Ashbury Golden Gate [Bridge]…what’s cool York City-based freelance writer. streets in San Francisco. about it is it has a lot of historical Bottom: A stop at the Cliff House, north of meaning while being in a good spot Ocean Beach, is a perfect way to wind down and having that local feel,” says Talia a day exploring Sutro Baths and hiking the Citron, 18, a Bay Area native. trails of Lands End. Citron recommends a stop at Louis’ restaurant for a meal “right on the beach” to complete a trip to the park.

County of San Francisco

The Marina to the Mission

BROCKEN INAGLORY

San Francisco comprises several captivating neighborhoods, from the Italian North Beach to the Beat-era reminiscent Haight-Ashbury. Two pockets that offer great options for nightlife include the Marina and the Mission. If it is a more chic scene you seek, the Marina is the place to go. For dinner, try Betelnut on Union Street for Asian fusion cuisine, says Georgina Martinez, 25. Then, head to MatrixFillmore, “a lounge with good dancing, and if you don’t feel like dancing, you can sit,” Martinez says. Popular movies play on screens throughout the bar, as well. If the sun

ERIC RISBERG

Lombard Crooked Street

Courtesy University of Minnesota Academic Health Center

University o

Partnerships completing more than 100 bone marrow transplants. 32

Courtesy Dr. Kumar Belani

The partnership with University of Minnesota has supported doctors at Manipal Hospitals in

of Minnesota Medical School and Indian hospitals partner

save lives and train health care providers.

By CARRIE LOEWENTHAL MASSEY

D escribed as a “matchmaker” by the University of Minnesota Medical School, for which he works, Dr. Kumar Belani has forged several partnerships with Indian hospitals. They are relationships that drive innovations in patient care, enhance training for nurses and doctors in both countries, and promote student exchange. One collaboration in particular stands out for helping to meet critical health needs in India: a partnership with Manipal Hospitals in Bangalore around blood and bone marrow transplantation. Initiated in 2006, the blood and bone marrow transplant program initially centered on educating and training doctors and nurses in India. Now, it also includes work on improving tissue matching for Indian patients in need of transplants.

Courtesy Dr. Kumar Belani

s for Good Health

“Our goal was to try to make sure we had a place we could partner with that could provide the stem cell and bone marrow transplant procedures we do here. We already had a relationship with [Manipal] and wanted to see if we could expand and collaborate on a clinical level,” says Dr. Belani, who is a professor of anesthesiology and assistant vice president of India affairs for the University of Minnesota Medical School’s Academic Health Center. He is also a Bangalore native. The partnership has supported Manipal doctors and nurses in completing more than 100 bone marrow transplant procedures. Manipal is also becoming a “center for excellence in India” for the transplant operation, Dr. Belani says, as it has turned into a gathering place to which Top far left: The University of Minnesota Medical School’s Academic Health Center. Far left: Nurses from Manipal Hospitals in Bangalore with a nurse from the University of Minnesota (center) who trained the team. Left: U.S. Congressman Erik Paulsen visits medical students from Minnesota at St. John’s Medical College in Bangalore.

To share articles go to http://span.state.gov JANUARY/FEBRUARY 2013 33

COLLABORATIONS

health care professionals from around India come biannually to discuss different cases and promote training. In 2011, the University of Minnesota and Manipal renewed the partnership for another five years.

When Indian medical students visit the University of Minnesota,

Educational exchange

they immerse themselves in

Developing global health practitioners Experiencing the Indian and other foreign health care systems (she also studied in Sweden and Uganda) has sparked Bard’s interest in incorporating global health into her future practice as an obstetrician and gynecologist. Dr. Belani hopes to keep forging partnerships that make such global medical collaboration possible. Presently, he is focused on designing a global certification program for nurses. Dr. Belani’s idea is that nurses that train at either partner university in the United States or in India would complete their degrees with the qualifications necessary to work in either country. Down the road, he would like to see such a universal degree for doctors, as well. Carrie Loewenthal Massey is a New York City-based freelance writer.

A match made in India http://goo.gl/cOmt7

University of Minnesota Academic Health Center http://www.health.umn.edu

Manipal Hospitals Top: A community-based rehabilitation survey, in which Beth Bard participated, in a rural area outside Bangalore. Above: Evaluation of previous imaging during the survey in order to determine what services the patient needed and what the medical team might be able to provide. Right: Dr. Michael Verneris examines a bone marrow transplant recipient in Bangalore.

34 JANUARY/FEBRUARY 2013

Courtesy Dr. Kumar Belani

http://www.manipalhospitals.com

Go Online

Courtesy Beth Bard

the American teaching model.

While the blood and bone marrow transplantation program does not generally incorporate medical student training, Dr. Belani has established a student exchange program with other hospitals, among them, St. John’s Medical College Hospital, also in Bangalore. Minnesota medical students, like Beth Bard, can travel to St. John’s and participate in the clinical practices at the hospital. Bard spent eight weeks at St. John’s and rotated through orthopedics, emergency medicine, obstetrics and gynecology, pediatrics and community health. Her goal, she says, was to “get an idea of what the health care system in India is like.” Bard noted several differences in approach. She observed that Indian medical education is more theoretical and classroom based, with hands-on patient care starting in the internship that follows medical school. Because of the time spent on theory, “the [Indian] doctors are walking textbooks. It’s impressive,” Bard says. Conversely, American medical students “take patient histories, do physical

exams, come up with plans and talk about them with supervising physicians” starting in their third year of medical school, she says. St. John’s students who come to Minnesota experience the American system in the same depth as Bard lived the Indian one. According to Belani, when Indian medical students come to the University of Minnesota, they immerse themselves in the American teaching model and are “treated just like our medical students.”

Transforming

Lives By KIMBERLY GYATSO

Photographs courtesy DESIRE Society

Pradesh, Karnataka and Tamil Nadu. Many cases are brought to them directly or outreach workers partner with local doctors, social groups and teachers to identify HIV-affected families in rural areas and have the children tested. If a child is HIV positive and orphaned, DESIRE Society admits him or her into an institutional care home especially designed to meet the childâ&#x20AC;&#x2122;s needs. These homes provide shelter, food, education, medical treatment and psychosocial support. Children who remain with the family are

The DESIRE Society provides support and education to children affected by HIV/AIDS. To share articles go to http://span.state.gov JANUARY/FEBRUARY 2013 35

SOCIAL DEVELOPMENT

ince its inception, the Dedicated to Eradication of Social Illness and Relief Effort (DESIRE) Society has been an emotional and medical safehouse for children affected by HIV/AIDS in India. With multiple facilities for housing and medical clinics, it exists as a self-sustainable community for many of these orphaned children. The nongovernmental organization, established in 2004, provides education and a supportive community to the children. The society has facilities in Andhra

Go Online ANIL KUMAR

DESIRE Society www.desiresociety.org

International Visitor Leadership Program

Dr. Raj Kumar of DESIRE Society examines a child.

http://eca.state.gov/ivlp

enrolled in a monthly supplementary nutrition program, a crucial component in keeping young bodies healthy while on antiretroviral therapy. According to the World Health Organization, “Huge reductions have been seen in rates of death and suffering when use is made of a potent ARV regimen, particularly in early stages of the disease.” Operating solely on private donations, the society believes that illiteracy and

poverty are major barriers in awareness and prevention of AIDS. The disease has shifted from solely high-risk group infections to common sections of society, validating DESIRE Society founder Ravi Babu Gogulamudi’s slogan: “HIV prevention is better than a cure.” When asked if he thinks that the recent FDAapproved at-home HIV test kit could alter the situation in India, Gogulamudi responds, “The saying ‘Necessity is the

mother of invention’ reflects our need to adapt these preventive modules and lead improved health strategies in dealing with the HIV children population.” He adds that India is known for its flexibility in coping with advanced medical technologies, which the U.S. Agency for International Development and Centers for Disease Control and Prevention have leveraged to effectively accomplish program success and sustainability.

U.S.-India Partnership for an AIDS-Free

Courtesy USAID

• India’s National AIDS Control Program has achieved a 50 percent reduction in new infections over the last 10 years. • Still, there are an estimated 2.1 million people living with HIV in India. • 90 percent of infections in India are sexually transmitted. • PEPFAR (The U.S. President’s Emergency Plan for AIDS Relief) has invested $262 million since 2004 to support India’s National AIDS Control Program. • India is one of the largest beneficiaries of grants from the Global Fund to Fight AIDS, Tuberculosis and Malaria. • The United States is the largest donor to the Global Fund, providing approximately 30 percent of the fund’s total contributions.

The United States, through PEPFAR, the National Institutes of Health (NIH) and the Global Fund, works closely with the Government of India, academic institutions, civil society and the private sector to address the HIV epidemic in India. PEPFAR/India is implemented through the U.S. Agency for International Development, the Centers for Disease Control and Prevention and the Department of Labor. The technical priorities of PEPFAR/India investments are in HIV prevention and health systems strengthening, including laboratory and strategic information systems, and training for health care workers. The Government of India looks to the U.S. Government as an important partner providing high-level technical collaboration in priority areas. Through PEPFAR, the U.S. Government has piloted and evaluated numerous demonstration projects with local partners, which subsequently have been adopted and scaled

up by the Government of India or the private sector. These include evidence-based prevention programs, private sector service delivery models, behavior change communication tools and strategies, telephone helplines and service provider networks. Lessons learned in successful India-U.S. collaborations on mobile HIV testing, laboratory quality assurance, and care for children affected by AIDS, for example, are being integrated into India’s national guidelines. The U.S. Government, through PEPFAR, is also supporting transfer of these lessons to countries in Africa and Asia which can benefit from India’s experience. The U.S. National Institutes of Health support a broad portfolio of basic, behavioral, clinical and translational research on HIV, which addresses scientific priorities for both the U.S. and Indian governments, including HIV prevention among key populations, pediatric HIV and TB/HIV co-infections. This research is conducted by Indian scientists and institutions, both individually and in collaboraUSAID Administrator Dr. Rajiv Shah with Government of India officials during a December tion with U.S. partners. In the past decade, 2011 HIV/AIDS Innovation Exposition at the Antiretroviral Therapy (ART) Center at Safdarjung Indian investigators have been increasingly successful in competing for National Institutes Hospital in New Delhi.

Courtesy DESIRE Society

As a previous recipient of the International Visitor Leadership Program, a U.S. State Department international exchange program, Gogulamudi has toured America and fulfilled a dream by visiting the Centers for Disease Control in Georgia and National Institutes of Health in Maryland, where he gained insight on latest developments and interacted with scientists and doctors. Gogulamudi is impressed with

Courtesy Market-based Partnerships for Health/USAID

Children study at the care home.

America’s zero mother-to-child transmission record and says: “This exposure has increased my understanding at a global level through researchers’ and doctors’ presentations, case studies and research facilities at both prestigious institutions.” Kimberly Gyatso is a freelance writer and humanitarian activist based in San Francisco.

(ORS) Courtesy U.S. Mission India

e Generation

U.S. Secretary of Health and Human Services Kathleen Sebelius (from left) with Minister of Health and Family Welfare Ghulam Nabi Azad, National AIDS Control Organization Additional Secretary Aradhana Johri and Health Secretary P.K. Pradhan during a meeting in New Delhi in January 2012.

of Health funds through a competitive peerreview process. The National Institutes of Health also supports worldwide clinical research networks with active sites and research programs in India, including the AIDS Clinical Trials Group. Working together,

Oral Rehydration Salts is the generic name for a balanced sugar-salt, electrolyte mixture. ORS, along with zinc, is a diarrhea management solution, recommended by UNICEF and WHO for the prevention and treatment of clinical dehydration. About 8,000 episodes of diarrhea have been managed under USAID’s Shakti Health @ Base of Pyramid initiative, covering at least 200 villages. Around 400,000 people are expected to benefit from this program over the next five years.

U.S. and Indian scientists are carrying out research with global implications. American investments through PEPFAR and NIH support targeted technical collaboration with the Government of India and its partners. The lessons learned through these collaborations benefit India, the United States and the international community.

PEPFAR http://www.pepfar.gov/countries/ india/index.htm

JANUARY/FEBRUARY 2013

Med School Diaries

Indian-American SHAWN VASDEV

By ANNE WALLS

Two doctors share their experience of medical school-in India and in America. Dr. Amit Chandra.

he times,” Bob Dylan sang in his 1964 hit, “They are achangin’.” In 1970, only a few years after this song was released, a young Indian student named Vinod Kothapa was about to enroll in a civil engineering program in Bombay, but his heart was not in it. “At my dad’s suggestion, I applied to about 10 medical schools. I was [young] and had no clue about the world or what I wanted to be,” Kothapa recalls. Luckily for him, and because of his good scores in high school, Kothapa eventually got into one of the top medical schools in India. “I was number 202,” Kothapa says. “My best friend, who is now a psychiatrist in California, was number 212.” Now flash forward 31 years. Another young student, Indian American Amit Chandra, had just graduated from McGill University in

38 JANUARY/FEBRUARY 2013

Quebec, Canada, with a double major in biology and economics. And he, much like Kothapa, was looking for his life’s direction. “In college, I was really interested in science, but couldn’t really see myself working in a lab,” Chandra says. “I was also really interested in economics, and I began thinking about careers where I could combine the two fields in an interesting way.” After volunteering in a summer clinic run by George Washington University’s interUniversity at Buffalo.

nal medicine department in Washington, D.C., Chandra got the hands-on experience that kick-started his drive to dedicate his career, and his life, to medicine. “Although I was just a volunteer in a white coat, I was amazed at how much people would confide in me, how

much they would depend on me to get them through their visit, and it made me realize how much I could accomplish as a medical doctor,” Chandra says. He went on to study at Eastern Virginia Medical School in Norfolk, Virginia. But we have not forgotten Dylan’s song—though these two stories of finding direction and drive in medical school may sound similar, Kothapa and Chandra’s experiences diverge there, due largely in part to the times and their inevitable…well, changing. When Kothapa went to medical school in the early 1970s, they accepted around 215 students a year. In America, current acceptance numbers are close to half that, with some programs accepting as few as 24 students annually. While U.S. business schools admit about 50 percent of their applicants and law schools admit 35 percent, a mere 8.9 percent of applicants were admitted to medical school in 2010, according to U.S. News & World

DR. NORIFUMI KURATANI

Doctors Then and Now Dr. Vinod Kothapa.

patient get better physically and mentally,” he says. Kothapa employs one of his favorite quotes, spoken by Dr. Francis Peabody in a

ciation o s s A n a Americ Physicians of of Origin Indian iusa.org

ine

Eastern Virginia Medical School.

ap www.a

http://

Virginia n r e t s Ea l l Schoeodu a c i d e M w.evms. ww p t t h :// Buffaldou t a y t i s Univerwww.buffalo.e abodyw?c e P . r D 2 Who isp://goo.gl/bh htt

speech to Harvard medical students: “...The secret of the care of the patient is in caring for the patient.” The year of that speech? 1925. Maybe things have not changed so much after all. Anne Walls is a writer and filmmaker based in Los Angeles, California.

MEDICAL SCHOOL

interactions that Chandra realized he was suited to emergency medicine. “As an emergency medical doctor, I could be an expert at helping people when and where they needed it most, not only in hospitals, but at major events, at the side of the road, on an airplane, or in any health setting in the world.” For his own post-medical school life, Kothapa followed the path his uncle, an anesthesiologist in Illinois, had carved out. In 1977, he was accepted to an anesthesiology residency program at the State University of New York at Buffalo. Now that he has been in the United States for more than three decades, Kothapa has some advice for young people thinking about getting into medicine. “The most important characteristic of a medical professional, from my perspective, is a fervent and heartfelt desire to help the

Go Onl

Report. Chandra knows how competitive the process is, having survived it recently. “The time after I submitted my applications was tough, since I finished my applications a few months after many of my friends did, and saw several of them get acceptance offers before I heard any news,” he says. Chandra calls receiving his acceptance letter from Eastern Virginia Medical School “one of the most overwhelming moments in my life.” What about the rigors of medical school itself? When asked to sum up his experience in the 1970s, Kothapa says the pressure came more from students’ families than the professors. “I studied hard to pass the exams so my parents would not be disappointed.” Chandra had a different experience: “Medical school was a mental and physical challenge, but it was also surprisingly a lot of fun.” His last two years of school focused on clinical rotations in different specialties. “For me,” Chandra says, “this was the most interesting and exciting part of medical school, interacting with real patients and learning about diseases and health care while taking care of them.” It was through these real-life

To share articles go to http://span.state.gov JANUARY/FEBRUARY 2013 39

Study U.S. in the

How to Respond if Placed on the

ED YOURDON, New York

Waiting List By DON MARTIN and WESLEY TETER

So you have been placed on the waiting list. Here’s what to do next. some ways, being placed on a Itoonwaiting list is the hardest notification receive—you still don’t know

Don’t assume you are going to be denied

anything one way or the other. But don’t despaair. Accept this decision, and consider doing the following:

Most likely, the opposite is true and there is still a strong interest in your candidacy. Otherwise, you would have been denied outright.

Don’t take it personally

Make sure you follow instructions

This is so much easier to say than to do. No one likes to be told they have been put on a waiting list. Most likely, this means that while you have some very strong credentials, you were not considered to be as competitive as those being offered admission. However, the good news is that you were not denied. There is still a very good chance you will be admitted.

Be professional and do what is suggested or asked of you. If you do not receive any information about what to do next, ask. Do not demand, complain or argue. Just ask if there is anything you can do. If you are told no, accept that and do not do anything. It may tell you something about this institution if they do not provide you an opportunity to further address your interest in their

program. If you are given specific instructions on what you can do, follow each one of them.

AcceptanceInsights from f you plan to begin studies in September, you should hear from the colleges you applied to by mid-April of that year. Schools that have offered you admission may ask you to send in a deposit if you wish to accept their offer. They will probably put a limitation on how long they will keep a place open for you. If you receive more than one offer of accept-

40 JANUARY/FEBRUARY 2013

ance, please notify the colleges you turn down so that they can make offers to those students still on waiting lists. We also recommend that you return unused student visa Certificates of Eligibility to those schools. Colleges usually send information on housing, health insurance and orientation at this www.usief.org.in point.

ere are some of the steps you may be told to take or you Write a confidential, hand-written note to

Hmay choose to take:

the person who signed your notification letter

Listen to what you are told. Do not argue, become angry, or get a chip on your shoulder. Thank the provider of the information and make sure you know how you should respond. If a letter from you is acceptable, write one as soon as you can. Address each issue head on and explain why or how you believe you can “overcome” the concern.

This could be sent a few weeks before you are to be notified of the final decision. Indicate your strong level of interest in the program and institution. Mention that you have responded as requested to your waitlist status. End the note by thanking this person for the time and attention he or she has given and will give to your application.

Mount a letter of recommendation campaign

Practice patience and professionalism

This is the time to have two or three additional individuals write recommendation letters for you. You may want some of your original recommenders to write another letter. You may ask others to do so. At most, do not send more than three or four letters of recommendation at this point. More than this is overkill.

Request an interview

If your request is granted and this is a top choice on your list, do it. If a campus interview is not made available to you, but you did have an earlier interview with an alumnus, contact him or her to see if there are any suggestions they would make. This person might even be willing to write a letter of recommendation for you.

Be cautiously creative Some waitlisted applicants may send a one-minute video, poem, photo album, acronym, e-card or a “Top Ten Reasons Why I Should Be Admitted” list. Please do not do all of these for the same institution. Choose one.

Ten Questions to

If ever you help admissions evaluators get a sense of you for better or worse, it is when you have been placed on the waiting list. There are several reasons for creating such a list; one reason that is not among them is that of deliberately trying to frustrate you. If you come across as being offended, inconvenienced, angry, resentful, argumentative or arrogant, you are almost certainly determining the outcome of your application—you will be denied. However, if you go with the flow, and hang in there with a positive and confident outlook, you will help yourself greatly.

Prepare for either admission or denial While one decision is much easier to prepare for than the other, be ready for either one. Don Martin is a former admissions dean at Columbia, University of Chicago and Northwestern; and author of “Road Map for Graduate Study.” Wesley Teter is a former regional director for EducationUSA in New Delhi. He is also the editor of the multimedia outreach campaign, 10 Steps to Study in the United States.

Ask Interviewers

Insights from EducationUSA: Some U.S. universities and colleges are able to interview candidates outside the United States. Former students of the university who happen to reside in a particular country usually conduct interviews. International students are not at a disadvantage if they are unable to be interviewed, but if you are offered the chance to have an interview in your country do not turn it down; it is a good opportunity to practice your communication skills, and learn more about the school directly from former students. Asking your interviewer two or three of these questions will make a positive impression for you: 1. Ask a question based on something you read on the institution’s Web site—

5. 6.

By DON MARTIN

something you did not quite understand. Ask a question that demonstrates you read the catalog information on the program of study you are considering. Ask the interviewer why she or he decided to become part of the respective institution. This question can be asked of a student, an alumnus or a member of the staff or faculty. What do you believe is the greatest asset of this institution and program? What do you believe is its greatest liability? What are three adjectives you would use to describe this institution? Is there life outside of the classroom? How do students relate to each other beyond academics? How strong is the alumni network? Do

you offer any sort of alumni mentoring? 8. Are students encouraged to be active in community service? If so, what types of opportunities are there in this area? 9. What do you believe is the best part of the location of the institution? 10. If you had one piece of advice for me as a student at this institution, what would it be? Don Martin is the author of “Road Map for Graduate Study,” 2009, all rights reserved. (www.gradschoolroadmap.com)

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If feedback is offered, ask for it!

Design by Vilimikata

By JANE VARNER MALHOTRA

Americans are adopting, and adapting, India’s pockets of snacking perfection.

h, samosas! Look around a bit and you will find a version of this mouthwatering snack in every country, in every cuisine—an empanada, a calzone, a pierogi, a Cornish pasty, a dumpling, a spanakopita. Savory food wrapped in a pastry served hot. What’s not to love? Americans lay claim to a number of delicious and innovative sweet pastries. For savories, however, we look to other countries and adopt, and the samosa is no exception. To share articles go to http://span.state.gov JANUARY/FEBRUARY 2013 43

FOOD

Sam-osa

Uncle

Michelle Edmunds Photography

“

To see these 7-year-old

American boys coming up to the food truck and asking for the

aloo matar samosas by

name was phenomenal.

Left: Samosa-seekers line up for Curry Up Now’s Indian street food in San Francisco’s financial district. Right: Chicago chef Suzy Singh dishes up another deliciously different samosa.

As Indian food becomes widely available in the United States—from urban take-out joints to the frozen-food sections of suburban grocery stores—Americans are ordering up the tri-cornered cornerstone of the subcontinent. And as we consume more and more samosas, over time we are, of course, modifying them and making them our own. A typical American might encounter her first traditional samosa by walking past an Indian market in a string of suburban shops. Drawn in by the aroma, before she knows it, she has put 75 cents on the counter and is feasting on a hot samosa and complimentary chai. Strolling happily through the aisles, the new customer discovers more than samosas for sale, of course—spices, rice and dal—and she fills up her cart with South Asian pantry staples. Indian grocery stores across America build customer loyalty through the humble, tasty, value-priced pastry. On a summer afternoon in Chicago’s Grant Park, two boys line up at a food truck during the Lollapalooza music festival, waiting to sample one of chef Suzy Singh’s famous samosas. The simple menu features three items: “The Addiction,” filled with butter chicken; the classic “aloo matar,” stuffed with potato and peas, served with tamarind

chutney; and for dessert, two mini “apple pie” samosas with a caramel dipping sauce. They choose the classic. “To see these 7-year-old American boys coming up to the food truck and asking for the aloo matar samosas by name was phenomenal,” laughs Singh, who operates Suzy’s Samosas food truck during the milder summer months in Chicago. “It made my day.” Singh was born and raised in the Chicago suburbs by her Punjabi parents, who are engineers. She enjoys the mobility of the food truck, which helps expose more and more Americans to the Indian snack. She also believes that a food truck fosters experimentation. “I’m always doing R&D in that kitchen,” says the former engineer, who appeared as a contestant on the TV show “MasterChef ” in 2011. “What’s beautiful about being on the truck is that you can make anything and see how it flies.” While the contents of her samosas can get creative—lamb shawarma, peanut butter and jelly, pumpkin, Nutella—she keeps her dough traditional. “You’ve got to pay homage to the Indian culture,” she says, insisting on the proper casing, the foundation for all her samosas. “Otherwise, fusion just leads to con-fusion.” Party appetizers offer another avenue for samosa introduction for many

Ken Sandhu Photography

http://goo.gl/GSq97

Suzy’s Samosas makes Chow Town debut http://goo.gl/xoNXe

CurryUpNow http://www.curryupnow.com/

Americans. Large suburban supermarkets sell dainty, bite-sized varieties in the frozen section. Some versions from the freezer such as the “crispy samosas” from Saffron Road come packaged in boxes of a dozen, neatly arranged on a plastic tray, sealed inside a plastic bag. The appetizer samosas feature a farmfresh veggie filling, according to the mouthwatering description on the box, with a delicate Greek-style phyllo dough. Baked for 20 minutes, these “all natural, premium hand-made” hors d’oeuvres make a tasty nibble but, despite the triangular shape, may be tough to recognize as a samosa. Another version may taste familiar, but the appearance lays bare everything that a samosa pastry works to conceal. In San Mateo, California, Indian street food fans rave about the “deconstructed samosa” sold by Curry Up Now, a brick-and-mortar restaurant with a few food trucks working the San Francisco area. Here the pastry forms the platter, and the veggies sit on top. Reminiscent of the first time your grandmother cut apart a samosa on a plate for you, this delicious approach appeals to those who want to know what is on the inside. A trip to Texas offers even more samosa creativity, with the Samosa Hut and Grill restaurant selling savory vari-

eties like Thai chicken and cheese pizza and for dessert, a Dallas cheesecake samosa sundae topped with whipped cream. Further south in Houston, Kiran’s Restaurant and Bar serves a mushroom and feta samosa, or for a few dollars more, a tempting crab samosa. For some, nothing suits a rainy after-

noon in Sunnyvale more than a spicy, old-school potato samosa. Improving on that recipe may be a challenge, but Americans continue innovating for the next generation of samosa lovers. Jane Varner Malhotra is a freelance writer based in Washington, D.C.

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Samosa Hut in Texas

ALISON HARBAUGH

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By JANE VAR

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Left: New Directions, the high school music group on “Glee,” performs the song “Valerie.”

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MUSIC

Bottom left: Choristers rehearse at the Clarice Smith Center at the University of Maryland, which hosts area choirs at the annual High School Invitational.

TOM KOHN

National Association for Music Education www.nafme.org

Why does a 15-y year-o old baseball player join an a cappella group? Top: The female members of “Glee’s” New Directions rock in their high school rehearsal room. Above: Students prepare for their choral performance at the University of Maryland. Above center: Ethan Kohn (center), 15, performs with his high school a cappella group. Above far right: Kohn loves playing baseball in addition to singing.

more students auditioning for singing groups and musicals, and more requests to perform songs that are featured on the show. Lisa Itkin, choral director at Bethesda-Chevy Chase High School in Bethesda, Maryland, is a big fan of the show. “I love ‘Glee.’ I think it’s a great show with comedy and fabulous vocal arrangements of current pop songs. I think there is great talent in the cast and it is must-see programming in my house,” she says. Itkin notes that “Glee” has had an impact on TV programming as well, with several primetime shows like “Grey’s

“It’s unique.î

Anatomy” adding a musical episode. Other programs have also inspired young people to seek singing stardom, such as the popular “American Idol.” TV networks are cranking out the song-anddance routines, with a cappella groups competing on “The Sing-Off” and music coaches working with singing teams on “The Voice.” In 2012, moviegoers saw the release of popular musical films such as “Joyful Noise” and “Pitch Perfect.” A reality spin-off of “Glee” began in 2011 on the Oxygen network—“The Glee Project”—featuring auditions and training for young people competing for a role in “Glee.” With its own app and scheduled “tweet parties,” the show encourages interaction among the viewers through social media. Washington, D.C. 9th-grader Ethan Kohn enjoyed following “The Glee Project” and joined a new co-ed a cappella group in 2012 with some class-

mates at his high school, Sidwell Friends. Among the 450 students, the school boasts at least four a cappella groups, in addition to a more traditional chamber chorus and a yearly musical play. Kohn says that shows like “Glee” help make a cappella singing normal in high school, as kids with a broad range of outside interests come together to make music with just their voices. Why does a 15-year-old baseball player join an a cappella group? “It’s unique. We do modern songs like ‘Too Close’ by Alex Clare, and ‘Cry Me a River’ by Justin Timberlake. It’s kinda cool, just seven people making this amazing sound—potentially,” laughs Kohn. Unlike New Directions in Lima, however, he notes that his group has much less drama. Jane Varner Malhotra is a freelance writer based in Washington, D.C.

TOM KOHN

http://www.youtube.com/watch?v=67jKi7FvkL8

ALISON HARBAUGH

Go Online

“Glee” http://www.fox.com/glee/ The Glee Project http://connect.oxygen.com Full Performance of “Gangnam Style” from “Thanksgiving” GLEE

uwahati city rocked to American beats in December with a carnival at Nehru Park. Visitors explored American Library facilities, clarified visa queries and chatted with experts from EducationUSA. In separate events, U.S. Consul General Dean Thompson (below) shared the stage with an engaged audience at the recording of his “townterview” on the DY365 TV network, while Kolkata Public Affairs Officer Jeff Reneau (right) reached out to young listeners at the Red FM radio network’s office with radio jockey Pahi. https://www.facebook.com/kolkata.usconsulate

Photographs by IPSHITA NANDI BANERJEE and ERICA BASU

Courtesy Discovery Student Network

eveloping her idea from a theoretical concept into an actual prototype that would help solve an everyday problem, 14-year-old Deepika Kurup won a $25,000 award to become “America’s Top Young Scientist.” The competition was conducted by Discovery Education and 3M. Kurup’s solar-powered water jug changes dirty water into purified drinking water. Her process can kill many types of bacteria in a fraction of the time required by other methods. Kurup is a student of Fairgrounds Middle School in Nashua, New Hampshire. http://www.youngscientistchallenge.com

Aimee Blodgett | USF News

rofessor Autar Kaw of the University of South Florida has received the U.S. Professor of the Year award for 2012. Kaw, an India-born professor of mechanical engineering, is among four recipients of the award, considered one of America’s highest honors for undergraduate teaching. Kaw was an early adopter of new technologies and social media to reach a diverse student population. He received his bachelor’s degree in mechanical engineering from the Birla Institute of Technology & Science in Rajasthan, and his master’s and Ph.D. in engineering mechanics from Clemson University in South Carolina. http://www.usprofessorsoftheyear.org

aying tribute to the victims of the Oak Creek gurudwara shooting, President Barack Obama sent his wishes to the Sikh community in America and around the world on the occasion of the birth anniversary of Guru Nanak Dev in November. In his message, President Obama said that the anniversary was “a time to celebrate the principles of equality, respect, service and interfaith cooperation that are the core of the Sikh faith.” First Lady Michelle Obama met family members of the victims of the tragedy at an anniversary event held at the White House. More than 150 Sikhs were invited for the event. http://goo.gl/5kdvV

HEMANT BHATNAGAR

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