Category Archive: Client Stories
by Vered Kater, RN, BsN, MsN, Newsletter April 2006
When the American Jewish World Service (AJWS) asked me to come to Mumbai and volunteer for SANKALP, I was not sure what to expect. I am a nurse and normally work in Jerusalem where I teach nurses at the Hebrew University in the School of Nursing.
I was asked to work with the nurses and give a first aid course for the outreach and Drop in Centers (DIC) workers. In theory this sounded fine but in reality the needs here are rather specific. At the first meeting with the learners I asked what they would like to be taught. Requests ranged from understanding hepatitis, coping with blood spills, treating bedsores and bandaging fractures and abscesses and treatment of convulsions.
Before beginning the training sessions I worked in the DIC’s and in the city with the outreach workers, observing needle exchanges and the communications of the staff with the addicts. In addition I spent some time at the shelter I learned to differentiate between the different users, chasers, smokers, snuffers and intravenous users. This opened a whole new world for me. I also assessed the difficulties of the nurses while treating abscesses and dispensing medications and the gaps in safety awareness when treating patients.
For instance, the nurses managed to infect all the utensils in the treatment box while treating a patient with maggots. In addition the gloves were thrown away in an open wastepaper basket, after which the nurse returned to the task of dispensing medicines without washing her hands.
On the streets of the city the SANKALP staff while exchanging needles, were also endangering themselves by carrying the used needles in a plastic bag. Jumping on crowded trains and busses increased the dangers of getting pricked by needles. With these observed needs together with staff requests, the training sessions were designed. My goal was to help the staff of Sankalp to help themselves and to teach them how to prevent getting infected while providing care. First Aid, First Us became a slogan, at all interventions, the implementation of universal precautions was practiced.
Staff training took place in the office and the attendance was very good. Each theoretical discussion was immediately followed by a practical session. The first topic was maggot care. A head was made from newspapers around a pot, medicine bottles were wrapped in white toilet paper and filled with food-colored water (3 different colors representing peroxide, setavlon and bethadine). One of the learners volunteered to demonstrate how to treat the “patient”. The end result was as expected, each bottle had 3 colors, as well as the anti-septic ointment (a plastic tube). Small basins are now used to pour the medications in before starting the treatment. By visualizing the effect of non-clean working practices the message was clearly understood by everybody.
Another session was dedicated on dressing and undressing a patient. This decision was taken after I had assisted with this task when we hospitalized one of the SANKALP clients. With a lot of laughter the staff discovered that pushing a floppy arm or leg in a sleeve is not the best way. Bedsores, massage and changing sheets with a patient in the bed were also practiced. One might argue that none of these subjects were related to first aid, according to my philosophy first aid is what is needed first and these were the identified needs.
I decided to work also directly with the clients that are on the replacement treatment and that stay in the DIC during the day. I taught them relaxation, positive imagery, affirmations and laughing meditations. These activities were appreciated and several clients are continuing these practices by themselves. The sessions took place every day and were frequently led by one of the learners who was tutored by me.
Small first aid kits were put together for the outreach staff, after a session on wound care they can now put to practice their newly learned skills.
Being with SANKALP workers not only gave me the opportunity to share my knowledge. I learned much from my learners, I admire their courage to work with the addicted clients in spite of or perhaps because of the fact that many have been on this road themselves. Their strength to continue to stay clean with all the temptations around them every day is amazing. SANKALP has apparently found the magic formula to help people to rehabilitate themselves.
Taken from a 2008 Newsletter
Sanjay reached Mumbai at the age of 15. His journey to fend on his own in life began when he was just 10. He was troubled to see his father having to struggle to make a living and to meet the demands of his children so he decided to take up a job away from home.
Sanjay’s first travels took him to a village in Ambala where he found work in a village household. Later he took off to a village bordering Himachal, where someone offered him a job as a rickshaw driver. But this was not enough to ward off hunger. He thought Delhi may provide him better job opportunities but that didn’t happen. At Delhi he slipped back into the same rickshaw driving job.
And that’s when the problems started. He got mixed up with a group of boys and got pulled into ‘outline’. The group were into everything, alcohol, ganja, nitrovates and brown. But a rift took place among them which turned out costly, ending in a murder. This forced Sanjay to flee Delhi.
Mumbai offered him instant jobs with caterers. However it didn’t take much time for him to turn to drugs too. This time he graduated to injecting. About seven years ago he got to know about Sankalp through a staff who was an ex user himself. At Sankalp, he got inducted to substitution therapy and after tapering it to low level, went through the detox camp programme and was clean. At least for some time.
As part of the recovery process, he decided to undergo HIV testing, which turned out to be positive. He relapsed, but with the help of Sankalp stood up again and was staff at Sankalp for one and half years. This is when he thought that it was time he visited his folks back home.
His family welcomed him most warmly and even started marriage plans for him. He lied to them that he was already married and had a family in Mumbai. He didn’t want to disclose his health status; neither did he want to cheat his proposed wife.
He returned to Mumbai, but was not at ease. This dragged him to relapse. It continued for some time until he has once again sought Sankalp’s help and that of NA.
However he has also begun to realize that though he can count on Sankalp’s services any time, he needs to learn on how he can stand on his own. For the past three months he is back at OST, pulling on till he finds the solace that he strives for…
Story from October 2005
Reema came from a very poor, orthodox family in Calcutta. Her misfortune was being born a girl. She sensed early on, as children do, that she was a burden to her family. And as she grew up, she was made aware of it in no uncertain terms. She was quite illiterate. Her father, and even her mother, grudged the very little they had to spend to feed and clothe her. She had no happy memories of her childhood at all.
When she started getting her periods, she was put out of the house for five days every month. She was unclean. No one cared what happened to her. Her mother would come out and give her some food, mainly leftovers, and disappear inside the house. Sometimes she could smell a fish curry being cooked – a treat for relatives who had come for a visit. If she got some at all, it was the worst piece, floating in watery gravy.
One day – one of ‘those’ days – a woman came up to her and asked her to go to Bombay with her. She would work as a domestic servant – be part of a family and well looked after. She agreed. Anything was better than her current existence. No one wanted her; no one cared what she did. They would be well rid of her and wouldn’t have to spend any more money on her or have to get her married off. And Bombay, she had heard, was the city of dreams. There were filmstars there, rich and famous people. She would have an exciting life.
So at the age of just 13, Reema found herself in Bombay. The job turned out to be a nightmare and she found herself on the streets. Overnight, the girl became a woman. She had to sleep on the road so a woman took her to a place, with rows of beds – a brothel, though she didn’t know what it was then. The woman gave her a sari to wear and after a few days, asked for it back. She kept shouting at her, telling her to give her the sari. “But I have nothing else to wear,” Reema said. “Go to a man, get the money,” the woman said.
That’s how she became a sex worker, and began to live in the brothel. She had to pay Rs 50 a day to the brothel keeper just for her bed or she would be thrown out on the street again.
She took to brown sugar, used to have it with beer. It became a strong addiction. In addition to servicing clients, she had to put up with abuse from people within the brothel. In particular, there was a man they called ‘baap’ who used to beat her. He was also trafficking in drugs.
When Reema was 20, she met a young man who was also a pimp, but somehow different, more caring. She fell in love with him, desperately and passionately in love.
Being in the grip of drugs, she was in and out of hospital. Then she heard about Sankalp and went through their rehabilitation programme. She went in for voluntary testing for AIDS. She was negative. She was in the clear and could start life all over again. They gave her a supply of condoms and advised her to always use a condom.
But she was in love and lost her head. She didn’t use a condom with him because he didn’t like it. She was in love and ready to do anything he said. Now there were not ‘men’ she was sleeping with, but one man whom she loved. She never thought she would have feelings like other young woman. It was a deliriously happy feeling. Even when they quarreled, it felt normal. Imagine, they were like other couples. Quarreling over silly things, being jealous, then making up.
After some time, Reema was back at Sankalp. This time she tested positive. Life does strange things. When she was at most risk, she was clear. But now she was HIV positive. She was going to die.
With medical treatment and daily counseling, Reema felt motivated to give up drugs even at this stage. She gave up drugs completely and forever. But by now Reema had become too weak to go in for anti retro viral treatment, which takes a heavy toll on the body. Meanwhile she was also diagnosed with a malignant tumour. Her health began to deteriorate day by day.
Sankalp got her admitted to the Kalamboli Jyoti Terminal Centre in New Bombay, paid her expenses. The sisters at the centre were kind and cared for her, gave her medicine for the pain. Till the end she remained a remarkably poised and dignified woman, with not a word of reproach for the lover who had most likely given her AIDS.
At the centre, Reema found pleasure in small things…doing a bit of sewing and light work when she was up to it. Traces of the attractive young woman who had come from Calcutta were still visible in those large-set eyes and high cheekbones. She passed her last days in dignity and also made some friends at the centre.
The Sankalp team visited her regularly. They had known her over the years and she had become more than a ‘case’. Sankalp was the only family she had now. She was a human being who had nothing to give but in a strange way she gave because she was bearing her illness with so much courage. She was always clean and well groomed and had a certain grace. She was very feeble the last time Sankalp visited her and her voice had become soft. But she was still polite and feminine.
Reema died on August 16th, 2005. She was 39.
A Chance To Be Human Again!
At the Sankalp drop-in-centre at Mumbai Central, the mobile service van halts to a break and the driver, Ravi Chandrakant Patil, steps out after driving through the town from an outreach programme. Ravi regularly goes out on outreach programmes with Sankalp volunteers, where he meets street drug users and motivates them to discontinue taking drugs. As he narrates to us what he did today, he is interrupted by a mobile call from his wife, Manju. She wants to know if he has had his lunch. He smiles as he explains how concerned Manju gets if he doesn’t eat on time. Ravi is a happy man. He has a loving family and he is proud of working with Sankalp. But life had not been always so easy.
Deplorable financial conditions at home forced Ravi to leave school at the age of nine and join a watch-making factory. To add some extra income to the poverty conditions at home, he also got involved in bootlegging. Ravi turned to alcohol at a very young age. Domestic problems after marriage made him a heavy drinker and he would stay out of home for days on end. On one such occasion a friend added narcotic pills in his coffee and within days Ravi was hooked on to drugs.
Matters got worse when Manju found out about his addiction and threatened to leave him if he didn’t give up drugs. Thus began a series of lies. Ravi fooled both his wife and boss but this only pulled him deeper into the hellhole of drugs. The addiction worsened and his bloodshot eyes soon betrayed him. He even stopped bothering if others found out. Drugs were all that he could think of morning, noon and night. Drugs cost money and Ravi needed it badly. He was desperate and resorted to stealing. But the law soon caught up with him with six months of jail time. This was no deterrent. The first thing that Ravi did when he came out of prison was to visit the nearest bar.
Things looked extremely bleak. He began to feel miserable that he couldn’t fulfil his genuine desire to be a good husband and father. He wanted to be there for his family but he simply couldn’t let go of drugs. Finally, he decided to ask for help and in August 2004, landed at the Sankalp drop-in-centre. After 22 days of medical treatment and a 15-day detoxification camp, Ravi stayed cleared of drugs for more than a month, the longest time in years.
On one of visits to the drop-in-centre Ravi was asked by Eldred Tellis, Director of Sankalp, about his work experience. On finding out that he worked as a driver, Tellis gave him the keys to his car and asked him to check the engine, oiling, etc. Ravi suddenly felt the urge to drive and, in spite of not having the permission, took the car for a spin. But the director was impressed and soon offered him a job as his personal driver.
But the road to rehabilitation was not that easy.
Withdrawal symptoms got Ravi hooked on to drugs once again. For the first time in his life he resorted to intravenous injecting as well. He lost almost 26 kg weight over four months. “I was so much influenced by drugs that I completely forgot everything that Sankalp had done for me. I betrayed their trust and faith in me. So in spite of realising that I needed help I couldn’t go back. I just didn’t have the courage to face the Sankalp team again.”
But an almost fatal road accident, changed his mind and will and he went back for help, once again, to the Sankalp drop-in-centre. This time he was admitted to the Nivara Night Shelter at Islampura. He was counselled and groomed and in February 2005 was given the charge of driving the Sankalp mobile van.
The very fact that today he can walk with his head held up high and support his family financially and emotionally is a huge achievement for Ravi. Sankalp volunteers explained to Ravi’s family that drug addiction is a disease and it takes time for a person to overcome his disease. These counselling sessions helped him build a good rapport with his family.
“People respect me today. Sankalp has helped me to live a productive life with dignity.”
Ravi has also found friends in the form of other Sankalp volunteers who help him keep away from drugs. When he feels tempted to use drugs his friends act as a support group and provide him with strength and emotional support. But most importantly he has found the emotional will in himself. He reflects, “The temptations are still there. But so are the painful memories. When I remember, what these drugs reduced me to, I instantly stop myself.”
Today Ravi passes on the message of saying “no” to drugs to others. He has set an example to other hard-core drug users that with the right will and support, anyone can resist the temptation. With his typical infectious smile he says, “Sankalp gave me the chance to be human again.”!