Little Fingers

by Alexandra Sevakian ’06
Photographs by Savannah Gordan

In fall 2005, the author assisted with a polio vaccination campaign in Mumbia, India, while studying at Champlain College’s campus there as a Professional Writing major.

I am waiting for Dr. Devendra Khandait to pick me up in front of a small bakery on the corner of Hill Road and Pali Hill Road, in Bandra, a district of Mumbai midway between the airport and downtown. The sun is painting my face. I can feel my skin change color, and the sweat continues to drip despite my efforts to wipe it away with my bare arm.

As on every day for the past two and half months, the little girl who begs on this corner is standing beside me. She is probably no more than six, but she is almost always alone. Her feet are bare and filthy, her eyes have dust in the corners, but the whites of her eyes glow brightly against her tar-colored face, and her dark hair shimmers under the morning sun. She does not say anything, but she brings one hand to her mouth over and over again while the other hand is tugging on my skirt and gripping my arm. I smile at her and pull from my purse an apple. This is our usual routine: I walk to the corner and find her sitting on the steps of an ATM booth, her dress pulled up to her knees. As soon as she sees me, she leaps from her seat and begins to beam and skip. She wears one of two dresses every day, and she always looks as though she is carrying with her a great, pleasurable secret. I try to bring her something, whether it is a piece of fruit or some water. Sometimes I bring her some chocolate, and this is when she wraps her arms around my waist and hugs me close. I do not know her name, but she calls me Auntie, as most of the children do in India. I call her Little Sugar.

ONE CHILD AT A TIME

Dr. Devendra is late. He has been traveling for days to Pune, Bangalore, and Delhi; now he is in Mumbai, and we will finally meet, and I can learn what it takes to eradicate polio in a place as densely populated as India. When the white jeep tumbles towards the corner and I see a small man wearing oversized glasses in the passenger side waving, I realize it must be Dr. Devendra. I smile at Little Sugar and wave.

Dr. Devendra gets out of the car. He appears to be an inch shorter than my 5’4”. I climb up to the back seat, and he climbs back there with me. We shake hands. The air conditioning stuns me, but I settle in and pull out my notebook.

The first thing I want to know is everything. What is going on with polio in India? How bad is it, and how do they vaccinate the children? What is easy about his job and what is difficult? Dr. Devendra stutters through his responses and between each sentence says, “tikke?” which means, “understand?” in Hindi. He explains that, since 1988, the United Nations has been assisting India in eradicating the disease. In 1995, the government in India got involved and developed a pulse polio campaign. The authorities decided that the campaign would hold a day of vaccinations each year, a day when volunteers, nurses, and doctors would move throughout India and vaccinate as many children under the age of six as possible.

Dr. Devendra tells me that the campaign met with problems: For example, it was difficult to get people together, and it was difficult to locate children for vaccination. In October of 1997, the National Polio Surveillance Project began. Dr. Devendra, a physician from a small community in the North of India, is a project manager for the campaign. In 1997, there were only 57 people working on the project; today, there are 300. This is still not a very large amount, considering that in July of 2005 India’s population exceeded one billion. The surveillance project is about people coming together—men, women, and children; some nurses; some doctors, other young social workers and students; and some street children—to help educate and rally people to get vaccinated. These volunteers work together going house-to-house or setting up booths where children can be vaccinated.

As we drive through Mumbai and the sun shines through the window, I watch the people moving along the street. Families live on the medians of the highways, on corners and in dilapidated homes, piled on top of each other along the water or in between buildings. Children sift through garbage dumpsters, filling plastic bags. Smaller children relieve themselves with their shorts down and their eyes cast downward at the roadsides. Women brush their teeth in dirty buckets, and men in groups play cards on big blankets with goats or roosters lounging with them. Old people, hunched and slow, move towards the window of our jeep to knock on the glass for rupees. Parents comb through their children’s hair, picking out what must be lice. Men shine shoes and sell fruit. Women sell plastic combs, bangles, spices, and nuts.

“How can you go house-to-house when so many people in India do not live in houses?” I ask.
Dr. Devendra points at me, shakes his index finger wildly, and offers me a great, tooth-bearing smile. “Yes!” he cries. “Exactly! It is very difficult. We must use street children to help us, television and churches and temples to help us. We must set up booths and tell the people, walk through the slums and knock on their doors, stop the children while they are playing on the street and talk to them, make them bring us to their home. We must go out at night and walk through the slums and under the flyovers and find the children, and every child must be vaccinated. It is the job of the surveillance project to find the problems and fix them, tikke?”

Just as he says this we slow down in front of a tall, crumbled building in the Panvel area of Mumbai.

“Here you will see where people are trained to do this,” Dr. Devendra says, “to help the children in India.”

We enter the building and climb a set of crooked stairs lit by the sun’s rays beaming through the window; I can hear a teacher lecturing to a muffled, chatty classroom down the hall. I walk behind Dr. Devendra into the room, and the entire class freezes. The teacher stops talking. The students look towards me, most of them offering smiles, others looking perplexed.

Suddenly I feel as though I am the guest of honor as Dr. Devendra motions me to the center of the room and announces my presence with a beaming smile. Some 70 or so people crowd into the long narrow room draped in sunlight from the two back windows. The light also illuminates the dust on the floor and the chipping blue paint on the wall. I wave and find a seat on the side of the room. I pull out my notebook again and begin to write.

I learn, along with the rest of the room filled mostly with men wearing brown polyester slacks and long shirts, that they must collect every child in every community in Mumbai who has not been vaccinated and that there is no excuse for failing at this mission. One child who has not been vaccinated is a threat. The teacher is tall and cheery and specific. I cannot understand what he is saying, since he speaks in his native tongue, but he shows slides with pictures of some of the slums that need to be visited and where booths will need to be set up. I stare at the faded screen and at the slides clicking along. Some of the slides are in English, and I learn that this audience is mainly made up of volunteers who are being trained as booth workers. They will be the men and women who set up booths and encourage families to bring their children for vaccination. Everyone is the room appears confident, nobody takes notes, and very few ask questions. I watch their heads nod and think that this will be a positive mission.

The teacher emphasizes an important aspect of being a booth worker: feedback. If booth workers do not communicate what they need from those higher up, then polio will continue to mingle amongst the poor communities all over India, and it will persist. Another lesson he encourages the class to remember is that, in order to communicate with the families, one must never be rude or insulting, but firm and assertive. I learn, too, that these men and women will have to cover areas of the city that will make their work even more difficult, like transit and train stations, under and around buildings and flyovers, and through apartment buildings where people live in piles in cramped apartments, in hallways, in basements, and on roofs. Many of the workers will be busy all through night, as some of the best time to find these children is after the sun has gone down and they have returned to their families to bring back the money they earned that day, whether it was from begging or from working odd jobs around a city that never stops moving. I sit back and rub the sweat from my forehead and look up to the ceiling fan that lazily turns and barely moves the stiff air.

After the meeting is over, the room slowly empties, and I find myself alone again with Dr. Devendra and another doctor named Dr. Thosar, who is older, his hair dusted with gray. He wears many gold rings on his fingers, and his smile is wide, like Dr. Devendra’s. Dr. Thosar introduces himself in a low, quiet voice that I can barely hear or understand. He will bring me to several slums the next day, such as Wadala, Antop Hill, and Sion, which is the largest slum in Asia.

INTO THE SLUMS OF MUMBAI

The next day I awake with the crows lingering at my windowsill, hitting their beaks against the bars. I leap from my bed, sure I am late, but discover, as I walk by my windows, that it must still be early, as I feel air touch my skin with light, fresh fingers. The heat of a typical Mumbai day has not yet set in and pushed any breeze far across the sea until the sun sets.

I meet Dr. Thosar waiting in his car; a driver sits with perfect posture in the front seat. We drive past Little Sugar, but she does not see me waving; she is pulling the hand of a smaller girl across the busy morning street. I can see, even as we drive quickly along the road, that her expression is serious and tired, and her hair is tangled. I wonder if she has been vaccinated.

We drive until the sun is high. Dr. Thosar asks me about school, the years I spent in New York City: ”Was I scared to live there,” he asks, “because of all the crime?”

I find myself inarticulate and staring out the window. I think I am nervous to see all the children today.

We arrive in Sion first. There are children the size of my three-year-old nephew standing, triumphant, a top a garbage dump, surrounded my crows and cats. They play. This reminds me of being a child in Montreal and racing to the top of a pile of snow with my face burning from the cold. I can’t imagine what it might smell like at the top of the dump. I open my window, but all I can smell is something burning and exhaust and cumin.

Dr. Thosar and I exit the car and enter a building that, from the outside, appears abandoned. The room is filled with women and plastic, fluorescent-colored whistles. I ask about the bags of whistles, and Dr. Thosar tells me, with a proud smile, that it was an idea that “young doctor Dr. Devendra Khandait” thought of. The booth workers will hand out whistles to the small children in an effort to recruit other children to visit the booths and become vaccinated. I think it’s a great idea and watch as some of the women hand out pink whistles to little girls with messy braids and torn dresses, and blue whistles to boys without shoes and missing teeth.

They all seem so happy to see me, and I realize that my presence is perhaps helping today because my skin and voice attract visitors big and small. I pick up some of the kids and swing them around until they erupt with giggles, and then they run away, waving and full of joy.

STREET SMARTS

At my booth, every so often a chicken will wander by my feet or between a car, or a child’s ball will roll past me, and the sound of adults selling grain or spices or soda will ring in the air. The booth is quiet. I expected more families to bring their children. I ask Dr. Thosar where everyone is, and he informs me that there is a currently a strike in some parts of the city by booth workers who feel as though they deserve more pay for their commitment. I shake my head and remember seeing nurses and transit workers strike at least once a year growing up in Montreal, I suppose it happens everywhere, I say.

“Yes, I suppose,” he says in his quiet voice, “but it is not fair for the children who need our help. They must be thinking of the children.”

I agree and look out the doorway at a group of children playing cricket in a dirty field with patches of yellow grass shooting out in a many directions. I wonder about them, too. Are they vaccinated?

A vaccinated child is known to be vaccinated by the black ink on his or her index finger. After a volunteer puts the liquid vaccine in the child’s mouth, he or she colors the little finger and sends the child off. When women bring small babies, the babies usually rest quietly and comfortably on the lap of the parent and take the vaccination with no complaints or expressions of discomfort or protest. Slum children in India have an air of independence from a very early age. I marvel at their straight backs and confident, curious smiles and the way that they all look me straight in the eye. They walk across streets, holding each other. They walk proudly. They play between rickshaws and cars as if they are in their own room, but none of them have had their own room, and maybe they never will. The mothers who bring their kids are timid and pleasant. They smile at me sweetly; they stay and chat for a moment with the booth worker, or they rush off, back to their lives on the crowded narrow streets of their slums. Often, as the children are being pulled out of the doorways with their tiny hands in the grip of an older sibling or a parent, they look back and smile at me one more time before they disappear. Each time, I can feel my heart swell up like a bruise.

MAKING A MARK

It is another hot morning, the air is thick and sticky. I sit under my ceiling fan, waiting for Dr. Devendra to call and tell me that he is outside sitting in the air-conditioned jeep, ready to take me to the next slum. I’m sweating even though my body is completely still along my cot. I’m weary from the heat and full of thought. I think about my youth along cement sidewalks and tree-lined streets, on concrete playgrounds, and snacks after school. I think about how I had never thought before that children could live the way they do right outside the window that offers me no air. When I close my eyes and listen to the dusty bustle outside, I see their faces.
The phone rings. I answer to hear Dr. Devendra say, “Alex, I am here now.” He hangs up.
I move down the stairs of the hostel and already feel stained from the heat. I push the iron gate open and say goodbye with a short wave to Gopal, the guard who stands barefoot at the entrance.

His smile is faint and warm.

I climb into the jeep.

“Today we go back to Sion,” Dr. Devendra says. “We will walk through the slum, we will go door to door today, and you will see how people live. You will see sometimes it can be difficult to convince people to have the child vaccinated, tikke?”

“Tikke” I say.

The ride is another long one. It is bumpy. We start and stop again and again and start and stop through the narrow roads and hilly highways of Mumbai. I see men and women kissing under wide, colorful shawls by the water, their motorcycles resting clumsily along the stone wall from which they lean. There are lines and lines of lovers kissing along the boardwalk. There are lines and lines of dirty dogs lingering along the boardwalk, and the city is hazy. The roads become scattered with crowds, and the small, dilapidated homes become greater in number.
Our white jeep stops on the side of a cramped sidewalk. There are people in every direction, and every one of them is staring at me.

I smile.

Dr. Devendra flings open his car door and hops out to stand beside me.
We enter the slum from the sidewalk, and it is as though we are in the middle of a crowded hallway. The doors of all the homes are a foot from each other and all along the wall. The simple buildings stand with the help of bricks, wood, and cardboard. Doors are painted turquoise, yellow, and red, and each one is chipped or peeling. Flies swarm, and water drips along the wobbly cobble and dirt pathway. I cannot figure out where it coming from. Little girls with oversized faded party dresses follow me, and little boys try to reach out and hold my hand.

Dr. Devendra stops at each door and knocks. A woman and her husband or brother or cousin will answer the door with wide smiles and curious eyes. Dr. Devendra speaks in Hindi, and he is enthusiastic and direct.

I like listening to the exchange but find myself distracted by the children leaning on my legs.

Most of the people we meet today have had their children vaccinated, and Devendra is bright with excitement when a parent shows him a little finger stained with black ink.

I look around and ask some of the children, in English, to show me their fingers. They stare intently at my mouth moving and my hands moving, and they stick their little fingers towards my face. They stand on their tiptoes to show me their fingers. I praise them with a short bow and my hands together. They giggle at my effort to adopt an Indian gesture. I laugh at myself too and feel glee under the heat that all the children around me will not get sick.

We continue to walk along the long slither of a street and meet the people of this small fraction of Sion. The day progresses slowly but successfully. Each child here is vaccinated. I notice a chalk-marked X and short lines on every second door or wall of each home and inquire what it means.
Dr. Devendra looks back and up at me and says, “The X tells me who is a vaccinated house and who is not. The lines tell me the number of children vaccinated in each house. Then we knock and ask anyway to be positive. Yes?”

“Yes, good idea,” I answer.

When the sun begins to sink behind the walls of the slum and a breeze begins to crawl its way towards night, we march back to the jeep. The children follow me to the door. I close the door and roll down the window. I can wave as they wave to me and grow invisible among the sea of people who shuffle and shift along slowly and calmly. I notice that the roads everywhere in Mumbai are crowded, yet there is no rush.

The sun follows us as we drive. It is a great, big, ginger smile from the sky. Today is my last day as a shadow moving through Mumbai’s slums to collect children with black-inked fingers. I look out at a city growing bright with electric lights, a city moving towards the end of a day. Yet, for many, including the children who live in the slums, the workday continues into the morning. They continue to wander and beg for money, or sell newspapers or porcelain trinkets or bottles of Coca Cola.

I return to my cot, under the fan and below the open window. Was I of any help today? I wonder, drifting toward sleep. Will Little Sugar be happy to see me tomorrow?