Prem Dan: Day One

As I mentioned in my last post, I am now in Kolkata (Calcutta), India, where I am volunteering with a few friends.  We are spending about a week and a half working with Mother Teresa's Missionaries of Charity, which started in Calcutta and now has convents and programs worldwide.  Without further ado, I will bring you the report from our first 24 hours.

Yesterday: Exploration and Registration

We walked the 20 minutes to the Mother House, where the nuns and novices live and where Mother Teresa is buried.  We came at the wrong time to view the small exhibition about her life, but her tomb was open for viewing.  It is a concrete sarcophagus on which the words "Give Until it Hurts" are arranged in yellow flowers.

At 3:00, we went to one of the thrice-weekly volunteer registrations.  People come from all over the world to volunteer here, and no one is required to give advance notice.  So there is a short registration and very basic introduction to the work.  We learned about each of the eight houses where people can volunteer, about what the weekly schedule is like, and about how to address the crowds of beggars who congregate near the backpacker street where most people stay.  The four of us wanted to volunteer at the same place, which significantly limited our choices since we plan to stay less than a month (eliminating most of the options with children) and we needed a place where both men and women could volunteer.  The sister in charge assigned us to Prem Dan, a home for adults who cannot live independently due to disability or old age.

Today:  Morning activities and Volunteering at Prem Dan

We awoke to walk to Mother House in time for 6:00am mass, which was attended by about 25 sisters, perhaps 50 or so young novices, and at least that many foreign volunteers.  The sermon was given by an Indian priest, who was discussing how the world pulls us to a certain standard of "normal," but (as he said), "I will follow my Jesus, and he was not normal."  I enjoyed hearing high, clear voices lifted in song.  There were several other priests celebrating the mass, including one from Korea and one from Australia.

At 7:00am, all the foreign volunteers gather for a simple breakfast of bread, bananas, and chai in the Mother House.  We met people from all over the world: Slovenia, Canada, Chile, Spain, Argentina, Ireland, Korea, and Japan.  In fact, around half of the volunteers seem to come from Spanish-speaking countries.

After a prayer and a song, people dispersed to their various assignments.  We are fortunate to be at a house within walking distance, so we spent about 25 mintues weaving through crowded streets and the slum by the train station to get there.  It was a great way to see more of the city.

On entering Prem Dan, we went to the volunteer room to get aprons and then headed to the laundry assembly line.  The bedding and clothes of the 100+ residents are hand-washed every morning.  This was my favorite time of day, since there was plenty of work and we were able to get to know the volunteers around us.

This was follwed by a long break in the sunny, tree-filled courtyard.  More bananas and chai!  I saw a large garden and a couple geese.

The ladies who stay at Prem Dan were all sitting on a porch area.  At this point, things started to get more disorganized.  Some volunteers were combing ladies for lice, while others were offering hand lotion, back massages, or fingernail painting.  We couldn't really communicate with the ladies, who don't speak English and some of whom don't speak at all.  I wasn't totally sure what to do with myself, but I hope to get to know some of the residents as we go back day after day.  Some appeared to be just elderly, while others were in wheelchairs, had problems with their hands or arms, or had other disabilities.  A lady in the corner showed signs of severe burns, especially on her face.

This time was followed by a chaotic lunch, with volunteers helping serve and feed those who couldn't feed themselves.  Then the ladies were wheeled or helped into their beds.  Some needed bathing or toileting.  Then we left.

I'm not sure what to think of the experience.  It was wonderful to see the ladies, but without any training or experience, hard to know how to actually help instead of being in the way.  I also enjoyed talking to the other volunteers.  Perhaps after a few days I will have time to give another report.

If you've made it this far in the account, I will reward you with a quote from Mother Teresa which is featured on my assignment card:

"We have been created for greater things, to love and to be loved."

Post Edit (June 14, 2011):  My time with the Missionaries of Charity was about two weeks.  When I returned home, I did more reading on the reputation of their work and found that many longer-term foreign volunteers have serious concerns about the practices of the Missionaries of Charity facilities, including negligence, improper diagnosis, lack of stimulation, lack of sanitation, lack of medical training, and harsh treatment of the residents.  The reports seem to vary depending on which house is being described, but I want to say on record that even my two weeks confirms that there needs to be much greater attention to universal precautions (such as hand-washing, needle sanitation) and to giving residents some hope of rehabilitation and proper treatment.  I noticed fewer concerns at the orphanage, but my time there was even briefer.

I think many people (myself included) volunteer at these places because we admired Mother Teresa or because we want to feel good about ourselves as volunteers.  In retrospect, I still admire Mother Teresa and think she provided a necessary service with huge heart and vision.  But the current work of the Missionaries of Charity is in desperate need of accountability, transparency, and reform.  Until that would happen, I urge foreigners to give their donations and attention to more responsible NGOs in Kolkata.

Below I will re-print in full a recent interview with a long-term volunteer I knew at Prem Dan:

17 year old girl left to die in Premdan, a medical facility operated by Mother Teresa's Missionaries of Charity

by Hemley Gonzalez on Wednesday, May 25, 2011 at 10:28pm

The following interview took place in Calcutta, India on April 6th 2011, with Megan Von Tersch, a student from Portland State University volunteering with the Missionaries of Charity through a special program called “service learning” which is a combination of schooling and volunteering for several months. Meghan chose to work at Premdan, one of several medical facility operated by Mother Teresa’s Missionaries of Charity. Please take a moment to visit the album filled with pictures about this house:http://www.facebook.com/media/set/?set=a.202937446414672.45825.181945775180506

Hemley Gonzalez: Thank you for meeting me and agreeing to speak publicly about your experience with The Missionaries of Charity. Let’s talk about your time in this particular house which bills itself NOT as medical facility but rather as what exactly?

Meghan Von Tersch: They call it a care facility for elderly people even though there are several elder as well as young patients with all kinds of medical issues currently residing in it.

HG: When you signed up to work at this house, what was explained to you about it during your orientation?

MVT: Not much really! I was basically told we would go and help wash clothes and spend some time with the regular patients as well as those from the “Home of the Dying” also known as “Kalighat” as that location that is now closed and they were all moved to Premdan.

HG: With my own experience volunteering with the Missionaries of Charity, usually they want you to make a commitment upfront about what timeframe you’re willing to spend with them; what was yours?

MVT: In the paper we’re given we are assigned a house and asked for how long we’re planning to work there. When I specified that I was in Calcutta for four months, the nun present during the admission muttered an “oh”, and she actually seemed a tad apprehensive, which I thought was a bit strange since volunteering is a free service and anyone willing to do as much for any organization should be greatly welcome.  

HG: Do you think she had a problem with volunteers staying so long?

MVT: I just felt she was apprehensive, she said “it’s a very long time” and not in a welcoming way.

HG: Tell us about your first day at Premdan:

MVT: I honestly felt like throwing up. Once I got inside the building the first thing I saw were rows and rows of women who are getting no stimulation, no physical activity, the Masis (paid workers as they are called here India) were actually quite mean, in one case there was a patient who was dragging herself practically naked beneath her skimpy gown on the floor to get to a bathroom and when I tried helping her, one of the masis came rushing and said “no, no, she can do it!” to which I replied, sure she can do it, eventually she’ll get there once she crawls through urine and feces at which point she’ll get a bacterial infection! The worker looked at me blankly and continued on: “don’t baby her” – It’s not babying her, is preventing her from actually contracting a vaginal infection!

HG: How many hours did you work each day?

MVT: Four hours each day, five days a week.

HG: What were your instructed tasks during your time there?

MVT: I was told to do laundry.

HG: Don’t they have washing machines?

MVT: They do not.

HG: Do you know why not?

MVT: When I asked, one of the nuns told me that if we wash the clothes with our hands wash them with love. Which is actually unacceptable, because several of the patients have communicative diseases such as tuberculosis and scabies; and these clothes were not all being properly sanitized. This is actually the process they use:

In the morning a worker uses a broom and scoops us garments filled with the urine and feces and they then go into a boiler and then they comes to my first wash bin but in the first wash bin you can still see the reminisces of feces and by the end you can still smell that is not clean and for Roxana, a 17 year old patient I looked after that’s not acceptable or for any other patient for that matter.

HG: Let’s talk about Roxana, you seem to have taken a special interest in her.

MVT: Roxana is a beautiful 17 year old girl, and when I first got here three and half months ago one of her legs was a bit swollen, she had wet lungs, maybe pneumonia, so I would just spend a lot of time with her specially since the patients don’t get many visitors and she would get really depressed. She even had stopped eating and the workers really care nor did the other patients as it meant more food for them; so I just tried to give her as much of my time and attention as possible.

HG: Are visitors allowed?

MVT: Apparently they are but very few of the patients get them. There is one woman, Margaret who had a severe burn when the back of her sari caught on fire and once she recovered, somehow she ended up in Premdan; her son comes often to see her. There’s another woman who occasionally gets a visitor, she has a huge tumor in her belly, she actually looks like she’s pregnant but she doesn’t have the money to get the surgery and is living in Premdan while she waits to be operated on.

HG: She’s waiting in Premdan until she has money for a surgery? Why don’t the Missionaries of Charity actually go ahead and cover the cost of the procedure?

MVT: I have no idea! I was just told she’s just here waiting for the surgery and no more details were given. There was another woman who came in once with a broken femur, one of the most painful things I have ever witnessed, the bone actually had broken through the skin and she remained in this place for two weeks until she was finally taken to a hospital to have her condition dealt with; which incidentally only happened after two foreigners came in and had a conversation with the nuns and immediately thereafter she was taken away to a hospital. So I feel like they probably paid for the surgery.

HG: Do you think that perhaps as foreigners they have more influence about how these nuns behave with the patients when they are present to witness it?

MVT: Actually I don’t think the foreigners have any influence whatsoever, Roxana being a case in point. I began pressuring the nuns and the doctors to take her to a clinic or hospital to deal with her leg as it kept getting more and more swollen each day and I was ignored. She has tuberculosis, I believe he liver is failing, she has an infection in her bladder because I noticed blood and a foamy clot in her urine and after consulting with another doctor who was also volunteering there; we also believe she has a clot in her left leg, which has became painfully sensitive; even the smallest touch makes her shiver with pain.

HG: How long has she been a Premdan?

MVT: She arrived shortly before I started volunteering and is now been over three months, and every day her condition gets worse.

HG: Have they brought in a doctor to see her?

MVT: No.

HG: Have they taken her outside the facility to visit a doctor, clinic or hospital?

MVT: No, every time I’ve asked the nuns, and not just me, two other volunteers who are nurses, another volunteer who is a doctor has spoken up about it we’ve all have gotten the same answer from this nun” “No she’s OK, she’s going to be fine”

HG: What is the name of this nun?

MVT: I’m not really sure; she’s light skin and heavy set. And now when she sees me come in she avoids me because she knows I’m going to ask to get Roxana to a hospital and try and hold them accountable for their negligence.

HG: How many nuns work in this house?

MVT: There is a about at least five who work there and perhaps a couple of dozen of the nuns in training.

HG: These nuns in training are the ones in the all-white saris right? They’re actually the ones I personally caught washing syringes with tap water while I volunteered in Kalighat and saw them reuse them on patients moments after and apparently that also has not changed according more recent testimonies from other volunteers.

MVT: Here in Premdan they actually wash the gloves!

HG: You mean disposable medical gloves?

MVT: Yes, when we get there first thing in the morning there are already rows of them hanging to dry in the roof, and they are reused all the time! It’s disgusting and so unprofessional!

HG: How long do you think is going to take before Roxana dies?

MVT: Given the condition of her “care” weeks if she’s lucky and the time will be painful and miserable. It took them two and a half months to tell me as a volunteer that she has tuberculosis!

HG: Isn’t that putting you at risk and every else present for that matter?

MVT: Every single person there is at risk! Now that everyone knows about her TB, volunteers are even more apprehensive about spending time with her, which breaks my heart because when I leave I know no one will probably spend as much time as I do with her. Who’s going to feed her? Who’s going to take the toilet to her? Who is going to wipe her down her head when she’s having a fever? No one because they don’t want to contract TB!

HG: Have you spoken to the nuns about changing some of their practices?

MVT: Yes. Every day for Roxana; every single day. I plead with them, I tell them she needs to go to a hospital, the reply has often been, “let things be, it’s god’s will”. Another young girl also inside the facility actually tried to commit suicide by jumping from one of the windows on the second floor; a volunteer caught her in the act and was eventually able to bring her down to the first floor at which point the nuns suggested to tie her up but followed by saying: “You can’t stop her, if that’s what she wants to do is god’s will” – Needles to say I was outraged! This is not “god’s” will; this is a young girl who is mentally unstable! She doesn’t need to be tied to her bed, she needs to be properly and medically taken care of! In one week alone she’s attempted to jump twice, and this one nun keeps saying “if that’s what she wants to do then it’s god’s will”

HG: The Missionaries of Charity also have another facility for women with mental issues, is called Shanti Dan, I’ve actually interviewed another volunteer who worked there for months and witnessed the unthinkable, electroshock being applied as punishment for some of the patients! Being as it may, why aren’t some of these mental cases taken there?

MVT: No idea.

HG: Have you witness donations being handed over to the nuns?

MVT: Actually not as many, and it seems there’s a group of long term volunteers who have realized that such donations aren’t going to be used properly on these patients if at all, so what I have noticed is volunteers doing things directly for some of the patients, for example, there is this one woman who had a major lice and flea infection so her head was shaved and a volunteer bought her a scarf to give her a shred of decency; so I see more of that going on than monetary donations or bags of items being handed over as it’s more customary in other houses from what other volunteers tell me.

HG: So basically these nuns just keep a bed for these folks and feed them?

MVT: As I mentioned earlier, I assumed that all the patients come in already with these severe conditions but the more and more I talked to the long term patients and began to see some pictures of the other patients taken by volunteers, I realized many have actually entered Premdan much more healthy than the state they’re currently in; and because they’re basically sitting in their bed for hours on end they start to lose muscle function in their legs so now they can’t walk on their own and develop other issues.

Some of the women have resorted to grunting instead of talking because that’s how the masis (workers) treat them, they yell at them and beat them if they become too much work or a nuisance for them, so they’ve resorted to limited speech and their behavior laden with fear.

HG: These masis (workers) come from where?

MVT: The come from the slums. They women are employed to do the laundry, cook, clean the facilities and just practically keep the place running. There’s about 10-15 masis in Premdan and only four of them live there full time, the rest of them arrive around 4:00AM and leave around 9-10:00AM

HG: So they are not necessarily qualified to perform some of the things that they’re doing, let alone deal with medical issues of the patients currently inside Premdan?

MVT: Oh no. In fact, whenever I ask them anything about Roxana, they immediately rush and get a nun. In addition they are pretty aggressive with the patients, and I know that often in Indian culture physically handling others up to some extend is somewhat accepted but these workers smack the patients in the head or push them around and scream at them for the smallest things; we’re talking about sick women who are also often also mentally challenged!

HG: These masis of course wouldn’t speak up because their livelihood is at stake or come forward about the abuse they witness from some of the nuns, let alone admit their own share of doing. Any idea how much money these workers make?

MVT: No, but one of my professors in the program who also actually volunteered in Premdan said they make a good money.

HG: Well, this would be the first time I hear this, as I’ve interviewed other volunteers and they seem to think the amount they’re paid is actually quite substandard; although it would make sense if you would want someone to keep quiet.

MVT: Yes, that would be a reason for higher compensation but I have no idea what range.

HG: So they are they basically willing players to the negligence taking place?

MVT: Yes, fully.

HG: What about other volunteers, clearly they can’t avoid seeing the same things you’re seeing. What do they have to say about it all? Do they not also see there’s something profoundly wrong taking going on in this place?

MVT: Some people actually believe they’re helping these patients, and are honestly more interested in feeling better about themselves by justifying cultural differences and that this is just how things are in places like India and others in the west wouldn’t understand; also the religious aspect of this organization is a huge factor for many who feel that speaking against Mother Teresa’s organization would be considered offensive or even blasphemous in some of their social circles or with their friends and families.

I honestly do try to see the good in Premdan, there are some small aspects.

HG: Positive aspects such as?

MVT: For example with this one girl they found on the streets with her skull cracked open, she would have died had she not come here.

HG: But why not take her to a hospital?

MVT: I don’t know that’s the catch 22, she would have died on the streets but now she has a miserable life in Premdan.

HG: It almost sounds like they bring these people to these houses and keep them alive, they become, and I despise using the word “specimens” for volunteers to visit and interact with.

MVT: Yes. The first day that I worked there I actually wrote a paper for one I my classes I basically felt that they were like animals in a zoo positioned for me and others to come and watch.

HG: I’ve often said these houses are poverty petting zoos, as I think this is the culture The Missionaries of Charity have created over the years for westerners to come and pet the poor and go home and feel good about themselves and align themselves with the “saintly” image of the founder of this charity (Mother Teresa) while not deconstructing the problem or actually questioning the blatant negligence. I wonder how many of these volunteers would find these practices acceptable for them or any member of their families.

MVT: If there weren’t women like Roxana or the other young girls who need to be handfed and physically attended to; many volunteers wouldn’t come to these houses; this may sound terrible but a room full of stagnant and immobile patients has no appeal to those seeking some sort of feeling of exercising compassion.

HG: Speaking of food; I’m getting conflicting reports about the quality of the food in some of the houses. What is the diet like for the patients in Premdan?

MVT: Not really sure about the breakfast as I’m not there to witness, but around 9-9:30AM they get biscuits and chai but what worries me is that some of the patients of the second floor which have more mobility and less health issues have preferential treatment by some of the workers and some get more food than others, and some of the weaker patients get lesser rations and when they asked for more are denied; so there’s definitely preference going on between the workers and some of the patients since the nuns don’t hand out the food.

HG: What do the nuns actually do?

MVT: I don’t really know! They do some type of medical procedures in the morning if you want to call it that.

HG: Medical procedures? Please explain:

MVT: They dress wounds, and inconsistently give iron injection to some of the women seemingly making no distinction between the weak or healthy one; but that’s pretty much all I see them do and then they spend the rest of the morning praying and singing.

HG: Doesn’t sound like there’s a logical order to their method. Do you think the nuns actually have any idea about what is going on?

MVT: No it doesn’t seem that way because everyday things change; what patient gets what medicine and how. It’s quite confusing.

HG: A doctor from the United States who also volunteered at Premdan for about a week, has asked that we not publish his name but had this to say:

“Ironically during orientation volunteers are specifically told that these are NOT medical facilities. No one explains what the overall objective is, from the simple explanation it is a home, not a hospital, but a home where people with illness and medical issues are brought in and constantly given medicines without proper diagnosis.”

“Are doctors on staff or permanently on site? No. A doctor visits once a week, Wednesdays usually, the “Kalighat” section or also known as “The Home of the Dying” there are about 50 men and women crammed in small rooms just lying on cots. Every person they take on is ultimately a patient, every single person is one. A mentally handicapped man or woman, someone with wounds or undefined health issues. Some of the nuns claim they are nurses of have had some sort of medical training but I have yet to see any certificates or documentation detailing their specialty. There’s some sort of log which one of the nun keeps but nothing very detailed. I once witnessed one patient with diarrhea who was given IV and an antibiotic but then nothing else for days”

“Wound care is decent. They are not operating to level they can be, not comparing it to the western world, and I personally think they could offer more physical and occupational therapy which they do very little of if not at all. There are no physical therapists on staff. Occupational therapy, teaching handicap individuals how to manage daily life tasks with a particular activities of daily living are essential to the wellbeing of all of these patients”

“My biggest issue even over some of the medical issues is the log sheets with lack of information, even a simple things as having names instead of  numbers for the men and women currently held there, and of course there’s no history of diagnosis, medicines given, etc. To some extent some of the nuns seem medically trained but to what degree and specialty it’s unknown. What country or what specialty they were trained in? Unknown, which school? Unknown. Degree unknown. And when medical action is required they don’t spring into action as I once witness a patient in the patio falling and suffering serious wound to his head while a nun just stood there staring, luckily me and another volunteer rushed him inside and were able to stop the bleeding after doing a proper dressing”

“Prior to arriving in Calcutta I was working on an east Asia location where an NGO clinic operating on $17,000- 22,000USD monthly which was able to provide diagnosis tests from HIV, CBC complete blood count, electrolyte panel, TB and malaria diagnosis, blood typing, blood transfusion, 50+ consultation emergencies from suturing to physical exams as well as administering DOTS direct observation therapy, 30-50 baby deliveries per month (all in the facility) 60 in-care, 300 out patients a day, and always looking to improve their facilities and equipment with every donation outside budget, etc, all of this with LESS than $22,000USD a month!”

“They should have at least minimum blood/lab work-up for HIV, sputum samples for TB, blood tests, x rays, one has to wonder where all the money is actually going”

“If I could change one thing it would be instituting activity programs immediately! The patients have absolutely NOTHING to do except just lay there, if volunteers are in the mood to engage with them, they might get some entertainment, a volunteers did card tricks one day but then he never came back. They should have educational, physical activities, gardening, go on walks, arts and craft and not sit there idle. It only worsens their condition!”

HG: How many volunteers would you say have come through the house during your months there?

MVT: Hundreds! At least 200-300 hundred!

HG: What’s the average length of time they work there?

MVT: From what I could see, 1-2 weeks.

HG: How do these patients arrive at Premdan?

MVT: There is dispensary work done in the filed by a small group of long term volunteers, and this is one of the strangest practices of the organization, as only some volunteers who are in Calcutta for a long term are specifically chosen by the nuns and are strictly forbidden to speak to anyone about their job, duties, or how they collect these patients off the streets. I totally stay away from the dispensary as I feel the whole thing is very shady. And once the patients are brought in, for example, if they survive Kalighat or the section now inside Premdan for the old “Home of the Dying” then they are moved to another section of the building.

HG: IF someone “survives” Kalighat? Please explain:

MVT: Yes. Kalighat being the first option to wheel someone to their death rather than actually figuring out what exactly is wrong with them first.

HG: We’re talking about the same building where these nuns could bring doctors, diagnose conditions or take patients immediately to hospitals, right?

MVT: Yes. And even simple things like controlling the lice problem.

HG: The lice issue seems to be a common problem in the houses operated by The Missionaries of Charity, why is that?

MVT: I have no idea! The volunteers are flabbergasted by this too!

HG: Slums that I personally know of and actually work with have LESS of a lice problem than these houses!

MVT: They just shave their heads, and they keep doing it in stages, so when a batch starts growing hair then the lice returns and it’s just a vicious and unnecessary cycle. And specially the patients upstairs who can often speak and refuse to allow their heads to be shaven, and rightfully so! These women have very little if nothing at all left, so they’ll fight to defend their dignity!

HG: What is your over all opinion of The Missionaries of Charity, Premdan, The Home of the Dying, etc?

MVT: I am so disappointed and conflicted; when I first got there I thought my time and energy was being used efficiently, then I was introduced to Roxana and became more observant and stopped being so ignorant and immediately started seeing the gaping flaws in everything which isn’t hard to miss, so it’s quite frustrating. In the one hand I like that they’re giving these women a place to live but on the other hand I hate that they have the money, resources to do physical therapy and stimulation programs, and to place women like Roxana in hospitals and save their lives!

HG: Was any of this remotely close to what you thought this organization was like or your work would be?

MVT: No. I thought I was going to be here assisting people in serious need of help and contribute to a developing society. I never thought I would watch a 17 year old die daily on my own watch; that is not what I signed up for!

HG: Do you think they will change any of their practices?

MVT: No. Every time anyone suggests anything to improve the facilities or conditions we’re basically “shooed” away! I was spoke to this way by the nuns every day I mentioned the fact that Roxana needed to go a hospital; and I refused to be quiet or go away, and every day I spoke up and every day I demanded that they take Roxana to a hospital.

HG: What happens when you leave?

MVT: NOTHING. Roxana will die, no one will care, and things will remain the same. New volunteers will come in and they won’t even who she was.

Meghan returned to Premdan the day after this interview to discover that Roxana had died overnight. Cause of death: unknown. She took a photo of her body wrapped up before it was sent to the crematory along with other photos of this “medical” facility operated by Mother Teresa’s Missionaries of Charity. Sadly Meghan was hoping to have a photo of Roxana while she was still alive but The Missionaries of Charity have a strict rule about photos being taken and only allow them on the last day of the volunteer’s duty and only after receiving a “photo permission slip” issued by one of the managing nuns.

Please take a moment to go through the photos in the album (http://www.facebook.com/media/set/?set=a.202937446414672.45825.181945775180506) and share this interview and our page: www.facebook.com/missionariesofcharity in your walls and or pages/groups you may manage. Roxana and countless others do not have a voice; it is up to us to stop this madness and make it impossible for the media and the Indian government to ignore this ongoing human rights violation!

Hemley Gonzalez,

STOP The Missionaries of Charity

www.stopthemissionariesofcharity.com

www.facebook.com/missionariesofcharity