The Northeastern state of Bihar has a long and proud history. Some time during the 6th
century BC, Buddha attained enlightenment under a Bodhi tree in Bodh Gaya. In the same century, Mahavira, the 24th and final savior of Jainism, codified the Jain religion. Not far from Bodh Gaya is the site of one of the world’s first universities, founded in Nalanda in 450 CE. The countryside is beautiful with endless fields and colorful buildings, and the Ganges River runs the length of the state from East to West. Bihar is the largest producer of vegetables in India and the second largest producer of fruit. This emphasis on agriculture is emphasized by the fact that only about 11% of its population lives in urban areas.
And yet, even with all of these reasons for pride, Bihar is a troubled region with one of the highest rates of poverty in India, the highest rate of domestic violence (60% of married women are abused), and one of the lowest literacy rates in India (64% overall, 53% for women).
When you tell someone in India that you’ll be going to Bihar, you’re likely to get wide eyes and stern admonitions to be careful. It has a reputation for petty crime (“Keep your car windows closed, no matter how hot it is, or people will reach in the window to steal your purse!”) and mistreatment of women (“Don’t go anywhere by your self and don’t make eye contact with anyone!”). It all seems a bit heightened and hysterical, especially after you’ve been there and had a lovely time interacting with warm, smart, friendly people who have only the best of intentions.
I am incredibly privileged to be working with the Institute for Healthcare Improvement supporting a joint effort between CARE India and the Government of Bihar to reduce
- Tejal Gandhi drops in on a meeting at the CARE office!
maternal and neonatal mortality across the state. WHO estimates that Nigeria and India combined accounted for one third of all maternal deaths in 2015. With one of the highest rates of maternal, neonatal, and infant mortality in India, Bihar is determined to improve. Our current focus is on 10 government hospitals spread across the state, where we are working with teams to cultivate improvement skills so they have the capacity to implement best practices for prevention. Once these initial hospitals have early successes and lessons to share, we will begin to spread to the other 28 government hospitals in the state, engaging outpatient facilities within each district as well. It is a huge project with immense potential.
I say “we,” but my role is relatively small and loosely defined. Still, this is a mission that I can’t help but embrace, and I will support it in whatever way I can. Last week, I was able to travel to Bihar for an Improvement Coach Workshop, where I helped present some of the content (on the fly when a speaker was delayed), and provided table coaching during exercises. It was a great meeting, with the director of the Improvement Coach program coming over from the states, the regional director for the IHI initiative there to co-present with her and translate into Hindi, and a skilled Improvement Coach from Ghana there to begin her 3-month residency in Bihar. In addition, we were joined by many members of the CARE team who are very involved in the initiative, and representatives from state government who were lending strong support. Despite language differences (sure, people speak some English, but it’s really not their chosen tongue) and cultural surprises (people casually wander in up to an hour late for meetings, and once given an exercise, will not stop until they are done, even when the time is up), it went well and concluded with great enthusiasm from participants.
I look forward to returning a few more times this Spring, to provide support for new improvement coaches, and to run a collaborative learning session. It feels great to participating in something so important and learning so much.
for the students, and singing the school song about all the things these children can become. I was impressed to see a 4th grade girl get up to speak to that day’s virtue: Gratitude. She stood up straight and spoke 
loudly and clearly to a room full of her peers, her teachers, and a bunch of strangers. She was followed by four high school students presenting stories from that day’s news. Not only did they have to speak without notes about current events, but they had to be prepared for questions from anyone in the room, many of their peers posing probing and thoughtful queries. Assembly closed after two beautiful songs by the school chorus.
such, acknowledging that they probably get more of his attention than his own sons received. This point is backed up by a laughing Ajit who says that he wishes he’d gone to Shanti Bhavan. Both stress that Shanti Bhavan is not run by money, but by love. They hope to soon break ground on a second school in Karnataka, with a long term vision of multiple schools around India to increase the impact of their efforts.
a few days on the Southwestern coast of Sri Lanka. A four hour drive from 
fact that it was our only dinner not on the beach. It was a tiny all veg restaurant (sorry, Laurence, though he didn’t seem to suffer), with about eight tables and a set menu. We quickly learned that the set menu was because it is basically home cooking. A kind woman and a small staff cook a few dishes: some dal, a ubiquitous caramelized onion and eggplant dish, a curry made with jackfruit, pineapple curry (Tom’s favorite), and other dishes. It took us back to our meals at 
The last morning in Hikkaduwa meant time to pack up. We bid farewell to Rachel and Laurence at the Colombo airport and spent one last night just the two of us back in 
directly above us on the 5th floor. Rooms were basic, but clean, and most showers had warm water. Luckily none of us mind stairs, and we very much enjoyed the pool with 
swim up bar serving some lovely fresh juice cocktails (that detail allowed us to relive one of the ways we were pampered in Fiji with Elaine/Mom and Aunts Linda and Sue). We stayed in Dambulla, placing us equidistant from 2,000-year-old Anuradhapura and the
the words of our guidebook, “energetic dwarfs cavorting around the outside.” And of course our day wouldn’t have been complete without a bit of wildlife in the form adorable monkeys and a snake! We then met up
with our driver and asked him to take us to the Dambulla Cave Temples.
for tourists. Our dining options consisted solely of hotel restaurants, so we decided we’d be just
as happy at our own hotel as at anyone else’s. And the evening buffet was pretty tasty, served by the charming and very international staff. And we couldn’t beat cocktail hour split between drinks at the pool and drinks prepared by our resident mixologist, Laurence, using fresh limes and passion fruits spirited away from the breakfast buffet.
for our final night as well. Coming from Bangalore, Colombo felt almost artificially sanitized. There’s a little bit of litter, sure, but no garbage piles at all. Traffic is a bit heavy in the city, but people actual use lanes for driving and (the biggest shock of all) they stop at crosswalks and wait for pedestrians to make it across the street. Amazing!
sampled our first hoppers (a sort of bowl-shaped, rice-based bread that’s thick on the bottom and crispy on the edges, often filled with things, not unlike appam, which we enjoyed at 
were to begin clearing away the food, so there was no time to waste! We frantically helped ourselves to everything that looked good and just barely managed to fit it all on our table. When it was time to leave Colombo, we didn’t want to go! We hadn’t yet done much wandering around the city itself, and it was hard to part with the luxury of the Movenpick. Such a happy thought that we could return for the final night of our trip.
to be there. We wandered around the fort area which had some gorgeous old buildings and monuments but paled a bit in comparison to the charm of Galle Fort which we’d visited just the day before. The heat was pretty incredible given that this is 
supposed to be the coolest time of the year, and we were glad to call an end to exploring by mid afternoon and retire to the terrace of the beautiful Galle Face Hotel where we enjoyed cocktails while admiring the ocean view before going back to our own hotel to relax before dinner.
didn’t even begin to do it justice. This was a magnificent place to 
stay, particularly after the more rustic choice we made for Mahabalipuram. We were able to buy groceries, including good coffee and pineapples. We also got everything we needed for Melissa to cook a pasta feast at home on Christmas Eve. Tom even made carrot paratha on Christmas to go along with the meal that we otherwise ordered in.
had been born on our first night there). We enjoyed the market with its jumble of beautiful 
produce, we found delicious French croissants and other tasty pastries, we strolled through the early 19th century botanical gardens where the French colonists had tested the strength of plants they wanted to plant there (and where the fictitious Pi Patel began his journey), and on Christmas morning we visited the gothic Basilica of the Sacred Heart of Jesus.
mostly, it was right on the beach. Laurence was amused by his interactions with the wait staff at both dinners, about 
Wellserton Wanderings 