About Caroline Richburg

Caroline is a sophomore studying Biomolecular Science and Anthropology. She hopes to attend medical school and continue to explore the overlap between anthropology and medicine, specifically how this relationship influences and shapes women’s health and healthcare systems. Caroline will be spending her fellowship in Mumbai with the Foundation for Mother and Child Health (FMCH), an organization focused on individualized care for severely malnourished and at-risk infants, community education, and support for local mothers. Caroline’s final project will explore what is meant by the term “actionable knowledge,” as used by FMCH healthcare professionals, organizational staff, and local mothers, as well as the uniformity and effectiveness of knowledge dissemination to two local community clinics. Her project will focus on the experiences and perspectives of a diverse audience to the uniform FMCH model.

Shedding Snakeskin

Yesterday morning, my first full day back home post-fellowship, I took a steaming hot shower for the first time in two months. I exfoliated, I washed my hair with coconut-scented shampoo, I shaved, I scrubbed in between my toes. And – I’ll admit – I just stood there under the hot water and inhaled the steam that swirls around the bathroom when the water is hot. It felt like an outside layer of skin melted off my body and slipped down the drain. For me, this is how reverse culture shock feels. It’s like a metaphysical shower or a snake shedding its skin in one, beautiful, uneven piece. It’s a physical separation from a suddenly disembodied experience, an experience that was and absolutely is transformational and central to my life.

Double-backpacking and reuniting with my Dad at the airport after 35 hours of transit. He was in all his Michigan gear!

Double-backpacking and reuniting with my Dad at the airport after 35 hours of transit. He was in all his Michigan gear!

Driving home with my dad from the Toronto airport, familiar things looked a little different around the edges, like when you have your contacts in backwards. Inside the car, my dad had brought me an entire platter of raw vegetables (No 20-year-old woman has ever been so thrilled to eat raw celery by the handful). It seemed to be washed and pre-sliced and wrapped so excessively. On the drive home, I caught myself answering questions using phrases like this experience “has been,” instead of “was.” Outside the car, the roads looked so empty, so green. No one was in the street… no people, no animals, no bikes. Cars drove so silently in their separate lanes that we could’ve been alone. The silence felt deafening. I got home and filled my favorite water bottle with tap water.

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Yesterday, for the first time in two months, I put on makeup. I put on jeans and a sleeveless shirt. I put back on the ring I wear every day but haven’t seen in two months. I put back on my Fitbit. I went to the eye doctor and got a new contact prescription. I got my eyebrows done. I pulled the power converters off of my chargers and manually changed the time on my computer because it couldn’t figure out quite where we were. At times, it all feels luxurious: reuniting with family, friends, and the comforts of home (hot water, A/C, and wifi, a group one of my Indian friends referred to as “the holy trinity”). But, at other times, reverse culture shock is tangible and confusing and uncomfortable in unexpected ways. Things feel superficial, frivolous, and impersonal. It feels like returning to a physical skin, except that my “self” feels different in frustratingly unexplainable ways.

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India was, in many ways, very lonely for me. It was the first time I’ve ever been truly “alone.” I went to U-M without knowing a soul, I studied abroad in France last summer, I’ve spent time by myself, of course, but I’d always been in a bubble of my own culture. While I consider myself very independent and love that my country has instilled this value in me, I also really value social connection. Having no one who could really relate to my experience in India was lonely and challenged me in a new way. I grew more introspective and fell in love with how warm and welcoming the Indians I met were. While I felt alone at times, I also felt like everyone I encountered was family. People hustled and bustled through the streets as one, every activity was a trial in teamwork, and family was the root of everything that didn’t end with biology.

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Shashi has taught herself perfect English through teaching cooking classes over the last 7 years. If you find yourself in Udaipur, take her class-- she is an incredible woman!

Shashi has taught herself perfect English through teaching cooking classes over the last 7 years. If you find yourself in Udaipur, take her class– she is an incredible woman!

The USA is lonely in a different way. I look out my window and see no life. I walk down the street and – if anyone else is there – no one is talking outside the people they’re with. You stand in line 2-3 feet behind the person in front of you and avoid eye contact. You can grocery shop for everything you possibly need and more in one stop and get out with zero words. The only animals I’ve seen are my pets. Car honks mean anger. Everything is so big and spread out. And, everyone is so privileged. How is it that five-year olds get pedicures on the same planet where they run around without shoes? These are all things I knew about the US before leaving, but they feel foreign and our privilege feels increasingly repulsive.

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Living and breathing and experiencing a new and vibrant culture alone was the single most empowering, terrifying, rewarding, challenging, lonely, gratifying thing I have done in my life. I want to avoid rambling into a cliched “I’m so blessed” sermon, but I’m heading back to Ann Arbor on Thursday feeling so much gratitude that I get to attend such an incredible university, challenge myself academically, and push myself to achieve. For much of my experience in India, I struggled to navigate how to respond to essentially winning the lottery of privilege and the associated sense of “survivor’s guilt” I feel. Reflecting, I recognize that simply rejecting my privilege here in the US is irresponsible. Instead, I’m returning to school feeling an intense obligation to use it by working hard and speaking up. During my time in India, I saw firsthand the ways that sociocultural and economic factors shape lives and healthcare. Now, I know with increased clarity that I want to use the resources I have to become the most stellar physician I can be and the voice that I have to advocate for socially-aware and culturally-sensitive healthcare.

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India shaped and changed me in ways that, just two days back, I cannot understand. For now, the best I can say is how overwhelmingly grateful I am for this life-changing experience.

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On Memories and Joy

Today is my last full day in India. I finished my volunteering in Mumbai and have spent the last week and a half traveling with two of my sisters. It was so special to share a piece of my time here with them. Now, I’m sitting in a little café in Rishikesh, solo again, overlooking the Ganges and Himalayan foothills searching for words to summarize my experience fully.

My view right now in Rishikesh... I can't imagine a more breathtaking place for writing.

My view right now in Rishikesh… I can’t imagine a more breathtaking place for writing.

At the Taj Mahal with two of my sisters, Lauren and Abby. It was so special to share a piece of my time in India with them!

At the Taj Mahal with two of my sisters, Lauren and Abby.

I’ve tried a few different beginnings to this post and they’ve ranged from existential crisis to disconnected and rambling mixes of thoughts. At the beginning of this experience, writing felt easy. I just described my surroundings as an observer. Now, I understand the “what” around me much better, but the “why,” “how,” and “now what” have become more and more confusing, complicating, and haunting. My first impression of India was that I wouldn’t be able to fully describe the experience to anyone, but I didn’t realize that I myself would be included in that group while I try to process the ups and downs of the past 2 months. I don’t know that I’ll be able to fully wrap my head around the ways this experience has and will continue to shape me until long after I’m back in the US.

Celebrating Indian Independence Day in Udaipur-- so colorful.

Celebrating Indian Independence Day in Udaipur– so colorful.

For now, I don’t want to forget. When I don’t have an umbrella and get rained on, I want to remember the little boys who proudly and excitedly took me under their own as they led me to clinic when I was lost in a slum during monsoon. When I buy groceries, I want to remember the familiar toothy grin of the man at the fruit stand I visited every morning. When I get overwhelmed, I want to remember the Buddhist monk who taught me that the gap between discomfort and letting go is understanding. When communication is challenging, I want to remember the kindness of the community manager in clinic who taught me Hindi phrases so that we could talk. When school is stressful, I want to remember the sheer elation I felt when my coworker tapped me on the shoulder to exclaim that she’d passed her final MBA exam. When I see my parents, I want to remember how special it felt when my mom texted me that she wished we could get brunch or when my dad sent me a funny meme—things so casual and natural which felt so juxtaposed. When I have children of my own and watch their Little League games on manicured baseball fields or see their dance recitals in air-conditioned theatres, I want to remember the joyful little boys I saw playing cricket in the slums.

India, for me, has redefined joy. The people I’ve met and experiences I’ve had have filled me with more love and life and passion than I’ve ever felt. While a part of me is excited to fly home tomorrow, it also feels a bit like turning the page on one of the most invigorating, moving, inspiring, and influential chapters of a book. But, for now, I still have today, and I’m spending it immersed in the joy I have found here.

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Candid

Picture me this: an office, full of intelligent women clicking away at computers, analyzing data, authoring reports, planning community education, training a fleet of maternal and child health warriors to sail into communities and make a tangible difference. Women in three different clinics in Mumbai slums spearhead nutritional counseling, pregnancy clubs, cooking courses, breastfeeding instruction, and mother-child bonding classes for local women. For my internship, I’m working with the Foundation for Mother and Child Health and the scene is just this. FMCH women are empowered, wise, strong, dedicated, and passionate. They are tabulating statistical analyses in the office and changing lives in clinic. FMCH is incredibly holistic and their dedication shines through everything they do; in an oral health camp last Friday, my coworker and I brushed our teeth 39 times each, because explaining proper tooth-brushing technique is not enough—you have to show people.

The FMCH Oral Health Camp group-- my coworkers are amazing!

The FMCH Oral Health Camp group– my coworkers are amazing!

My teeth have never been cleaner than they were this day!

My teeth have never been cleaner than they were this day!

Day-to-day, I analyze community data and write assessment reports that FMCH will distribute internally and externally to their donors. One of the most rewarding things I’ve been able to do is observe the three local community clinics and their partner-organization about an hour and a half northeast of the city. Talking with community organizers all over Mumbai has really impressed on me how culturally diverse the city is and how creative FMCH has been in adapting to meet unique local needs.

I was talking with a coworker earlier this week and she began to tell me about an atypical family. The conversation really shook me. In the vast majority of cases, mothers bring their children to clinic. If mothers are unavailable, the mothers-in-law bring the children. The fathers very, very rarely attend. But, this case was different. My coworker explained that the father had afternoons off work and he would bring the children in during that time. Interested, I asked why. I mentally primed myself for an example of flipped traditional gender roles, expecting her to say that the mother was working a job outside the home, had uncontrollable hours, or was caught up with busy afternoons.

This mother was different,” my coworker began, “She was not as interested as other mothers about the health of the children, so the father was actively involved in the health of the children. Actually, the problem was, they had multiple children, 4 to 5 … so she was also depressed of the fact that she had all girls. So she wanted a boy child and she had all girls. So then she was not very happy giving proper care to all these girls.” She went on to describe verbal abuse from family and neighbors, shaming the mother for having only daughters.

It felt like lead had been poured down my throat— fiery, boiling, and dense enough to burn everything in its path to a thick, tar-like sap. The sludge hardened into an uncomfortable and twisted rock in the pit of my stomach. I didn’t know how to respond. I still don’t know how to respond. I sit in an office full of empowered and successful Indian women every day; how can both of these extremes exist in the same space? I could not – and still struggle to – reconcile the contrast. Granted, this is a unique case. It is not the norm. But, she acknowledged it so casually, moved on so quickly. It is rare, but it isn’t the only case, and it was mentioned almost in passing.  I’ve struggled to make sense of this disparity and explain to myself why this conversation continues to be so piercingly difficult for me to digest.

Street art near one of the clinics: "They are our sisters. Respect them."

Street art near one of the clinics: “They are our sisters. Respect them.”

And then it hit me. In in a parallel universe, I am one of those little girls. I’m the third of five daughters. In picturing this family – these real little girls, these real parents, these real, living, breathing people – I can’t help but see my parents, my sisters, myself. I hear my dad chanting “girl power” into our ears before we could speak English and I hear my mom chanting “girl power” across the finish line of her 9th full marathon. I think of my childhood and how the five-year-old version of myself never gave gender a second thought. I think of my sisters today, expected to achieve, independent of gender. And my heart aches. Because the root difference between my experience as one of five daughters and that of these little girls is an attitude, a mantra, a value. “Girl power.” My heart aches because these little girls are barely being given a chance at nutrition.

There’s a concept in anthropology called ethnocentrism. It’s the assessment of another culture based on the standards and moral framework of one’s own culture. In its most basic form, it is thinking your culture is superior to another’s culture. As an anthropology major, I so value the validity and importance of different beliefs and practices and have a genuine appreciation for differing frameworks that construct others’ lives.

But, what is culture and what is injustice? How does culture relate to morality? Is it ethnocentric of me to feel that this blatant gender discrimination is not cultural – that it’s inhumane, completely and utterly wrong? Where is the line between respecting another belief system and recognizing something as immoral? What happens when that line is crossed or blurred? Is there an obligation to take a step back, and if so, who has the power and the duty to initiate that step? What is my place in this hierarchy, as a single and fiercely independent woman by herself on the opposite side of the world from her home, completely immersed in another culture?

At times, it feels like I’m inhabiting a different space, delicately layered with surgical precision atop this other world which I can’t fully comprehend. I share physical space with my coworkers. We share delicious chapatti and genuine belly laughs. Together, we work towards the common and meaningful goal of bettering nutrition and health for Mumbai’s women and children. I am genuinely and deeply touched by the strong and empowered women I’ve met at FMCH, but simultaneously shaken by quotes and moments like these.

These stark contrasts and confusing contradictions leave me wondering – what is my place here? People are shocked that I’m unmarried, that I don’t live with my parents, that I’m here by myself, even that I cook and pack my own lunch. People are shocked when I say I went to the movies by myself, did yoga alone, explored Mumbai or travelled by myself. What does it mean for me to be here, integrated and adjusted, but simultaneously, a complete anomaly?

India, it seems, “is” and “is not” simultaneously. It is itself and it is its opposite. It’s mysterious, it’s elusive, it’s just as much an experience or a feeling as a place. India escapes words and words escape me.

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On Adjusting

Phase 1: Aaah I’m here!— World appears in technicolor, overwhelming sense of enthusiasm unobstructed by reality.

  • Takes pictures of everyday scenes and objects: traffic, cows and goats, coconut trees, rickshaws, streets. Picture 21st century Dorothy exiting Kansas for Munchkinland, iPhone in hand.
  • Adrenaline-induced lack of jetlag because WHY sleep when there’s SO much to see?!
  • Forgets all warning and eats anything and everything, irrespective of one’s ability to identify or pronounce it, with an abandon typically reserved for children left unattended with bags of Halloween candy after trick-or-treating.

Phase 2: What the hell am I doing here? – Symptoms include delayed jetlag, food poisoning, getting caught in monsoon, and the profound realization that a full-time job is, in fact, full time.

  • Everything eaten during Phase 1 exits body quickly and violently. Enter: weeklong diet of apples scrubbed hyper-clean with Aquafina mineral water, peanut butter, and Greek yogurt, eaten with a level of caution comparable that of a helicopter parent bubble-wrapping his child before her first day of middle school.
  • Goes outside during monsoon without an umbrella. Receives free shower.
  • Exits first day of work by promptly embracing the asphalt like a long-lost lover, walking away complete with ripped pants and a bloody knee. Looks back to see if coworkers noticed for fear of appearing unprofessional. (Coworkers did not see, but yes, those children are laughing at you.)
  • Wears new kurta to work inside out. Coworkers giggle and communicate through the language barrier, that yes, in fact, you are an idiot.
Lessons learned the hard way... the dry spot in the middle of my shirt is where I had my arms crossed to keep my phone and wallet dry... I was soaked!!

Lessons learned the hard way… the dry spot in the middle of my shirt is where I had my arm pressed to keep my phone and wallet dry… I was soaked!!

Phase 3: I’m here, I can laugh at myself, and I can do this.

  • Diet re-expands to adventure… with a side of apples, peanut butter, and Greek yogurt. (Old habits die hard… I am who I am!)
  • Purchases umbrella and trusts NO ONE when it comes to the rain. The fact that it looks sunny right now means nothing.
  • Realizes that, after the work-day is over, this experience is kind of a 2-month long date with self. Treats self to dinner and a sold-out, opening night Bollywood movie, yoga, runs around Joggers Park, and a long walk along Marine Drive.
Bollywood doesn't joke around with their movie theatres... complete with a restaurant, cafe, and a lounge with velvet chairs.

Bollywood doesn’t joke around with their movie theatres… complete with a restaurant, cafe, and a lounge with velvet chairs.

Sunday morning yoga and meditation in Bandra

My incredible view for Sunday morning yoga and meditation in Bandra

Enjoying BEAUTIFUL Chowpatty Beach and Marine Drive

Enjoying BEAUTIFUL Chowpatty Beach and Marine Drive

During my first two and a half weeks here, just about every aspect of my life has gone through these phases in one way or another. I’m climbing a huge learning curve. Quite frankly, I literally know nothing here. But, I kind of love that. I love that everything is new and different, but also that I don’t feel like a blank canvas. I feel very much like myself, but with a different, surreal level of awareness.

It’s impossible to take a good, hard look at yourself while surrounded by the little constants of home that go unnoticed every day. Here, all of that is blurred. I’m more aware of my little quirks and the habits from home that I can’t let go of, as well as the nonessentials that I don’t miss at all. I’m more aware of how I react to things I’ve never considered or experienced before—and the values behind those reactions. I’m surrounded by people full of so much love, kindness, and dedication, and I feel so welcomed into both my NGO and to Mumbai, in general. I’m growing and learning and adjusting, and I’m loving it.

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A Cacophony of White Noise

Upon boarding a long flight, the world inhales. Earth holds its breath at the top, soaring over the space we call home and laughing at the concept of time. The plane smiles down on rotating earth for a breathless pause, and people just exist. It doesn’t matter where they come from and it doesn’t matter where they go after the plane lands. For those small hours, it is just a flying bubble of humanity bunched together 35,000 feet above familiarity, waltzing through the clouds until the warp is burst like a child popping a soap bubble with a splash of bath water and a high-pitched giggle. Either that, or you’re the one-woman-audience-gone-disembodied-ear to the plane’s resident chatter, in which case, time does exist, just perhaps on 0.5x speed.

Eventually, Earth exhaled. My flight touched ground, and everything was slowly different. Colors more vibrant, tastes more flavorful, traffic more bustling, heat more pounding, differences more stark.

On my cab drive into Varanasi, emotions swirled through my mind like a bewildering cacophony of white noise. Cars, rickshaws, bicycles, cows, motorcycles, and people weaved through one another like bees atop the decorative paint I used to call “driving lanes.”

A not-too-busy road in Varanasi

A not-too-busy road in Varanasi

Some barefoot children on the roadside played makeshift cricket and cackled with laughter in fits of unadulterated joy, others used their entire bodyweight to heave water from wells to buckets, and still others simply stared into space. Women balanced large baskets of goods atop their heads and babies on their hips, men pulled carts of handicrafts through the streets to market. In that moment, I realized that I will never be able to verbalize this experience to anyone. No words could fully encapsulate the complex, diverse lives I feel so blessed to be able to witness. The way that traffic teases the laws of physics, how informality flirts incessantly with logic, the way that poignant poverty so visibly and sickeningly besieges communities.

I feel so nauseatingly privileged. It is not fair. It’s not fair that, as a starry-eyed white woman, I get to show up on the other side of the world, experience this vibrant country and learn from so many kind-hearted individuals, many of whom don’t have the same access to come back to my country and do the same. It is unfair that I have never so much as had to walk home without a pair of shoes, while there are people here, on the same planet, at the same time, literally cutting off their feet just to beg more pitifully. The inequality is nauseating. Some way, somehow, I was born into a Suburban family with an air-conditioned home and a college-bound mentality. I could’ve been born anywhere to anyone. During my fellowship, I genuinely, desperately hope to use the immeasurable privilege of being here, being in college, being a white, 20-year old American woman, to give something of value to the amazing people here in some small way.

Though I feel it’s necessary to first acknowledge my privilege, it would also be a huge disservice to the captivatingly diverse and intricate cultures that make up India to NOT mention how incredible it is here. I am currently in Mumbai and will start my internship with the Foundation for Mother and Child Health in the morning, but I spent the last week exploring Varanasi and Dharamshala.

Varanasi was a nosedive into India; as the spiritual capital, Hindu pilgrims come to bathe in the Ganges and individuals bring passed family members to burn at ghats alongside the river. Religion was prominent in every aspect of Varanasi. I was really moved by the people’s genuine, enduring dedication to their faith, day in and day out.

Our kind boat driver in front of the main burning ghat, Manikarnika Ghat

Our kind boat driver in front of the main burning ghat, Manikarnika Ghat

After the evening Ganga Aarti Ritual at Dashashwamedh Ghat

After the evening Ganga Aarti Ritual at Dashashwamedh Ghat

Two overnight buses and a day in Delhi later, I arrived in Dharamsala, home to the Dalai Lama and the Tibetan government-in-exile. Unfortunately, I missed the Dalai Lama’s birthday party because I was curled in the fetal position vomiting the contents of my digestive tract for 48 hours, but luckily I recovered in time to hike the Himalayas with a Tibetan monk, oral rehydration salts in tow. (Now, THERE’S a sentence I never thought I’d write!)

Splashing around by a waterfall, hiking in Dharamsala

Splashing around by a waterfall, hiking in Dharamsala

"Mountains have a way of dealing with overconfidence." - Nemann Buhl

“Mountains have a way of dealing with overconfidence.” – Nemann Buhl

As I sit here in a little café, nestled in the corner of Mumbai that will become my home, I realize that I have gained such a rich set of experiences from just a week and a half in India. With many, many weeks ahead, and my first official day of work with FMCH tomorrow, I’m filled with so much excitement, nerves, readiness?!, fear, and passion for all that is to come with my internship and experience here in India.

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Pre-departure: Fifth Grade Field Trip to Trip Across the World

I grew up in Jacksonville, Florida—a sunny, southern city just 2 hours north of the place that stressed and sunburnt tourists dub “The Happiest Place on Earth.” I was in fifth grade when the Esteemed Graduating Class of Julington Creek Elementary School was to go on a class field trip to Disney’s Animal Kingdom—very Florida, I know! Expedition Everest, Disney’s brand new roller coaster at the time, was all the gossip amongst the eleven year-olds. It was the tallest mountain in all of Disney World. It went backwards. Who would be brave enough to ride it?

Wanting to be fully prepared for the challenge, I spent weeks researching the ride; I read statistics about its height and speeds, learned about the Yeti supposedly hiding inside the mountain, and even watched YouTube videos in an attempt to learn each twist and turn of the ride before I was strapped in. The morning of the trip, one of my sisters even slipped a “good luck” note under my bedroom door. You could say I was a pretty cool fifth grader.

Preparing for the Summer in South Asia Fellowship feels a little bit like the twenty-year-old version of tackling Expedition Everest: I am “strapped in,” equipped with all the knowledge I’ve been able to pack inside my mind and an incredible amount of support, yet somehow I know that the experience will be more than I’m capable of understanding just yet. The simultaneous feeling of surreal, immeasurable excitement and gut-wrenching nerves is indescribable—perhaps because I’ve never experienced anything just like it.

Rewinding to October… I stumbled across the Summer in South Asia Fellowship while scrolling through MCompass after a life-changing study abroad experience in Grenoble, France. The flexibility of the program really appealed to me— I’m a premedical student passionate about anthropology and women’s health, so the possibility of adapting a program to fit all of these interests seemed like a dream. The opportunity to travel to India instantly captured my attention, as well. As a ballet dancer, I’ve always admired the energy and precision of Bollywood and classical Indian dance. As an Anthropology major, I’m fascinated by the country’s diverse cultures, religions, languages, and breadth. After seeing a heartbreaking video about infant malnutrition in developing countries in my Childbirth and Culture class, I was inspired.

I will be working with the Foundation for Mother and Child Health (FMCH) in Mumbai. The organization provides both intensive medical care to severely malnourished infants and nutritional education to local mothers. My final project will focus on the uniformity and effectiveness of FMCH’s dissemination of nutritional advice information to two local clinics. I’m really looking forward to learning more about the different perspectives of those involved.

Despite the hours spent applying, preparing, researching, learning… it all still doesn’t feel like real life just yet. It’s pretty surreal that I’ll be flying to the other side of the world in just under 2 months…

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