About Neha Tiwari

Neha is a Junior with a major in International Studies: Global Environment and Health, and a minor in Biochemistry. She hopes to pursue a career in public health and medicine with a focus on health equity and mental health. Neha will be spending three months in Goa working with Sangath, an NGO dedicated to improving health by empowering existing community resources to provide appropriate physical, psychological, and social therapies. Neha's final research project will explore the effectiveness of the integration of community-based lay counseling in a traditional mental health treatment program.

Final Farewell

*Supposed to be posted June 22nd

I look around my empty room. This tiny studio apartment with the little kitchenette and cube like bathroom lays empty and my bed is bare. I’m exhausted as I spent the previous night and much of the early morning trying to fit my life her in Goa into my tiny blue suitcase. My flight to Varanasi is in three hours and I can hear the cab driver downstairs honking his horn to let me know we’re running late. I do a last minute scan of the room to make sure I haven’t missed anything before carefully pulling my stuffed suitcase and backpack out the door and into the cab driver’s hand. I duck back into my room for a final goodbye and immediately go to the balcony for a final scan of Calangute, Goa – my home for the past three months. Yesterday was my last day at the office and I will always remember my time at Sangath with fond memories. The other interns – all 7 of us girls–had formed a close bond during our shared time working here. I know I’ll miss going out and exploring Goa with them on the weekends, going to the beach, and just grabbing dinner after a long day at the office. I’m truly so grateful for this incredible opportunity I’ve been afforded this past summer. Sangath has such a welcoming environment for interns and it helped shape a 3 month program that would build my skill set and experiences while still making sure the work I provided Sangath was useful to their research endeavors. I made so many friends and connections here, my mentors and their guidance, whom I have to thank for such a enriching experience and helping me realize my professional goals as well as addressing gaps in my own understanding of what it means to treat mental health from a global perspective. And I’m grateful to all the friends I made in the office who shared with me their home here and made my stay feel very personal and comfortable.

I hear the driver honk again and I rush out into the waiting cab. I miss my home in Michigan and I’m excited to explore the rest of India, but now I know after 3 months in Goa that a little part of me will always remain here.

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A Day out in Anjuna

*Supposed to be posted June 15th

This is my last weekend in Goa and luckily I had a visitor to share it with me! Brianna is also a student from the university of Michigan who is conducting an internship this summer in India at a PHC in Delhi. She flew down to Calangute to stay with me for the weekend and we went out to a great local restaurant right on the beachfront. Souza Lobo is a famous restaurant located right on Calangute beach. It’s been open since 1932 and boasts fresh caught seafood, Goan dishes, and live music every night. It was some of the best prawn curry I’ve had since arriving in Goa.

The next day we took a day trip into Anjuna. It’s another costal town about 20 minutes north of Calangute and boasts some spectacular local artists and cute café/boutiques. We stopped by at Artjuna for brunch –it’s a Portuguese styled café venue that serves both local and international dishes that focus on local produce.   They had a shop attached that sold local artwork such as wood carved trunks, jewelry, and cloths. We spent much of the day exploring Anjuna. One of the things I adore about this place is all the lush greenery surrounding the town; it makes it feel like you’re smack in the middle of a jungle and only coming upon pockets of inhabitants. I love it especially during monsoon season, when all you can smell is rain, fresh soil, and the ocean, being in Anjuna is like no other experience.

After three months of staying in Goa, going out alone can still feel daunting, especially when you’re bogged down with work and you just can’t seem to get yourself out of bed on the weekends. But I’m glad I got to hang out with Brianna and get to see more of Goa. It was a fun and relaxing last weekend, one that I am happy I got to share with another wolverine!

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Field Experience

*Supposed to be posted June 27th

Today I woke up 3 hours before I usually do to catch a ride with my coworkers into a rural community in northern Goa. This was my first field experience since coming to Sangath and even though the sun was barely up, I felt excited that I would finally be able to see mental health work in action in the field. Three of my coworkers who were also trained lay health workers were tasked with conducting training for the Gatekeepers of that specific community. This is based off a task shifting model where in low resource communities, lay health workers and gatekeepers- people identified by the community to be important members that hold access and the trust of the community members—are trained to identify and give basic treatment for mental health illnesses and to point people to other resources and agencies that are equipped to treat them. In this training we spoke with Anganwadi workers of the SAFE Project on Helping hand course that would encourage the AWW and the self help group members to strengthen their general skills for communicating and referring the patients to Sangath and to other similar organization. It was a successful training conducted for 41 participants and received positive responses as well as a greater demand for similar trainings to be organized in more communities by the participants. I felt so lucky to help out on this vital part of Sangath’s services and to see all the hard work my fellow coworkers put into the training process come to fruition in the smiles and answered questions of the Anganwadis. I got to interact with the community members who come face to face these mental health issues and now are better equipped to give support and refer resources to those who did not previously have access to care. It’s an experience that I won’t likely forget anytime soon and one that I will carry into my professional career.

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Sangath

* Supposed to be posted June 2nd

I think one of the most poignant things about my internship is how at home I feel at Sangath. Everyone has been so welcoming and warm to me since the day I got here.   They’ve made a place for me at the office with my own desk space and have provided me with two mentors to help guide me while I conduct research here. I’ve gotten to know my coworkers here through shared lunches from the shack down the road, team meetings, and daily tea breaks. Some of the other girls interning here have even showed me around Porvorim – taking me to great South Indian restaurants, the market place in Mapusa, and to some local beaches. I feel like I’m building strong friendships and a real sense of community among my coworkers here at Sangath. My mentors are leaders in the field of mental health work and I’m learning so from them through workshops, meetings, and observing their work. This converted bungalow seemed so daunting my first few days here, but now as it greets me in the morning, I can’t help but feel a sense of familiarity and excitement to see the office and dive head first into the work being conducted at one of India’s leading mental health research institutes.

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Down the Coast: Road Trip to Goa

*Due to technical issues could not post on the correct date – supposed to be posted May 19th  

My first few days of my internship have ended and I reflect on how I arrived here in this tropical wonderland of villages. I had landed in India May 8th and stayed with my cousins in Mumbai before we all decided to make a family road trip down the western coast to Goa. It was an estimated 10 hour car trip through winding mountain roads and jam packed express highways. The almost 600km journey could not be attempted in one go so we stopped for the night at Kholhapur – a town midway that boasted beautiful temples and amazing local chicken dishes. The city is home to a beautiful black stone carved temple that resides on the eastern side of the city. Here thousands of people come from all over India to visit the beautiful Shri Mahalaxmi temple– the only relic still around in that part of the state that hadn’t been destroyed by the past.

The next morning we packed up our bags and headed out to Goa. The second leg of the journey was beautiful and scenic. We drove through mountain roads and back tracks, my uncle and aunt wanting to make sure I could get the full scope of India from the rural villages to the sprawling forests and mountain ranges that line the western coast. It has been by far one of the best road trips I have every taken.

I’d encourage anyone who is traveling in India to try to take at least one road trip – it doesn’t matter where (of course some places provide more scenic routes than others) but the important thing I learned from this trip is that I got to see another side of India I could have missed had I flown directly to Goa. I got to immerse myself in the natural beauty that encompasses this complex and eclectic state. I also got a brief introductory glimpse at the communities that form the true heart of Goa – the ones I hope to serve and get to know better during my internship.

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Remembering Goa

I’ve been back in Michigan for about 3 weeks now but it seems like parts of me are still left behind in Goa. I think about all this fellowship has provided me with this summer from the chance to travel half way around the world and live independently in another community, to that fact that I got to hands-on experience in the field what I hope will become a very big part of my future career. While at Sangath, I learned not only about global mental health, but also a lot about myself and where I can fit into the future solution of bridging the treatment gap.

Throughout the internship I had valuable mentors that could provide me with guidance and support, a whole host of coworkers that were engaged and connected with the community and who could show me the parts of Goa that are often hidden behind the façade of being a tourist destination, and a talented and diverse cohort of interns that shared my passion to be a part of the solution. This internship not only opened my eyes to the gaps and ignorance of my own knowledge about mental health care in low and middle income countries, but it also allowed me to see how innovation plays into solving problems in countries that may not have the necessary funds or resources to care for their population. More specifically, I learned that I had a lot of skill gaps and knowledge gaps in the field of public health and this internship allowed me to understand that a lot of my learning will be done outside of classrooms and in communities that are facing these challenges everyday.

Sitting at home as I write this, I realize how much I miss Sangath, the friends I made there, and the vibrant city of Calangute that I called home this summer. I hope that someday I can go back, but until then I am so incredibly grateful that I could complete this journey as it is definitely something that will stay with me for the rest of my life.

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Goa-ing back to India

I stand above an empty suitcase with trepidation.  I should be packing for a 3-month whirlwind adventure in Goa, India. However, something stops me.  Be it the nerves of traveling across the world alone for the first time or perhaps the realization of the magnitude of what I’m about to dive into – but I can’t seem to move my body and start packing. I gently remind myself that this is what I’ve spent months working towards.

Ever since I attended the Summer in South Asia Fellowship presentation back in October I pictured myself where I am today preparing for what in all expectations will be an amazing experience working with Sangath. When I heard I had been selected as a fellow, I was beyond ecstatic! A renowned NGO in Goa, Sangath’s mission is to provide health across the lifespan by empowering existing community resources to provide appropriate physical, psychological and social therapies. They have an international and local renown for combining research with multi-disciplinary interventions to provide under resourced communities and vulnerable populations with greater access to health care. Their programs are considered revolutionary in community based public health work and here I was being offered the immense privilege of working with their research sector to see how mental health is perceived, treated, and de-stigmatized through innovative methods such as lay counseling. Standing above my empty suitcase shaking with nerves, I can’t help but be incredibly humbled by this opportunity.

So I remind myself why I applied to this program. I plan to pursue a career in global public health and medicine with a focus on health equity and community based interventions. I’ve taken many classes during my undergraduate career that focus on global health and it’s become apparent to me that mental health is a sector of health that is often underrepresented, overlooked, and subject to inaccessible treatment for a majority of the world’s population. As someone interested in community based treatments for mental health, I admire innovative ways to tackle the problems that stem from lack of access to care and systematic/structural barriers, which is why Sangath’s approach resonated with me.

But this internship so much more personal for me. I’m a first generation Indian American with a history of mental health issues in my family, specifically affecting the women in my family. I personally understand the cultural stigma attached with mental health in an Indian household and I have witnessed how the day-to-day pressures stemming from that stigma affect the struggles of accessing mental health care. I truly believe the unique methodology that is being implemented in Sangath to treat mental health can be employed on the front lines of fighting that social stigma in many societies towards mental health. It can pave the way for a new vision of mental health treatment. I want to be a part of this process and learn how empowering a community to change it’s perception on mental health can knock down barriers in a society to improve the lives of so many individuals who have previously had no resources nor access to mental health treatment.

There are a lot of expectations I’ve placed on this experience and myself. I’m terrified of traveling across the world by myself. I’m terrified that something will go wrong during my internship or that I may get lost. I’m terrified of saying the wrong things or doing the wrong things while working in a community that is not my own. But what I also realized is that I’m excited to spend 3 months working with a team of passionate and dedicated public health workers on an issue that is near and dear to me. I’m eager to return to a country my parents call home and immerse myself into the local community and culture.  I’m ready to travel and explore new places. But most importantly, I’m eager to begin this journey that will allow me to grow as both a student and an individual and really understand what it means to engage with the global community through an ethical, responsible service based framework. I look down at my still empty suitcase and smile this time – I can’t wait to begin!

 

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