Category Archives: India

Shop With Shakeel!

Pink scarfSo as I said in an earlier post, I missed out on some major souvenir shopping because I left my money and credit cards in Mumbai before traveling to Aurangabad. Fortunately, I had the bride’s gift on me as this is what saved me while I was in Aurangabad. That and the Taj hotels were tremendously understanding and helpful.

At the Ellora caves, there were tons of hawkers, all wanting me to buy their things. It was overwhelming, sort of like turning instantly into a famous movie star and having paparazzi surround you and not let you go.

It was exactly like that.

Which is how I met Shakeel. He was the most persistent and as a result I wound up hiring him to keep the rest of them away from me.

plain blue scarfThis was a brilliant plan except he wasn’t allowed to go inside the caves with me. Within the caves lurked the cave masters. Ok, so that’s not what they’re called, but they are park employees wanting tips, and since I was low in cash, spending through the bride’s gift, I wasn’t my usual understanding and generous self. Do the math. Thirty four caves at at least 100 rupees a cave equals 3400 rupees!!!

In U.S. dollars that is approximately $53. And I didn’t have it. But anyway, I digress.

Shopping is what I wanted to talk about. Silk scarves in India are to die for. I love them. What a great way to feel and look like a girl. Yippee!

The catch is that they aren’t cheap. The ones I’m talking about are hand woven on the loom with intricate patterns. I swoon still just to think of them.

That’s when Shakeel stepped in and saved the day. I was able to work with him to buy the souvenirs I would have bought, but didn’t. We handled these “negotiations” via WhatsApp with him sending me countless photos of scarves and me asking, uh, do you  have anything else?

orange scarfPoor guy. He had the patience of a saint. The best salesman I’ve ever met.

So, check out the treasures of Aurangabad and Ellora though Shakeel. Let him be your personal shopper.

I got my scarves today! And they are lovely. I’m not the greatest scarf model in the world, but you get the idea.

To learn more about Shakeel and what he can do for you, check out his website at www.shopwithshakeel.wordpress.com and Shop With Shakeel! 🙂

Music!

One of the things that seemed noticeably absent from India was music. And this could be because I just wasn’t there long enough to find and associate with music lovers.

Thankfully, one of my new Indian friends has pointed out some artists for me. They are:

Aslam Saabri (below is an example)

Nusrat Fateh Ali Khan

Sabri Brothers (Ghulam Saabri)

Arijit Singh

Indian telephone number

It can make things a lot easier to get an Indian phone number while traveling in India. It’s helpful for arranging cabs and nice for when you meet people. Also, if you are visiting friends in India, having a local phone number can make communicating cheap and easy.

Ok, so how do you do this?

Basically you’ll be replacing the SIM chip in your unlocked cell phone (the key here is that your phone must be unlocked, not all phones are and as far as I know you can’t unlock the phone yourself. You buy a phone that is “unlocked.” Sorry, that’s the extent of my technical knowledge on that subject.)

I went to the concierge at my hotel to get the SIM chip. The brand I got was Vodaphone. It didn’t cost a lot, maybe ten bucks and was well worth it.

I had to show my passport and the phone number for India was set to automatically expire when my Indian visa expired. It was all very neat and tidy.

So I took my SIM chip back to my room and then realized that I didn’t have anything to use to open my phone so I could switch my existing chip with the new chip. That’s when I thought of my earring, and this worked perfectly.

Aurangzeb’s tomb

It’s a simple resting place for the sixth Mughal emperor, Aurangzeb Alamgir (1658 -1707). Said to be one of the most controversial figures in Indian history, the Muslim emperor Aurangzeb remains a bit of a mystery. He ruled for 49 years over a population of 150 million. He was fabulously rich and even possessed the Kohinoor diamond, which now rests in Queen Elizabeth’s tiara. He built the Bibi Ka Maqbara and one of the largest mosques in the world, the Badshadi Masjid in Lahore, Pakistan.


But his final resting place is an open air grave in Khuldabad, Maharashtra, India.


I wasn’t going to visit it. Why, after all? But then I met several people at the Ellora caves, hometown men from Khuldabad, eager for me to see the resting place of this great ruler.

Aurangzeb is the namesake of Aurangabad, the city where my friend got married. He and I have at least one thing in common; we have both explored the Ellora caves, well according to Audrey Trusche’s book. The Ellora caves were lost for a while and then found and all these dates are escaping me.


The place is special to me, not so much for the emperor who lived back then, but for the people who live in Khuldabad now.

Indian Food

I’m back in the States now, but there are several more points I want to cover, so I’ll be posting for a few more days. Tonight I celebrated being home by visiting one of my favorite Indian restaurants here on Oregon. This evening I woke up with that old familiar feeling, heart aching, general malaise, and mild depression. Welcome back to America, the land where we are killing ourselves with food.

I’ll admit that I was a little freaked out about the prospect of eating in India. This is because of everything I had heard about the poor quality and sanitation of the water in Mumbai—from books, websites, and my travel Doctor. I left the U.S. not really knowing what or where to eat. My main guiding principles were 1) don’t eat meat, 2) don’t drink tap water, 3) don’t drink alcohol, 4) eat things that have been cooked at high temperatures. I still think these were good guidelines and I kept to them, well, most of the time.

Coming back from India after two and a half weeks, I felt like myself again. My blood pressure went back to normal (just had it taken at the dentist’s office) and I felt sane again. After eating traditional Indian food, I felt energized instead of how I normally feel here, which is worn out.

So what’s different? I’m actually not quite sure. I think we Americans don’t need to eat as much meat as we do and I think we eat way too much sugar or foods that have a very high glycemic index. While I did eat potatoes and flour in India, I also got a lot of green vegetables and spices. I also am pretty sure I went without MSG, high fructose corn syrup, and canola oil.

On a cultural note, Americans seem to have established a bad reputation for not liking Indian food. Everyone I met was super concerned that I would not like the food. And pride in the food seems to run very deep. My advice is that if it’s a green purée, dive in. It will be delicious!

The Taj Mahal Palace Hotel in Mumbai

I think that when you travel to Mumbai, this hotel is a must see. A landmark in its own right, the Taj was built in 1903 by a man who was not allowed in other hotels because of the color of his skin. He vowed to build the grandest hotel in Mumbai and surely he accomplished that goal.

People who have stayed here or graced these grounds are numerous and humbling. Duke Ellington, John Lennon, Yoko Ono, Oprah, Hillary Clinton, Barack Obama, and Ghandhi were all here.

I suggest staying in the Tower wing. It is newer and cheaper but most important it gives you an excellent view of the older part of the hotel which is stunningly beautiful.

Visa for India

Right before my trip, I had some concerns about how to get a visa for India. I contacted the travel office where I work and was instructed to go through a third party as they didn’t recognize the website I had found. The third party was expensive and was going to take some time. This is their website: https://www.g3visas.com/ Sorry, I’m just going to say it. This was bad advice.

That might be a great website for getting a business visa to India, but for a simple tourist visa, there is a much faster and easier way. In fact, by following the instructions to the letter, I received my e-Visa to India (and it worked) in 24 hours. Here is the website for that: https://indianvisaonline.gov.in/visa/index.html

One more tip. When you get your passport photos (I got mine done at a local FedEx office), get several copies. The other copies will do for your visa and then once you get to India and you want to get an Indian phone number, a passport photo comes in really handy because they will want a photo of you when you get your temporary Indian phone number. More on that in a later post.

The importance of knowing Hindi in India 

People will argue with me about this, but I’m going to say yes it is important. Knowing at least a little Hindi will set you apart from all the other foreigners. Just knowing please, thank you, hello, goodbye, etc really goes a long way to showing interest and respect.

And, in my experience here, the people I was most drawn to knew very little English. 

Yes, you can get by without knowing anything. Most educated people will speak English, but you have to remember that their education is a result of privilege. Privilege insulates you from the harsh realities of the world and can even breed entitlement. In my experience people who feel a strong sense of their own entitlement are not only ignorant of the world but down right dull.

To meet all the coolest people, learn some Hindi.

Vipassana Pagoda

This is the Buddhist temple that none of my Mumbaikar friends knew about. It is within view of Esselworld, the amusement park located in the northwestern part of the city. It is quite a drive to get here. Worth it? If you are a Buddhist, I would say yes. After all the tightness of the main part of the city, the openness and cleanness of this area is a great relief.

Ellora Caves: Best ways to see

Tips: People tell me the best time to go is in November. This is for lush greenery and nice temperatures. They also say the rainy season is good for the waterfalls that run right past the caves. So that means June on into November. Take shoes with good tread for the rainy season because these rocks can get slick, and I personally would take a walking stick for this weather.

The posh experience: For luxury in India, it is my bet that you can’t beat the Taj hotel and its affiliates. Just be aware that you get what you pay for. These hotels can be as expensive as nice hotels in Seattle and New York City. But their service is phenomenal.

Authentic and more affordable Ellora caves experience: For much lower prices but to still get a safe and enjoyable experience, I have a couple of people to recommend. These guys are “hometown” men and know the region better than anyone. I have full confidence in them and they are who I would contact if I ever decided to return to the region. They can get you an affordable hotel walking distance from the caves! If you want to support local people, this is a great way to do it.


Mr. Sadeek speaks fairly good English. He knows everyone who is anyone in town. People go to him to get their problems solved. In other words, he’s the man.

The other person I met I don’t have permission to share his name and contact number simply because I didn’t ask. This person took me on a wonderful tour of Khaldabad, the resting place of Aurangzeb himself, and he too knows everyone. Younger and less experienced than Sadeek, this man is highly honorable. If interested, contact me via this blog and I can ask him if I can share his contact info.

For the finest cloth I have ever seen, hand spun on looms, you must visit this place. It is fairly close to Ellora caves.

I will be shopping with them online and possibly via WhatsApp.

And for great, trustworthy, knowlegable cab drivers, my choice is:

Lost my credit cards, bank card, driver license, dollars

Yep, that’s what I discovered on my friend’s wedding day. I frantically tore through all of my luggage, and it was gone.

The driver was coming in 15 minutes and I had to face down the reality that I didn’t have the card to pay for the hotel or the cash to travel around Aurangabad and quite possibly I would miss seeing the caves.

Was it stolen? Did I drop it? Where was I not keeping an eye on it? When was I apart from it? When did I last see it? Think!

I spoke to the hotel manager while the driver waited. I gave them things to do, research bank numbers, etc. No time to cancel anything and besides I could dispute charges. The main thing became:how was I going to pay for my room?

The wedding was beautiful. The bride was radiant. The groom was handsome. It was fun being around everyone and taking part in the action. It was such a happy day.

I knew that somehow my problems would all get solved. I still had my passport. I still had some money though certainly not much. All of a sudden I had friends and I knew I had a place to sleep in Mumbai if I needed it.

After the wedding, I checked my email and the Taj had found it! I think the Taj just may be the greatest hotel in the whole world. When you dare to dream of unsurpassed customer service, it has to be the Taj. The Vivanta Taj in Auragabad is quite spectacular too with its beautiful garden oasis and exceptional customer service. My room is lovely with high ceilings and an attached terrace.


I won’t bore you with the details, but we got things all figured out. I feel like an idiot of course, but I am very glad and sincerely grateful to both Taj hotels.

Our office in India!

I just had to put an exclamation point on that. The community feeling at our company is so strong  and our confidence in each other is so great that we can literally fly halfway around the world on a few days notice and instantly feel at home. 

It may sound like I’m drinking the cool aid, but our values cross international borders and our company culture is strong. Whether I am vacationing by a remote campfire in the Olympic National Forest in the U.S. or meeting a colleague in Mumbai, I continue to hear stories of how our products are the best on the world. It’s something for us all to be very proud of.


And the view is pretty sweet.

Sorry, you have to have a badge to go any further.

The Taj Mahal Palace Hotel has a bookstore!

The Taj has at least two wings of high end shops. I’m not much of a shopper these days, but anyone who knows me knows I have a weakness for books. And the Taj, being the wonderful place that it is, has a very nicely stocked bookstore with high quality reading material.

Since I’m traveling, I only bought 3 books.

Jehangir Art Gallery

The Jehangir Art Gallery showcases the work of local artists, and when I went yesterday, there were four exhibitions. The artists were onsite and ready to explain their work. They were all good, but one stood out above the rest. I think she is nothing less than a great artist and thinker if our time.

Now granted I am a layman when it comes to art and art critique, but as with science I also don’t hold an isolationist or an exclusivist view of the subject. I believe that art and our ability to enjoy and create art is one of the qualities that defines what it is to be human. (Though I could be wrong as some birds so clearly exhibit an artistic bent on dance and nest design).

I believe that art is for everyone and everyone is entitled to his opinion and reaction to art.

Milburn Cherian is a surrealist who paints complicated scenes with acrylic on canvas. I don’t feel knowlegeable enough to describe her work in technical terms, so please visit her website to learn more.

One of her pieces struck me so forcefully that it almost seemed like a memory. Complicated, symbolic, technically masterful, and thought provoking, Milburn Cherian brings a unique and moving perspective into the world. She clearly is comfortable embracing that often terrifying yet exhilarating creative force.

Her website is http://www.cymroza.com
Milburn Cherian

Milburn Cherian Artist Website

Planning my last day at the Taj

Goodness, this blogging stuff takes time, but it is nice to keep a record. The screen on my iPod malfunctions and WordPress autocorrects with sometimes embarrassing words and I don’t always notice it.

 Tomorrow is my last day at the Taj Mahal Palace Hotel and I am sad! Sometimes a stay can be too long, but not here. I haven’t really even explored it yet!

Ringo Starr and John Lennon stayed here. This is the hotel where John and Yoko didn’t emerge from their room for five days!

Duke Ellington, my most beloved composer, stayed here!

And many others.

So photos are forthcoming.

The swelling on my feet and legs has gone down, but is still present.

This afternoon I will visit my company’s office here. That is pretty exciting,and I already have it in mind to talk shop and ask how my department can better serve our India office. I have a few of my own ideas of course!

Last night I got to meet my colleague and his family, and he was kind enough to bring Epson salts for my feet!

He has a lovely family and they have very generously invited me over for dinner tonight. So I will see another area of Mumbai.

At the Taj Mahal Palace Hotel


But I digress. I was going to write about my plan for tomorrow.

6 a.m. – Rise and shine.

7 a.m. – Grab a quick bite and go to the Gateway of India and take photos of the birds.

8 a.m.  – Swimming pool for the rest of the day!

So I drank the water I was served today and it wasn’t from a bottle. I was assured a few days ago that the Taj is very careful with their water and filters it, etc. So we shall see.

Mosquito Report

Before coming to India, I was warned by the doctor at the travel clinic that mosquitos carry all kinds of diseases, not just malaria. He said: don’t get bitten.

Today at the Chhatrapati Shivaji Maharaj Vastu Sanghralaya museum (formerly known as the Prince of Wales museum), I was bitten 10 times. I didn’t think to wear Deet to the museum and the windows were open.

Cool museum though. More on that later.

The Caves at Elephanta Island

Located 9 km into the Arabian Sea, off the coast of Mumbai, is the small island known as Elephanta. Formerly, as with most things in Mumbai, it used to have a different name, Gharapuri, which means the place of caves.

These caves contain magnificent statues carved from rock and are thought to date back to approximately the 5th century AD. The caves are named after the basalt elephant that the Portuguese saw as they approached the island. This Elephant now resides at a museum in Mumbai.

Spoiler alert: I did not see all the caves. There is one primary cave that the Portuguese did their best to destroy back in the 1600s. The others are much more “Spartan” and after seeing three caves, I was good, what with the heat and the tourists, stray dogs, monkey families, and random young men approaching for photos, plus the prospects for a ladies room looking pretty slim, I decided not to be a hero about this tourism stuff. And, since the 20 hours of flying I had just done, both my feet have swollen up like balloons with the swelling crawling up my legs toward my knees.

Regardless of the defacement performed by the mindless idiots several hundred years ago, proving once again that humanity’s stupidity is timeless, regardless, the cave sculptures were pretty cool.




Survival Instincts

As a woman traveling alone, I’ve become keenly aware of my oneness. Just this morning, the trip from my hotel to the Gateway of India (only across the street) was trying. It seemed that people were approaching me from all directions to get me to commit to something they could charge me for.

Relentless.

My number is 4. After 4 “no thank yous,” I start yelling. I’ll be polite and demur up to a point, and then look out.

I’ve thought a bit about how to keep myself safe. There are the no brainers. Don’t go out alone at night. Don’t drink. Careful how you interact with men.

Today, I began to notice my knee jerk social strategies that for better or worse do seem to be mine.

In the Dubai airport when I felt a bit out of my element, I befriended a young mother with two children who was struggling to find her terminal. We were both going to India!

Today, at the Gateway, I needed directions for where to board the boat, so I knew I had to find someone who spoke English. I walked around listening, and then spotted some white people. They were from Argentina. Spanish was their language, but they knew just enough English to tell me they didn’t know where the dock was. But fortunately this group of adventurous foreigners had a tour guide.

Friend of Richard Gere and lady who paid my debt to a Spaniard
On the boat, I noticed another white lady alone. She turned out to be 71, fabulously wealthy, and an acquaintance of Richard Gere.She ultimately paid the 3 dollars I was lacking to a Spanish man I had convinced, no easy task, to pay the money I needed at the gate.

It’s a long story, basically I only planned to take the money I needed, plus a little extra. After patting myself down a few times, it was obvious that I had not planned for 3 places where I would have to pay: the ferry ticket counter, the entrance to the island, and again after climbing what seemed like a mountain of stairs, a foreigner’s price right before the caves.

On the way back to the boat, tired, hot, feeling poor because I had misplaced my cash and actually had to beg for money to pay my ticket into the caves, I was getting a wee bit depressed until I saw a Sikh and determined that I was in good company after all.

I didn’t talk to him but just knowing about the Sikh philosophy of respect for all humans made me feel better. I wasn’t completely alone.

The Spanish man and the rich lady had tossed a little shade my way over the three dollars.

It recalled to me how it was to be in Russia, when strangers watched out for me and questioned me about whether I was freezing to death and emptied their kitchens to throw dinner parties. I remember my friend from the Republic of Georgia who was on a strict allowance for school, who was barely making it reach into her purse and give money to beggars on the street. Her heart was so big. Do large wallets shrivel the heart?

And all that time, I had the money, just in a different pocket.

When I told an Indian man who was trying hard to be my last minute tour guide how I had to beg for the money to get into the caves, he laughed. 

And then after seeing the weird irony of it all, so did I.

Elephanta Island

Here’s a tip for anyone well adapted to cold but not heat—go in the morning! Take the first ferry, which leaves at 9 a.m. 

Someone tried to stop me on the way to the ticket office and convince me to go in the afternoon, but that would have the wrong choice for me.

The trip takes about an hour. To sit on the upper level, you have to pay 10 rupees more. Either place, top or bottom seemed fine. I opted for the top.


Once you get to the island, you take a small train to the base of a hill you must climb to see the caves.

Porters will carry you up the hill for about 1200 rupees.


I chose to walk in hopes of relieving the swelling in my feet that happened after my 20 hour fight in.

It was a hike, but doable.

I had hoped to see the rest of the island, but proved to be too harsh an environment for me. Heat, bugs, mosquitoes, seemingly abandoned dogs, monkeys, and people eyeing me, sometimes not in an entirely friendly fashion.

These people laughed at me for how I was wearing my scarf (incidentally it was like a babushka), so I questioned them about it and then took their photo.


See, still smirking. They said there was nothing wrong with my scarf, I think they just couldn’t find the words. So, here’s me with the scarf.

I thought maybe it was the color or the pattern, but the concierge at the Taj said that this is how old women in remote Indian villages wear their scarves out of modesty and respect.

Later on someone really liked my scarf. So there.

Trains in Mumbai

There has been a lot of advice to NOT ride the trains in Mumbai. They are crowded. They aren’t designed with foreigners in mind. They can be dangerous. People die on the tracks every single day. Blah, blah, blah. I’m totally going to do it. (I think.)

Notes to Self on Trains

  • Mumbai has 3 major train lines that run north and south.
  • There is also a new metro line in the northern suburbs and a monorail in eastern Mumbai.
  • The “Western” line has the most points of interest for travelers. (It starts in the south from Churchgate Station.)
  • To get around not being able to read or understand Hindi,  note your stop, how many stops you’re traveling, the stop before your destination.
  • Avoid peak hours! (9 to 10:30 a.m. and 6 to 8 p.m.)
  • Avoid going South in the morning.
  • Avoid going North at night.
  • At the ticket window, there should be two lines, one for second class tickets (right) and first class (left)
  • Tell the ticket attendant: [destination station] + first class + return journey + head wobble?
  • First Class ticket costs between 10 and 50 Rupees
  • Female only cars are green
  • First class is denoted by red and  yellow strips on the columns nearby or red and white stripes on the actual rail car

train-platform-sign

From Reality Tours and Travel

 

Questions:

  • Can I just get a monthly pass or something like that? Do I have to buy a ticket every time?
  • Where do I get a map in English?

Special thanks to:

http://realitytoursandtravel.com/blog/guide-mumbai-trains/

Elephanta Caves — Planning

I love history and archaeology, so the moment I learned about the Elephanta Caves (a World Heritage Site), I knew they were first on my list. Although it’s unknown who built these caves or when, art historians have placed these caves at the 5th to 8th century A.D. Some say these caves are not man made.

The Elephanta Caves on are Elephanta Island, which is east of Mumbai (old?) and west of Navi (new) Mumbai. The island is 1.5 miles in length, and the journey there by ferry will take about an hour. Mango, tamarind, and karanj trees cover the island.

Below is a map of my new stomping grounds: (click to enlarge)

depart-to-elephanta-caves

Place/Activity Times Cost   When Closed Notes
Elephanta Ferry 9 a.m. — First boat leaves Apollo Bandar

2 p.m. — Last boat leaves Apollar Bandar

12 Noon — First boat departs island

5:30 p.m. — Last boat departs island

₹150 Mondays It takes one hour to get to the caves.

Boats leave every 30 minutes.

Elephanta Island and Caves

Please imagine that the images below fit together properly. Travel has no place for perfectionism. 😉

elephanta-island-north

elephanta-island-south

  • Historical Shiv Mandir (Northeast on Island)
  • Historical Shivja Temple (Northwest on Island)
  • Elephanta Caves (Central)
  • Elephanta Lake Garden (South Central)
  • Cannon Point (West)
  • Shree Datta Mandir, Gharapuri (South)
  • Gaondevi Temple (South)
  • Someshwar Mandir (South)

*******

New Word Alert!
Mandir — a Hindu Temple
Bandar — Port
Hillock — small hill or mound
Stupa —dome-shaped structure erected as a Buddhist shrine

*******

Here is what the inscription at the island says about the Elephanta Caves (take from a tourist video on YouTube):

The island of Elephanta, originally known as Gharapuri, derives its name from a massive stone image of Elephant now displayed in the “Veermata Jijabai Bhosale Garden” (Victoria Garden) in Mumbai. The cave complex of Elephanta comprises a total of 7 caves. Of them, 5 are in the lower western side, while 2 are at the eastern top of the hillock. Out of 5 caves at the lower side, the Cave No.1 is exclusively carved with various manifestation of Lord Shiva. It consists of a pillared hall with a small shrine and four entrance doors flanked by the guardians. While the massive but graceful figures of divinities, guardians, and certain architectural features, such as the square pillar with cushion capitals suggest Chalukyan influence, the depiction of mountains and clouds and the hairstyles of woman are  reminiscent of Gupta art.

Facing north this main cave consists of a sanctum and massive hall divided into 5 bays. The excellent carved panels on the walls of this cave include the Yogeshvara (Lord of Yoga), Nataraja Shiva (Cosmic Dancer), Shivaparvati, Ardhanarishvara Shiva, Kalyansunder Murti, and Maheshmurti. The ceiling of the  main cave is believed to have been originally painted with different colours. The Maheshamurti of Shiva is depicted on the south wall with three aspects of creation, protection, and destruction, revealing a masterpiece of Chalykyan Gupta art.

The circular pedastal in the open courtyard marks the seat of Nandi (Bull), the vehicle of Shiva. The side cave has a small shrine and a Pradakshinapatha (circumambulatory passage) with an interesting panel of Ashtamatrikas (eight mother goddesses) flanked by Kartikeya and Ganesha.

The other caves are plain and lesser embellished. The other antiquarian remains found in Elephanta Caves are stupa (3rd Century B.C.) at the top of the hillock Kshatrapa coins of the 4th century AD and some sculptures including Mahishasurmardini, four headed image, Brahma, Vishnu and Garuda.

This site was declared by the Archaeological Survey of India as a monument of national importance vides no. 2704-A, dated 26.5.1909 and thereafter inscribed by the UNESCO as a World Heritage Site in 1987.

According to a Wikipedia article about the caves,  the Portuguese, who took power in 1534, did considerable damage to the caves. “Portuguese soldiers used the reliefs of Shiva in the main cave for target practice, sparing only the Trimurti sculpture. They also removed an inscription related to the creation of the caves.”

 

 

 

 

 

Immunizations for India

Electron micrograph of red blood cells infected with Plasmodium falciparum, the parasite that causes malaria in humans. During its development, the parasite forms protrusions called 'knobs' on the surface of its host red blood cell which enable it to avoid destruction and cause inflammation. Using scanning electron microscopy, this image shows a knob-rich infected blood cell surrounded by knobless uninfected blood cells. Rick Fairhurst and Jordan Zuspann, National Institute of Allergy and Infectious Diseases, National Institutes of Health. @2006.
Electron micrograph of red blood cells infected with Plasmodium falciparum, the parasite that causes malaria in humans. During its development, the parasite forms protrusions called ‘knobs’ on the surface of its host red blood cell which enable it to avoid destruction and cause inflammation. Using scanning electron microscopy, this image shows a knob-rich infected blood cell surrounded by knobless uninfected blood cells. Photo creidt: Rick Fairhurst and Jordan Zuspann, National Institute of Allergy and Infectious Diseases, National Institutes of Health, @2006.

(Before you read any further, please note that if you are traveling to a foreign country, you should consult a medical professional on what immunizations are advised because the risks are always changing. I am noting the particular immunizations I am taking for my upcoming trip to India so that I have easy access to what I’ve gotten—just in case. Also, the vaccines were a little more complicated than I expected them to be, with scheduling concerns and time needed pre-trip for dosing.)

I have heard about the risks posed by immunizations, and while I think immunizations for children are important, I suspect that we Americans might be overdoing it. Maybe we get too much, too soon?

Also, actions speak louder than words. When it came to my own body, I didn’t hesitate about getting immunizations. For me, weighing all the potential risks, it was a no-brainer.

My general practitioner said he couldn’t give me the immunizations and advised me to consult a “travel clinic.” So on January 23, 2017, I visited the travel clinic in my area, and since these immunizations are not covered by insurance, I paid $442 for two shots and a prescription for two sets of pills. I walked out with a travel card, which in medical lingo indicated the vaccinations I had just received. Thankfully, this was also written out for me (in layman’s terms) in my departing paperwork.

The vaccines I got are listed below: (A shot in each shoulder. As of Feb 5, my shoulders still ache slightly; 24 hours after the shots, I experienced extreme drowsiness and fatigue to the point where I questioned if it was safe for me to drive; this subsided after a day.)

  • Diptheria/Tetanus/Pertussis (Tdap)—(Offers long-term protection)
  • Hepatitis A and B—(need to return prior to the trip for a booster; afterward offers lifetime protection)

Pills:

  • Vivotif for Typhoid—(pills contain weakened live bacteria) Yum. A booster is needed every 5 years for those to remain at risk. (Protection up to 5 years.) A neat feature for this medication is that you can text TRAVEL to the manufacturer, and they will send you reminders so you’ll take your pills on time.
  • Atovaquone-proguanil (aka Malarone) for Malaria—(real-time protection; not long lasting)

Vivotif. The pills are a little tricky, especially if you have many distractions in your life. The Vivotif offers, but does not guarantee, up to 5 years of protection from Typhoid Fever. You have four pills to take, which must be taken a day apart. You need to finish the entire round of medication at least one week prior to departing. Pills must be taken on an empty stomach (two hours after a meal or one hour before a meal).  Vivotif must be kept refrigerated. I figured, why wait to the last minute, so I’m beginning my course of Vivotif today.

Malarone.  I have to take these pills with me to India. I have to start taking the pills 2 days before I depart and continue taking them for 7 days after I return.

*******

So now, what am I hopefully protected against? My departing paperwork says the following:

Clostridium tetani
Clostridium tetani

TETANUS (Lockjaw). Rare in the United States today. Causes painful muscle tightening and stiffness, usually all over the body. Can lead to tightening of the muscles in the head and neck so that you can’t open your mouth, swallow, or sometimes even breathe. Tetanus kills about 10% of those infected, even after they receive the best medical care. Enters the body through cuts, scratches, or wounds.

Corynebacterium diphtheriae
Corynebacterium diphtheriae

DIPTHERIA. Rare in the United States today. Can cause a thick coating in the back of the throat; Can lead to breathing problems, heart failure, paralysis, and death. Caused by bacteria. Spread from person to person through secretions from coughing and sneezing.

Bordetella pertussis
Bordetella pertussis

PERTUSSIS (Whooping Cough). A baterial disease that causes severe coughing spells, which result in difficulty breathing. Marked by vomiting and disturbed sleep. Can cause weight loss, incontinence, and rib fractures. Up to 5% of adults who contract pertussis are hospitalized or have complications that include pneumonia or death. Spread from person to person through secretions from coughing and sneezing.

Hepatitus A virus
Hepatitus A virus

HEPATITIS A. A viral disease that affects the liver.  Caused by ingestion of contaminated food or water or via contact with an infected person. Most people recover from infection. Associated with lack of safe water and poor sanitation and hygiene. Can cause acute liver failure, which is often fatal. Does not cause chronic liver disease. Most people recover.

hepatitus-b-virus
Hepatitus B virus

HEPATITIS B. Hepatitis B is a serious infection that affects the liver. It is caused by the hepatitis B virus. Can cause cirrhosis of the liver or liver cancer. Can cause loss of appetite; fatigue, pain in muscles, joints, and stomach; diarrhea; vomiting; and jaundice. People who are chronically infected can spread the disease even though they don’t look sick. Virus is easily spread through contact with blood or other bodily fluids of an infected person. People can also be infected from contact with a contaminated object, where the virus can live for up to 7 days. Can be infected by breaks in skill (bites, cuts, sores), contact with objects (toothbrushes, razors, unsanitized medical devices), sex, sharing needles, being stuck by a used needle.

salmonella-enterica-serovar-typhimurium
Salmonella enterica serovar typhimurium

TYPHOID FEVER. Can be caught from eating or drinking contaminated food or water. It is caused by a bacterium, S Typhi. Causes a high fever, fatigue, weakness, stomach pains, headache, loss of appetite, and sometimes a rash. If untreated, kills up to 30% of those infected. Some infected people become carriers and spread the disease to others.

a sporozoite of Plasmodium bergei migrating through the cytoplasm of midgut epithelia of an Anopheles stephensi mosquito
A sporozoite of Plasmodium bergei migrating through the cytoplasm of midgut epithelia of an Anopheles stephensi mosquito

MALARIA. A serious, sometimes fatal disease caused by a parasite. There are four kinds of malaria that can affect humans. You get Malaria from the bite of a malaria-infected mosquito. Once a person is bitten, malaria parasites enter the bloodstream and travel to the person’s liver where they grow and multiply. The parasites leave the liver any time from 8 days to several months, and enter the person’s red blood cells, where they release toxins, which make the person feel sick. Symptoms include flu-like illness, shaking chills, headache, muscle aches, and fatigue. Nausea, vomiting and diarrhea may also occur. Malaria can cause anemia and jaundice due to the loss of red blood cells. P. falciparum type of malaria can cause kidney failure, seizures, confusion, coma, and death. Some malaria parasites can rest in the liver for up to 4 years! Prevention: Take the antimalarial drug exactly on schedule without missing doses. Prevent mosquito and other insect bites. Use DEET repellent on exposed skin and wear long pants and long-sleeved shirts, especially from dusk to dawn when mosquitoes tend to bite.

Other diseases which could be of concern in India, but for which I have not received vaccinations include:

  • Cholera(risk exists throughout the country; not sure why I didn’t get this one); potentially fatal bacterial disease of the small intestine; severe vomiting and diarrhea; can kill within hours if not treated; spread through contaminated food or water from infected human feces
  • Japanese encephalitis—(Risk exists, but I’m not traveling to a high-risk area; insect precautions recommended)
  • Rabies—(a very expensive vaccine at over $400; but risks are significant from dogs, bats, monkeys; scratches should be taken seriously)
  • Brucellosis—(Risk exists throughout India; travellers advised not to consume unpasteurized dairy products.)
  • Chikungunya—(Peak transmission from June through October; risk exists throughout year, especially in Southern India; daytime insect precautions are recommended.)
  • Dengue—(Significant risk exists in urban and rural areas; transmission occurs throughout the year especially during rainy season; daytime insect precautions are recommended.)
  • Leishmaniasis—(not prevalent in Maharashtra state; insect precautions recommended)
  • Leptospirosis—(risks to those in Maharashtra with fresh water exposure)
  • Melioidosis—(risk exists throughout the country, especially in Maharashtra and other states; highest transmission activity is June through September; avoid contact with potentially contaminated soil or water)
  • Traveler’s diarrhea—(High risk throughout the country, including deluxe accommodations; My doc recommended that I take Immodium and Peptobismol with me; still need to purchase those.)
  • Tuberculosis—(India is in highest risk category for TB; IGRA should be taken by those planning to spend more than 3 months; “travelers should avoid public transportation and crowded public places whenever possible”); stay away from people with persistent cough.

Misc. Risks: Air pollution, terrorist, train accidents.

Other precautions: hand washing; avoid street vendors, buffets without food covers, shellfish, raw or undercooked foods, unpasteurized dairy products, mayo, unpeeled fruits, and salads, tap water, and ice. Use sealed water bottles for brushing teeth.

My doctor began our vaccination discussion by saying that the majority of the world’s drug-resistant diseases originate in India.

Shopping List: Immodium, DEET (30-35%) or Picaridin (greater than 20%), Peptomismol tablets

Predeparture:  pack eyeglasses, sunglasses, hand sanitizer, lip balm, medical insurance

Medical Care in Mumbai:

  • Private ambulance in Mumbai—Breach Candy Hospital — +91.22.2366.7997
  • P. D. Hindjua National Hospital and Medical Research Center— +91.22.2445.2575 or 1298