Leprosy in India

As an epidemiologist and academic, I traveled to most corners of our globe. Eventually my passion for the arts shaped my life but I still keep in touch with the public health and medical literature. The past decade has seen the resurgence of infectious diseases and having worked in pulmonary tuberculosis research I have a propensity of reading the literature on infectious diseases.

Recently I came across a number of articles on the alarming trends of leprosy in India. I know a bit about the situation of this disfiguring and socially isolating disease as I have seen it in India. So I did a bit more reading and wanted to find the few pictures I had taken in Mumbai a few years back.

.. It was in the early 1990’s when I went to Mumbai and Hyderabad for academic work. I was in good hotels and the universities were competitive with their Western counterparts. While poverty was apparent in Mumbai, it was only during a drive through the city that I realized the extent of the social tragedy that public health challenges eventually struggle to keep under control when prevention becomes a herculean endeavor.

We drove through the center of Mumbai to an area called Dharave, which I was told was Asia’s largest slum. Fifteen years ago it was estimated that 600,000 people lived there but no statistics were reliable enough to trust that forecast. I was accompanied by a physician from the Bombay Leprosy Project which was, and I believe still is, the leading organization created by the government to identify new cases, document the relapsed ones, and provide medical treatment.

What was special about this slum is that it was also home to the “leprosy colony” (I dislike this terminology). Given the traffic jams in Mumbai, any car driving near the shanty shacks that make up Dharade is expected to come to a halt. And that is when one literally comes face-to-face with leprosy. Indeed, the moment our car stopped, I saw two hands, missing fingers, holding a tin cup, which made their way through my open car door window and asked for money or food. It was a teenager, half naked. He was a leper. I looked around and every car that had stopped was surrounded by young boys, sometimes even toddlers. Most cars had their windows up making the scene even more uncomfortable to experience.

I remember having second thoughts about taking photos from my car window. I eventually took a few to describe the scene without infringing on the identity and dignity of the young boys. I had a 1960s Yashica Electro 35mm camera with me that day.

In the above photo, a sliver of the slum of the leprosy colony of Dharave can be seen in the background, on the right.

… The rest of Mumbai and Hyderabad were similar to other developing countries --lots of color, street vendors, and heavy traffic consequent to the characteristic lack of driving rules.

Yet, the lack of basic public health behaviors continues to pave the way for infectious diseases, among others. Here is a butcher shop where refrigeration of meat is nonexistent in the depressingly hot temperatures of Mumbai.

Indeed, according to the World Health Organization, near 140,000 residents of India were diagnosed with leprosy in 2012-2013, representing about 60 percent of newly diagnosed leprosy cases in the world.

This trend is especially disturbing since in 2005 the government of India declared victory on leprosy and classified it as “eliminated”. As such, the resources dedicated to prevent, identify and treat leprosy were channeled to addressing the challenges of new epidemics such as HIV and the stubborn tuberculosis.

…Meanwhile, the social stigma of leprosy remains, even if Dharave, the largest slum of South Asia, is located in the center of Mumbai and no one seems to know how many people, disfigured and in extreme poverty, live there.

February 12, 2016

© Vahé A. Kazandjian, 2016

We, the Humans

I was walking with my dog on California Avenue, in Palo Alto. It is one of the places where I have heard more people “talk to themselves” rivaling my experience in Singapore. The difference is that here the topics discussed seem to be related to technology and science. In fact, I have the impression that even when folks are walking in the street they are taking part to a meeting, somewhere.

It is Silicone Valley, after all.

So, as I was walking with my dog and enjoying the first signs of spring (daffodils open already in sunny spots) I heard someone talking on the phone while trying to pass me. The accent was British or Australian and as he passed by I heard:

“We need to get the IT team together at lunch: they just do not understand the organizational anthropology of our customers.”

Wow!

… Anthropology (and sociology by fiat) has often been used in all disciplines where an understanding of present behavior (mostly human) is placed within the context of past behavior and the environment. There is organizational anthropology, ethnic anthropology, geo-political anthropology and yes, visual anthropology. I have written about the latter here: http://liveingray.blogspot.com/2015/12/visual-anthropology-do-we-see-what-we.html

But anthropology was originally a very different area of inquiry. It was in the late 1850s when the Société d’Anthropologie de Paris was created following the influence of evolution theory in zoology. The definition used by the founder of this société, Paul Broca, was “Anthropology is the study of the human group, in relation to the rest of nature.”

The original attraction of anthropology to photography was more mechanical – anthropologists used photographic tools to document the “primitive” features and behaviors of social groups they studied. 

Then, anthropology (as part of social sciences) adopted analytic and problem-solving methods as a requirement for all studies and proposed hypotheses.  As such sociology and anthropology became closely linked and essential methods of analysis for anyone interested in understanding group behavior. (My interest in this topic goes back many decades as my doctoral training was accompanied with a minor in medical sociology.)

…So, today as a photographer and author, I do see aspects of my “other life” and training reflected in what I see (my visual anthropology…) and what I capture on film. When I came back from my walk, I decided to find some of my photos where such social sciences inclinations, perhaps unconsciously, could have predisposed me to notice some compositions as I walk among people.

A. Malaga, Spain

I had time to click only once on 1980’s Olympus OM-1 as the man moved and the frame was gone. There was a natural harmony between his posture and that of the classic depictions of man’s evolution that was behind him on the side of the conference building. However, he was facing the wrong way! Is this “De-volution?” Or even “Re-volution?” 

B. Santa Cruz, California

I took a few photos around Santa Cruz last week. To My surprise, some, taken with a 1970s Nikkor-H 180mm lens, have some anthropological backdrop.

Two different cliffs, separated by a common ocean. On the forefront albatross are lined and watch the waves crushing. On the further back cliff, humans, looking like extra terrestrial creatures in their wet-suits, seem destined to enter the ocean.  Yet the humans do not have the necessary structures as part of their anatomy hence carry surf boards. The albatross, with their wings and oily feather, seem best “designed” to fly over or dive into the angry waters.

But humans can also be on the cliff, and in their own way, watch the waves loudly crush…

But wait! Today’s humans have a new part to their ancient anatomy and it is called an iPhone! Now they can watch the cliffs, the albatross and the extra-terrestrial surfers, take pictures, and send these immediately to all friends around the globe. 

Yet, there is something about humans that somehow finds a symbiotic relationship between the arts and sciences/technologies. For me the photo below expresses this without fanfare. Especially since the man was playing Piaf’s “La Vie on Rose” on his accordion…

February 5, 2016

© Vahé A. Kazandjian, 2016

You walked with me, footprints in the sand and helped me understand where I'm going (Leona Lewis)

There is something distinctive about being near a sea or ocean.  Perhaps it is the memory of our umbilical sac; or the soothing yet threatening rhythm only water and waves can provide. No matter, since I was born in a city upon the Mediterranean Sea, waves, rocky shores, their allure and their dangers have remained with me. Mostly in me.

Yet, there is much fascination with footprints on sand.  Having lived in the Arabian Peninsula and traveled in Sub-Saharan Africa (Afrotropic Ecozone), I have seen and left many a footprint in the desert sand. And now that I live in the high desert of Arizona, I continue to ponder on the attraction and magic footprints in sand have on people, give inspiration to spiritual expression and influence the sang and written arts.

I suppose footprints on a sandy beach have special suggestive powers since the waves erase the proof of being there immediately. Tabula rasa at its best. And in some ways it goes beyond “being there” to become about “have been there”. The waves take away all sense and record of our passage.

A legacy, a memory, and a remembrance by others that we have passed through life are important for humans. A sandy beach is cruel and unforgiving.

… But as a photographer and poet, I remain attracted to the unique moments each one of us experiences next to an angry ocean or at sunset on a pristine lake. In fact, the publisher of my last book (2014) chose one of my “sand walk” pictures taken in Nazaré, Portugal. It shows footprints away from the erasing power of waves….

While the above picture shows a couple, sandy beaches can also harbor much loneliness. This picture I took in Oporto, Portugal is among my favorites in that vein of thought.

Recently, I took a few pictures of people next to the Pacific Ocean along the coast of Monterrey Bay, California.  This one is the simple walk on the beach, but it is also purposeful in the sense that she is walking on the edge of the water line as if wanting to leave no trace of her passage. I find it most telling about a person the path they choose on a beach – these are often similar to their paths in professional work, relationships with others, and propensity to embrace the challenges of big cities or new cultures.

And then, there is the “beach walk” away from the beach! This kind of walk is mental and spiritual. We walk the beach without touching the sand with our feet, but with our mind. This is transcendental and allegoric. I have done many of these “walks” around the world. Perhaps this photo comes close to describing the moment.

February 3, 2016

© Vahé A. Kazandjian, 2016