Rain pelts the window of the ambulance, tired windshield wipers creak and groan, frantically sweeping across the foggy window. I reach across and hurriedly roll down my window and "fresh", damp night air rushes in the small opening. Ashley sits beside me holding his nose. Our driver, clad in boxer shorts, red pan spit dribbling down his chin, eyes wide open and shifting gears at break neck speed, urges the ambulance to swerve around slow moving motorbikes causing puddles to explode against their drivers. The cracked blue siren casts an eery glow on the road. I turn around in my seat and watch as Ganesh rolls with the frantic movements of the vehicle. Brown water (diarrhea) sloshes over the side of his stretcher and creates puddles on the floor of the ambulance. We are headed to Sion hospital after being refused admittance to Rajawadi Hospital in nearby Ghatkopar.
Two hours earlier Ashley was sound asleep in the comfort of his home after a long and stressful day of work and I was on the other side of town having dinner with a friend in Bandra. Just as the food arrived at our table my phone began to ring. Looking down at the call display I saw Ashley's name. In my two years of working with Ashley I have never received good news after 9 pm and I took a deep breath before answering. Ashley's voice was strained with sleep as he told me that Ganesh was found in a terrible state under a tarp in Saki Naka and needed immediate medical attention. He was on his way to find him and I would start the journey from Bandra to meet them at the hospital. I said a quick goodbye to my friend and headed across town. DWP has no set office hours and its mandate "to see a need and fill it" dictates when and where we work.
I arrive at the entrance to Rajawadi Hospital in the pouring rain and tip-toe through ankle deep water heading towards the casualty ward and spot Ashley standing outside. There are throngs of people huddled at the entrance, many of them covered in red and pink dye, their Ganpati celebrations cut short by an accident on the road. Piles of discarded flip-flops lay scattered around the door. I follow Ashley in and and peer through a dusty metal gate at Ganesh laying on a stretcher, his pants covered in his own waste, his breathing laboured. I reach through and touch his arm but he doesn't move. I turn away and come inches away from a dead man lying uncovered in the hallway. Ashley and I head for the exit, but are held back by police as another patient is wheeled in followed by a crying mother. We step out into the rain and Ashley fills me in. I listen to the story and spot Timsy (Ganesh's sister) near the door. Ganesh was found laying under a tarp near the stairs next to a group of drunken men who were gambling, but they failed to notice the severity of his situation. Finally, Ashley was called and Ashley and Ganesh's friend carried him up the stairs into a waiting rickshaw.
Rajawadi Hospital is understaffed and filled beyond capacity. They tell us that Ganesh can have one bag of saline but then we have to move him to another hospital and they suggest Sion. We gather Timsy and her friends outside and tell them that Ganesh needs to be moved. I offer to pay for the ambulance to shift him but one of them will have to stay the night at the hospital with Ganesh. (Municipal hospitals require one person to remain with the patient at all times). Timsy quickly refuses and I am stunned and speechless, Ashley is not. Timsy says they will take him back to the community and I ask where he will stay once there. She will not let her dying brother stay with her and says that he can sleep under the tarp where they found him and they will check on him in the morning. I am outraged and begin yelling in English with Ashley interpreting as quickly as he can. I'm frustrated at her lack of regard for her brother. We then offer to pay for Ganesh to stay in a private hospital near Saki Naka, making it close and easy for her to stay the night, and again she refuses. Ashley and I walk away afraid of what we might say or do and realize that we are the only ones who care enough for Ganesh to help him. We speak to the doctor again and he tells us that Ganesh should be taken to Sion hospital immediately and we arrange an ambulance. As we finish speaking with the ambulance driver, Timsy says she's cold and goes home and I struggle to find words to express my disgust.
The ambulance avoids hitting an elderly women near the entrance and comes to abrupt stop outside the emergency doors to Sion hospital. Ashley heads into the hospital as I pay the driver. The back doors swing open and Ganesh sits up and is helped down, his pants wet and sagging from continual bowel movements. His shirt is wide open, his rib cage protrudes, his eyes are wide and unblinking as he staggers up the ramp.
I open the doors to the emergency ward and find myself standing still. Doctors and nurses shout across the room while worried relatives of patients vie for their attention. A homeless man lays curled under the first bed in a pool of vomit and urine. A doctor steps over him to attend to a screaming women in agonizing pain. The floor is littered with medical waste and the energy is both depressing and frenetic. Every bed is filled with at least two patients lying side by side, some unconscious and some screaming for help. A few torn and filthy shower curtains separate a few of the beds and I slowly part them looking for a place for Ganesh. Ashley tries to get the attention of a young doctor but he has little time for Ashley's polite tone. Ganesh collapses on the floor with another bowel movement and the smell begins to envelope the already stinking room. This gets a doctor's attention and he yells at us. Ganesh awkwardly stands and then lays beside an unconscious man. The man's family are disgusted by Ganesh's hygiene and voice their displeasure to me. I shrug my shoulders unsure of what to do or where to go. Five members of this family begin to shake Ganesh and kick him out and he falls into the next bed beside another man who is sedated and slowly muttering to himself. Thirty minutes later a doctor hooks him up to a saline bag and tells us to find him when the saline runs out.
The next thirty minutes pass by unbearably slow. I stand beside Ganesh trying to concentrate on the drips that form in the tube leading to his arm. More and more patients are wheeled in as the deceased are wheeled out. A passing doctor asks me who I am and Ganesh looks up and says, "mera dost", which means my friend, and I feel tears well in my eyes. Beside us, a young wife is hunched over her husband and collapses in tears. The harsh environment becomes too much and Ashley and I head out for a breather.
Outside is no better. Ambulance after ambulance brings the dead and the nearly dead to the doors of the over-crowded hospital. A pool of blood now gathers at the entrance way from the last arrival and remains there for the next 5 hrs. I side step the blood and head back in. Blood-streaks lead us back to the ward and it seems busier and worse off than before. A man in the corner lays on his back coughing blood with no one around. Doctors are busy with other patients, and nurses unsure of what to do, stand and watch. An hour later, a young ward boy grabs two old x-ray sheets and starts to scrape the blood into a pile. This fails to surprise me because my mind feels numb by this point. Ganesh's system refuses to hold any liquid and his bed partner is moved, leaving Ganesh laying in a puddle of his own waste. The ward boys and nurses refuse to clean the bed and we have no clean clothes for him to change.
Fast forward 4 hours and the emergency room has become quieter. It's nearly 5 a.m., but Ganesh has not gotten any better. His blood pressure is low and the doctor finally agrees to admit him. They hand us four tubes and say they need stool samples. I'm confused when the doctor hands me a vile and say he will require my help in taking blood. Ashley finds each of us a pair of gloves and we quickly make the transition from bystander to nurse. Ashley places the tubes into the puddles forming around Ganesh and as the doctor unclamps the tube in Ganesh's arm and blood slowly begins to drip, I am instructed to hold the vile underneath to catch the drops of blood. It takes more than 10 minutes to get the sample. An hour later Ashley is instructed to remove Ganesh's pants and helps the doctor roughly insert a catheter into Ganesh's penis.
It is now 6 a.m. and we have been up for 24 hours. Tired, emotional and mentally exhausted, we phone Timsy and tell her that we need her to come or send someone to give us a break as we have to start work at the school. She tells us that she will just have a chai and will come immediately. We find ourself a chair amongst the many people who crowd the outside waiting room and sleep uncomfortably for an hour. I crack open an eye and see Ashley on the phone. He hangs up and tells me that Timsy hasn't left yet.
We hop into a cab and part ways to shower and meet again at 8 a.m. at the school and find Timsy sitting on the pipeline. I'm tired and very frustrated and begin to yell but it falls on deaf ears and I walk away from her in mid-sentence.
Ashley and I decided that we had to force his relatives to handle his situation and take responsibility so we pulled back and did not visit the next day, but sent Ganesh's friends to visit and find out his situation. Work over the next 24 hours keep us busy all over the city and we didn't make it back to the hospital that day.
The next day, we took Timsy and a relative to the hospital to check on him. We arrived in his ward but he was missing? I spoke in broken Hindi to a nurse while Ashley spoke to a doctor. I looked over the young nurse's shoulder as Ashley approached me. His face had become small and it was obvious that Ganesh was gone.
Over the next 5 hours, Ashley helped Timsy wade through endless stacks of paper and Indian bureaucracy in attempts to have Ganesh's body released. By 3 p.m. Ashley had identified the body, been to the police station, the morgue and the hospital administration office and we were nearly finished. Finally, friends and a few relatives arrived and we sat outside the morgue awaiting the release of Ganesh's body. We asked Timsy and the family to pick up the body but they were too scared of spirits. Ashley and I entered the morgue, a mix of bleach and death curled in the air and invaded our lungs. Uncovered, deceased bodies lay in the hall awaiting examination. Blood-covered faces and bodies wrapped in white cloth are a harsh reminder of how short and tragic life can be.
Ashley and I shift Ganesh's body onto the stretcher and carry him towards the waiting ambulance. Seven of us pile in and sit opposite his body and the truck rumbles to life and spits a cloud of blue smoke into the air as we enter Mumbai traffic. Ashley is busy on the phone ensuring the community is ready for our arrival. The journey takes 45 minutes and we finally turn into the slum and drive along the small laneway separating the pipeline and our garden. Children and families line the pipe and are at eye level with Ganesh. Word travels quickly and a crowd gathers as the truck comes to a stop in the garden. The doors are opened as people file into the garden to see who is wrapped in the sheet. Death is an all to common visitor in these communities. I lift Ganesh and pass him to the men waiting at the back of the truck. Over the next hour his body is washed and dressed in new clothes while a bamboo stretcher is prepared. His body is covered from head to toe in beautiful marigold garlands while rituals are performed. Women and children huddle behind us crying while the men stoically perform his last rights. His body is lifted overhead, a small clay pot made with dried cow dung and incense is carried and leads us out of the community. Men chant as we carry the body leaving the women and children behind and we snake past the main road, across the bridge. The journey takes 20 minutes. School children stop and watch as we pass by and traffic is halted to allow our procession to move. We reach the gates of the government crematorium and perform one last ritual by breaking a coconut and pouring the water over Ganesh's head.
The body is then brought to the fire. Thirty men gathered to sit and wait for the fire to be lit.
Ganesh didn't die with dignity, and his last hours were awful, but he has left everyone in the Saki Naka community with the memory of his beautiful voice, his child-like ways, and his ability to bring cheer and fill the air with laughter. He knew he was much loved by the community. The passing of Ganesh has left a silence that can't be filled.
2 ambulance trips 1050 INR - $22.85 CDN
Tests and medicines 300 INR - $6.52 CDN
Rikshaws for family and friends visiting Ganesh. 600 INR - $13.05 CDN
Bamboo, cloth, powders, incense, garlands. 880 INR - $19.55 CDN
New shirt and pants 550 INR - $11.95 CDN