In the waiting room of Dr. Kumar’s Eye Clinic, we stood out. We were the only foreigners and the two middle-aged sisters who were grasping our hands were the only obviously poor women in the fancy doctor’s office in the suburb of Andheri West. Dressed in simple saris covering their parched, nut brown skin, they stood in stark contrast to the room full of well-dressed, light-skinned, upper and middle class Mumbaikars. Eyes followed us around the room as we navigated where to sit in the vast, ultra modern waiting room.
Bhivarabai at her first visit to the clinic.
After many weeks of medical tests in far-flung clinics, rickshaw rides, trips in taxis, and hilarious adventures on the modern metro which required them to be pulled unwillingly onto and off of an escalator, we had brought Bhivarabai to Dr. Kumar’s clinic to finally receive cataract surgery. We sat in quiet contemplation on the comfortable couches, while the two sisters, who smelled faintly of the wood fires they use for cooking and burning garbage, held hands full of rumpled tissues and dared not to look around at the stares of the other patients. We sat beside them; we were wary and unsettled. We’d made the decision about her treatment on her behalf and now they sat beside us with complete faith that we had done the right thing. Bhivarabai laid her head on my shoulder and squeezed my hand while we waited. I breathed in the sweet smell of coconut oil used to keep her grey braid in place. Meera held her other hand, the bond between them solid and so familiar that they are like one person. When one hurts the other cries.
Bhivarabai, just before we head to Dr. Kumar's for her surgery.
Bhivarabai is about 50 years old. Her doting sister, Meera, is a few years older. She lives in a village outside of Mumbai and Meera lives not far from Saki Naka in a slum community down the road. They came to us through a relative who lives in the community who asked us if we could help Bhivarabai with money for cataract surgery. One look at this slight, under-nourished woman, was all we needed to decide to help. Both of her eyes are cloudy with cataracts. A previous infection from a failed surgery in her left eye has left her with blurred sight in that eye and a perpetual fog in her other eye. She manages to get around with the help of her sister who assists her through the traffic, winding laneways and broken footpaths near her community.
Bhivarabai and Meera waiting outside the clinic before an appointment.
Bhivarabai was in an arranged marriage years ago to a violent husband who decided early in the marriage that she was not up to his standard. Even then her eyesight was failing and he became angry that she was becoming incapacitated. He left her with a small son whom she struggled to care for, who died at age two. She moved in with her elderly parents who died soon after. Meera’s husband died at a young age after being hit by a car. While Meera moved to a relative’s small room in a Mumbai slum where she lives now, caring for relatives, Bhivarabai stayed in the village and still lives in her parent’s simple home, getting help from relatives for rations. Meera works at a factory in Mumbai cutting loose threads from garments earning 5000 rupees ($100) a month. Bereft of children and the trappings and traditions of arranged marriage they have settled into a life of caring for each other. Their lives are filled with tough compromises, no choices, difficult, dismal living conditions and disappointment, but without apparent bitterness or blame.
At the clinic getting tested.
Dr. Kumar’s Eye Institute has a charitable wing dedicated to helping local Charitable Trusts bring patients for surgery. We brought a patient to his hospital a few years ago and were relieved to be given the same treatment at a much reduced cost thanks to a letter of introduction from Ashley Pereira from Janvi Charitable Trust. After a series of tests, the doctor was considering a number of possibilities including an eye transplant for the eye that can’t be fixed through surgery. There was talk of cutting and twisting the cataract to the top of her eye so she would be able to see out of the bottom half-moon portion. We reeled at the variations in treatment and the decision we would have to make on her behalf based on cost. When the final word about the type of treatment was offered, we were relieved that it would be the simplest of the surgeries; a basic cataract operation that might have complications because of the thickness of the cataract. A day before the surgery, Todd took Bhivarabai back to the clinic to confirm the treatment and for further testing. Dr. Kumar gave the option of multiple lenses that he would be inserting, each one costing more. The two sisters who are illiterate and can only use fingerprints to sign documents they don’t understand, understood little of the procedure, and put their trust in Todd to pick the right lens and agree to the operation.
Indu explains the post-op medicine instructions.
On the day of the operation, the met us in the community in the laneway near their relative’s home for pre-op eye drop treatment. In the relative quiet of the early morning, with cooking fires being stoked by small children and a few men peering out their doorways doing puja and brushing their teeth, women gathered around us to chat, to gossip and to offer advice about how to put the drops in and quiz us about the procedure and how we would be travelling to the clinic. I booked an Uber car so we would be able to leave as soon as the last drop bathed her eye. The four of us wandered slowly down the laneway, leaving the other women chatting and sweeping while waiting for their children to wake.
Her surgery could be watched on a television screen in the waiting room. Todd, Meera and I watched though our hands over our own eyes, wincing in unison, as Dr. Kumar worked his magic with scalpels and needles and miniature hooks poking and prodding her eyeball. Bhivarabai walked out of the operating room an hour later guided by a gentle nurse to sit beside us. Dr. Kumar confirmed the operation had been a success and that she was indeed lucky to have sight as he feared there might be complications. With her eye patched, the bill paid and some protective plastic glasses purchased, we were free to head back out into the heat and chaos of the city, with aftercare instructions and a promise to return the next day for a post-op check-up.
Bhivarabai wearing her protective glasses a day after the surgery.
There were multiple drops to take at multiple intervals along with antibiotics and after-care instructions. Meera and Bhivarabai speak Marathi, the language of Maharashtra, so my limited Hindi was of no use for giving detailed medical instructions. We took them back to the slum where Indu was waiting at the tuition centre with a room full of children making inspired drawings and using gobs of glue to stick things to paper and each other. Surrounded by the constant chatter of children at play, we sat Bhivarabai down and spilled her medication out of the bag so that Indu could explain in Marathi how to take each drop with constant, probably irritating, reminders from me about the need for clean hands and excellent hygiene when dealing with her eye.
We visited them with Indu a few days later at Meera’s one-room home in a slum community not far from Saki Naka. Bhivarabai is feeling fine, her eye is healing and her face is no longer swollen. We chatted in the small, clean, simple room, the walls covered in peeling turquoise paint and a sepia photograph of their parents that hung on a small nail by the door. They served us a delicious meal of stuffed puri with sweet milk, rice and dal, and a gulab jamun to finish.
Meera and Bhivarabai don’t want or expect much at this stage in their lives. They survive on very little, but the gift of sight has given them both a release from some of their daily struggles. Their gratefulness is infectious and humbling. The time we spent with them was full of charades, laughter, some anxiety, maybe a lot of anxiety, and in the end we all came away happy to be in each other’s company and thrilled that she has sight. Bhivarabai awakes every morning with clear vision in one eye and is adjusting to her new world of sight for the first time in decades.
Cost of Bhivarabai’s surgery:
(surgery, medicine, medical tests, Dr. Kumar’s fees, transportation) 16,896.08 ($333.66)