Meenakshi Temple and Departure from Madurai

Today began early, around 7 am for most of our group, with our last breakfast at the Inspiration Guesthouse. Shortly afterwards, we met Vignesh, one of the resident’s from Aravind who has been showing us around this past week, and piled in our van to head to the Meenakshi Temple. This brought our trip full circle – on our first day in Madurai, we walked around this enormous structure – which spans nearly 17 acres in total – and wandered through the markets outside of it. Today, we finally got to go inside!


One of the Eastern gopuram

After removing our shoes and giving up our cameras (luckily cellphone cameras are allowed) we entered the eastern entrance of the temple that is dedicated to the goddess Parvati, the wife of Shiva. Our incredibly knowledgeable tour guide gave us a distilled but rich summary of the temple’s history, and the significance of each part of its design and decoration. The temple could have easily been appreciated for its beauty alone, but his explanations made our experience so much deeper, so I will do my best to summarize the main takeaways for you here.


The ceiling of the inside entrance dedicated to Parvati


Maya looking lovely as we enter the temple. A local woman put the traditional ropes of jasmine in our hair before we entered the temple, so the girls in our group were looking (and smelling) pretty for the tour


The building of this Dravidian style temple began in the 6th century BCE and concluded in 1655 CE, making it by some estimates nearly 3000 years old. As the matchstick model depicts below, the temple is comprised of an outer boundary with 2 eastern, and one north, south and western entrances. Each entrance is marked by a gopuram (gateway tower) that is entirely covered in sculptures of Shiva, the destroyer, and his wife Parvati, the goddess of fertility, love and devotion.


We entered through the entrance in the bottom right corner of the image. The gold domes to the left side are the sanctums dedicated to Shiva and Parvati

The sculptures tell stories about the deities, and each floor of the tower depicts a different type of narrative, a theme which is repeated with the smaller towers found inside the temple walls. Inside the main gates, shops sell flowers, oil lamps, and spices to use in worship of the gods, and throngs of people are gathered – to ask for guidance, blessings, or to meet with one another. As we snaked through the winding walkways of the temple, flanked on all sides by sculptures carved from monolithic pillars of granite, our guide told us that one’s journey through the temple is reflective of the journey in life – to get to something beautiful, one must work hard and learn from each part of the passage.


One of the estimated 33,000 scupltures in the Meenakshi temple…I wouldn’t be surprised if there’s more depending on what you count


A shop selling gifts, incense and other offerings inside the temple


Locals gathered inside the temple to meet and chat. Our guide told us that some people come to the temple a minimum of once a day

We found this kind of metaphor throughout the temple, and our guide instructed us that symbolism is the most prominent tool used by Hinduism. For example, a mythical creature called a Yali, which appears often in the temple, combines an elephant, lion, horse and a bird, and is meant to instruct us on the importance of balance in life: the claws of the lion symbolize “grip” or self confidence, while the horse can represent strength.


A Yali, flanking the entrance to one of the sanctums

Unique in many ways, the Meenakshi temple is atypical in that it has two sanctums, one for Parvati and one for Shiva. The sanctums are restricted to Hindu’s only and we couldn’t enter, but based on the grandeur of the rest of Meenakshi, we can only imagine how beautiful this oldest and most sacred part of the temple must be.


Even the floor was breathtaking!

After visiting the temple, we explored the open-air markets before heading back to pack and have our last meal in Madurai. We said goodbye to the kind and gracious staff of Inspiration, who made our stay in India comfortable, convenient and very tasty! At this point in the trip, we also parted ways with Arun, who is visiting family in India, and the rest of the troupe headed to the airport. Chennai bound!


The crew at the Kebab Factory, unaware of just how much delicious food we’re about to eat!

We had the singular treat of eating dinner at The Kebab Factory in Chennai. As advertised it was truly an “experience” where we got to try small portions of traditional dishes from across India and surrounding countries. We even got to celebrate Dr. Zegans birthday early with a rousing rendition of the song, a cake, a firecracker candle, and even an embellished headpiece worth of a fearless leader! (He was beyond surprised, and I’d be happy to post pictures, but grades aren’t yet finalized for the course, and I’m not taking any chances).


Some weary travelers down for the count

As I’m writing now, the group is playing cards, napping, and preparing for the long trip back to the United States – minus Maya and Caroline who are spending a little more time traveling. In this moment, I am full of delicious food, surrounded by peers and professors who have challenged me academically and at the same time become my lasting friends – and I don’t think I can express how deeply grateful I am. Beyond cementing core themes of biology, this course challenged me to cultivate professional presentation skills and research design strategies, and to consider the potential for international academic collaborations. The Aravind researchers and clinicians inspired us with their daily dedication to excellence. I know that their warm welcome and sincere engagement with our ideas made me want to strive for the same high standards in my own work, wherever it may take me in the future. I think can speak for the whole group when I say that we learned invaluable lessons from our time in Madurai, from our much-loved leaders Dr. Zegans and Dawn Carey, and from each other.

It has been a true honor to be a part of the Bio 70 academic community, and I hope that many more Dartmouth students are given the same opportunity to grow through team based experiential learning. Now, our adventure takes us back to the United States – See you all soon!

– Emma Hartswick, ‘17

Day 6: Is it time to go already?

With the confirmation of the chief minister’s death and the realization that our trip was drawing to a close, there was a somber atmosphere this morning.

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To start, we visited the Aravind Hospital to shadow the surgeons. With several students interested in pursuing surgery, this was a unique opportunity to witness world renowned surgeons practice their art. We were guided by a first year resident and a first year fellow. The resident had just completed his first surgery by himself the same morning, and we were very grateful that both were taking time out of their busy schedules to provide us more information about the surgeries.

It was so interesting to see how the facilities at Aravind differed from American hospitals. Part of Aravind’s high volume and high quality of care comes from their compartmentalization of tasks. The pictures below show the areas that patients are guided to in preparation for their surgery. According to Dr. Zegans, the procedures done here would usually be done by the attending in the OR in the US, contributing to the surgeon’s efficiency in Aravind.


We watched the surgeons perform through these giant glass panels in the OR. The first major difference we noted was that each room had three patient beds (although only two were in use at a time when we were observing). The multiple beds allowed the nurses to prepare the next patient as the surgeon completed the surgery. As the resident and fellow explained what was happening inside, Dr. Zegans would recount to us what would be done differently in the US. We were able to observe a variety of different procedures, even though they were all cataract surgeries, owing to the diverse patient population at Aravind. Some of the what we saw included phacoemulsification, small incision removal, and even watching a surgeon adroitly manage a complication with the vitreous humor. The most prolific ophthalmologists in the US performed about 600 cataract surgeries per year whereas the Aravind ophthalmologists performed 170 cataract surgeries per day. Amazing!


Then, we attended a presentation at the LAICO Center on Aravind’s multiple vision centers. This highlighted Aravind’s strength on both ends of the care spectrum: not only were they able to deliver high quality specialized procedures as we saw this morning, but they are also able to provide primary care to areas that lacked nearby access. These differed from the outreach camps in that they were permanent facilities, but were still able to provide high quality care regardless of the patient’s ability to pay. To avoid overlap in the populations covered, Aravind placed these primary care facilities in areas that did not have access to the outreach clinics. What amazed me the most was that each primary eye care facility was able to meet eye care need within 5 years of its opening.IMG_20161206_110413

After lunch at the Inspiration House, we reflected on the trip as a group. Since we had bonded so much during the term and also on the field, we felt comfortable sharing openly the pros and cons of the course and the activities. Lastly, we had some time to wind down, reflect, and prepare for the next day before dinner at the guest house. Tonight will be the last night that we (well, most of us) will be sleeping in India for the trip. This trip has exceeded my expectations, changed my perception on research and health care, and inspired me to ceaselessly strive for excellence. I am sad that it is drawing to a close, but will cherish the memories and experiences decades later.

Signing off– tomorrow is going to be a whirlwind of a day!

-Tammy Hua, ’17

Quick update


Just a note to share with our readers:  All is well.

Last night, the official notice came out about the death of Jayalalithaa, Chief Minister of Tamil Nadu, the Indian state where we are spending our visit.  It sounds like she was an incredible — and incredibly complex — woman whose death is shaking the local population.

We are so lucky in being here with our colleagues at Aravind, who are monitoring the situation for us both here and in Chennai for when we fly out. Presently, all our flights are on schedule, and we see no issues with our return flights and itineraries.

We want to share with you a lovely article written by the Grandfather of one of our students.  He is an esteemed statesman here in Chennai, and his article reflects the loss felt by the people of Tamil Nadu.

What an extraordinary trip this has been!


Dawn and Mike

Day 5: Aurolab

To cover the events of today we must start with events that occurred yesterday. Arun knocked on Tammy and my door around 11PM to see if we were watching the news. Apparently, the prime governor of Tamil Nadu has been in the hospital for several months and her condition worsened last night. The news came out last night that she is on life support. Several of Arun’s family members had called to let him know that we might need to modify our plans for tomorrow because of the political unrest.

This morning everything was still normal in Madurai so we continued with our plans to visit Aurolab, Aravind’s manufacturing facility outside of the city. Just like yesterday we piled into the van and drove through Madurai’s hectic streets to the outskirts of town. We arrived at Aurolab, a large modern facility constructed by Aravind in 2007.

DSC07449As part of the Aravind Eye Care System Aurolab fits into the overall goal of providing low-cost, high-quality eye care by manufacturing medical equipment. Prior to Aurolab’s development the cost of surgical equipment and pharmaceuticals served as a major barrier to Avavind’s mission. Aurolab solves this problem for the Aravind system and also expands Aravind’s impact by providing equipment and pharmaceuticals both for Aravind patients and patients all over the world, particularly in other Southeastern Asian countries, Africa, and Latin America. For example, the cost of an intraocular lens used in Aravind’s common cataract surgeries was reduced from $200 on the world market to $10 when produced directly by Aurolab.DSC07451

Although we were not able to take photos inside the Aurolab facility we did get a photo in what Maya called our “Ooompa Loompa” outfits before heading in:


We were lucky to have a fantastic tour guide, a member of Aurolab’s domestic marketing team, to show us around Aurolab’s five departements: intraocular lenses, suture needles, blades, pharmaceuticals, and general equipment. The whole experience felt a bit like being in an episode of Discovery Channel’s “How it’s Made” and we were mesmerized by the process, from the microscopic examination of suture needles to the simple mechanical boxing of eye drops.

What I found particularly amazing about our visit to Aurolab was the way that even in a sterile, air-conditioned setting, far removed from the individuals who benefit from Aravind’s products the same value based motivation we saw in the hospital and vision camp was still present. This was evident both in tour and on a message board created by Aurolab’s employees. As one of the messages said they see themselves as part of Dr. V’s path to providing vision for people all over the world:


When we arrived back at Inspiration House for lunch we received word that our planned visit to Madurai’s Meenakshi Amman Temple was off due to the volatile situation with Tamil Nadu’s governor. Although we are hopeful that we will get the opportunity to tour the temple before we head back to the States we all got some much-needed rest. We napped, watched the local news, and rested up for the final remaining days of the trip!


-Kristen Chalmers ’17



Day 4: Outreach Clinic and Gandhi Museum


This morning started a little later than the previous ones. With some time to lounge before setting off, we were well rested and ready to start the day at 10am. We loaded into our van and set off for one of Aravind Eye Care System’s (AECS) many outreach camps, which was set up in a religious center closer to the outskirts of Madurai. While Aravind’s main hospital and research center is incredibly impressive, the outreach camp was uniquely inspiring to all of us. Here we could see the kind of work that happens at the grassroots level and the true commitment that this organization has to all people of India. The camp’s main goal is to provide an accessible screening clinic for those who would not have the resources or the opportunity to travel to the main hospital. In this way, many, many more underserved populations are able to be screened, diagnosed, and prioritized for treatment. More than 300 people are seen in a day at this camp alone, and AECS has 15+ monthly camps around Madurai and beyond.


Our van pulled up the the clinic, and we disembarked into the Madurai heat. This was the hottest day so far, but the sunshine was welcome after the days of rain before. As we rounded the corner towards the entrance we were first met with the sight of many shoes lying out around the stairs to the main hall. We removed our shoes, left them alongside all of the others, and climbed the stairs into the main center. 50+ people were seated inside, all efficiently organized into 5 stations.


I was particularly struck by the thought put into how to most effectively set up a system that would be able to serve hundreds of people of all demographics including the illiterate or blind. In one section, small booths were set up to test refraction in order to recommend eye glass strength. The technicians mentioned that refraction was usually determined with an eye test set 6 meters away, but because of the limited space they had modified the test to work at 3 meters. I thought that this “let’s just make it work” attitude was inspiring and very different from the rigidly regulation-oriented systems in the United States.

 There was a commitment there to bringing eye care to the people no matter the barriers placed by resources or location. This was also particularly demonstrated by the impressive timeline of treatment. This camp would diagnose those who needed surgery, and that surgery would be scheduled for the next day at the main hospital. They wasted no time in getting care to the people who most needed it.


We then had the incredible opportunity to interview a new patient at the clinic. We brainstormed questions that we thought were important and pertinent, and Arun led the interview in Tamil. The patient was so gracious and willing to answer our questions, and she was not unnerved one bit by this large group surrounding her. She spoke about her respect for AECS, and we all laughed with her when she energetically commented that she wasn’t scared for her cataract surgery. She knew AECS would do a good job, and the faith that she had in AECS only increased our respect for the institution. The chance to talk with a patient was really special, and it made this high-volume work seem more personal. Although many people are seen daily at the AECS main hospital and clinics, each person is unique and important and is getting a chance to see better because of this institution. I was very moved by how many lives were being changed because of the work done there.


We loaded back into our van and went to a buffet-style lunch at a nearby hotel. It was deemed the “spiciest food so far!” by some. This was an opportunity to relax and re-energize for the second half of the day.



Our next stop was the Gandhi Museum. Set back from the road, this museum was beautiful and spacious. It was really a treat, especially for those of us with a Western education that never really went into the details of the astounding work that Gandhi did to free India from colonial rule. Everything that Gandhi said sounded like poetry, and I found myself snapping pictures of his quotes all around the museum so that I could look back on them for inspiration long after I left India. I inserted one quote that seemed particularly beautiful and relevant. “I do not want my house to be walled in all sides and my windows to be stuffed. I want the cultures of all lands to be blown about my house as freely as possible but I refuse to be blown off my feet by any.” I think this quote speaks to exactly what we are doing here in India. The cross-cultural exchange of ideas is a privilege, but it is something that we should all strive for throughout our lives. Our group is here in India to let the culture of all lands blow around our house, as Gandhi would put it. By recognizing all there is to learn through AECS and through this country as a whole we can grow as people. But perhaps more importantly, we can allow this experience to alter the way we see healthcare and service as we go back to the United States and launch our careers in medicine, research, and public health. We can “refuse to be blown off our feet by any [one culture]” as we attempt to integrate all of our experiences at home and abroad. I personally left the Gandhi museum with new inspiration to make a difference in this world.



We headed back to Inspiration House for some needed downtime before meeting back to head out for dinner.


A few hours later, we started our journey to the Taj Hotel. As we stepped out of the van into the cool night air, we found ourselves up on a hilltop and were greeted with a beautiful nighttime view of Madurai below. We strolled around the grounds before ending up in the restaurant for a decadent meal. This was another opportunity to sample all kinds of delicious Indian food from the North and South. I have personally loved how open everyone on this trip has been to trying every kind of food available no matter how foreign it seems. We battle the spiciness, but it is all worth it. When in India…

Maya Raghavan

Day 3: Concluding the AMRF-Dartmouth Research Conference

This morning was the second and last day of the conference, and we were excited to have Yike, Rachel, Arun, and Christine present. After breakfast, we all waited eagerly in the lobby of Inspiration House before the talks. Before the talks, we had a great photo on the steps of Aravind, to commemorate this wonderful two day conference.


The opening remarks were brief and then we launched into the meat of the conference. The first presenter was our TA Yike Jiang. She headed over to the room to set up, before anyone else got there, and her presentation was incredible. She was dynamic and had great illustrations to tell the story of the role of autophagy in HSV keratitis. She presented some of her already published work and talked about some of her findings from right before she came to the conference. With her passion and all-encompassing knowledge, watching her talk was a great example how we all aspire to present research.

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With energy in the room high and our minds primed, Rachel launched in her presentation on Ligneous Conjunctivitis. Unsurprisingly her talk was excellent and inspired crosstalk between her, Dr. Zegans, clinicians and scientists. She even wowed the crowd by signing off her presentation with a thank you in both English and Tamil.

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Next Arun gave his extremely relevant talk on treating Vitamin A Deficiency using Retinol Palmitate. It was clear that he had been engaging with the scientists here at Aravind, because he mentioned some of the state sponsored programs that Tamil Nadu has regarding Vitamin A, and incorporated that understanding into his presentation. The audience was very appreciative to hear what Arun had to say, and they offered suggestion and comments which were well received by Arun.

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Our final student talk was giving by Christine Park. The only way I can describe it is to paraphrase the words of a scientist that heard the talk who said “That was an amazingly detailed presentation if you only had data it would easily be a PhD thesis.” Her presentation on a novel and safer treatment for Retinitis Pigmentosa, which was so thorough the audience hardly had any questions to ask her.

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At the coffee break, there was a new sense of ease in the air, as we spoke with our Aravind colleagues without the pressure of performing looming over us. There was laughter and scientific chatter abounding, as we headed into to hear talks from some of the senior Aravind scientists.

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After the break, we had the privilege of hearing talks from the senior AMRF scientists and learning about the way that biomedical research complements and strengthens the medical care provided by the hospital. We heard about the practical applications of proteomics and next-generation sequencing to eye disease from Dr. Jeya Maheshwari and Dr. D. Bharanidharan, respectively. We also learned more about the molecular diagnosis of retinoblastoma from Dr. A. Vanniarajan and about stem cells and corneal transplantation from Dr. C. Gowripriya. Having the chance to learn from and ask questions of experts in their fields who have seen the way that these diseases affect populations in India was truly a unique opportunity. (Dr. Jeya Maheshwari and Dr. D. Bharanidharan pictures below)

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We enjoyed lunch at Inspiration House and chatted with the staff who have been introducing us to Southern Indian food for the past few days.

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After lunch, we headed to the second round of lab tours of the amazing facilities at Aravind. We donned our protective footware with an automatic applicator and were off. Aravind was generous enough to have their senior scientists take the time to engage with us, and the first lab we went to was that of molecular geneticist Dr. P. Sundaresan. He was an animated speaker who showed us the equipment in his lab like the real time PCR. He spent time talking to us about his career, and what brought him to Aravind. He spoke about his mentors and his projects. However what was truly exceptional was that he took the time to learn all of our names and our projects and to integrate facts relevant to us into his words. He filled us with his passion for science and as we headed down the hall we chatted with his PhD students about their work and how it related to our projects.

We then spent time with Dr. S. SenthilKumari in Ocular Pharmacology. She spoke with us about pharmacodynamics, as well as her projects on glaucoma. One of the most exceptional parts of Aravind is the equipment available. As Dr. SenthilKumari was explaining how draining of fluid by the trabecular meshwork can be modulated by drugs. She was showing us how to run an experiment to test the efficacy of this drug using donor eyes in Aravind’s Human Organ Culture Anterior Segment facilities. Be able to set how theory can be directly applied to patient samples and to see and be able to visualize the experiment is truly an unparalleled experience.

As we walked out of our last lab, we were surprised with a last minute opportunity to tour the lab of Dr. C. Gowipriya. In a short tour we saw the flow cytometry machine, RNA facilities, and confocal microscopes. We also learned about the applications that the machines have in research. After an informative afternoon, we headed for final coffee break and closing remarks session.

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To close the AMRF-Dartmouth Education and Research Conference, we mingled with Aravind researchers over cookies and tea and shared conversation about our homes and theirs. After two days of deep discussion about complex scientific topics, we loved the chance to get to know the Aravind researchers on a more personal level and to chat with them about this beautiful city and country that we are visiting. The Aravind researchers played a video about Madurai, and in return we shared Jake Gaba’s rendition of “Happy,” a video that we thought captured the Dartmouth spirit.

Finally, we went to dinner at Hotel Heritage, a resort where we could see the footprints of colonial history in India. We were joined by several of our hosts from Aravind Hospital, and we enjoyed a glorious buffet dinner with them. We again seized the opportunity to bombard our Aravind friends with questions about their lives, experiences, and views; we talked about everything ranging from comparative health systems to careers in medicine to popular movies. Dinner ended up stretching for hours, and yet we felt we still had so much to learn from our new friends from Aravind.

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Today, our time interacting with the students and many of the researchers at Aravind Hospital drew to a close. As Professor Zegans put it, perhaps we may run into our Aravind counterparts at some scientific conference somewhere, someday–and that would be truly amazing.

– Victoria Chi ’17 and Jalen Benson ’17

Day 2, Part 2

We kicked off the second half of an action-filled day at Aravind with a tour of two research laboratories within Aravind: the proteomics lab, and the microbiology lab. Given the immense clinical magnitude of the Aravind Institute, the research sector of Aravind holds its ground pretty well! At the start of our tour, we donned some fancy kicks to prevent contamination.


I was a fan.

We ventured into first into the proteomics lab. To be perfectly honest, I did not know what proteomics was, so this was definitely a learning experience for me. Turns out that proteomics is the characterization of proteins; in the case of Aravind’s research, mainly the proteins found within the eyes of individuals with varying vision-threatening conditions (most commonly, fungal keratitis). Because I work in a lab at Geisel, I found it very interesting to compare the set-up of the Aravind labs to those back at Dartmouth. I think that the students may have cleaned up for our visit/ the conference– it didn’t look as though any experiments were actively running.


Here’s a shot of a bench in the proteomics lab.

A student who had presented a (very cool, very interesting) poster on the immunology behind fungal keratitis infections during the poster session led us around to show us some machinery, including Mass spec machines, and a Typhoon apparatus used in protein characterization. Next step was the microbiology lab, where we learned some captivating info about a parasite found in Southern Indian ponds that causes granulomas and uveitis in the eyes of children. The parasite uses a pond snail as a vector. We had the privilege of having this research project explained to us by the first author himself, whose work was featured on the front page of Ophthalmology. I think everyone was suitably impressed.

After a long day of sessions, the group had an extremely special treat. Arun’s incredibly generous family (aunt, cousins, uncles, and grandmother) invited us over to a delicious meal at their home in Madurai. This meal included the best desserts that some group members had ever tasted, in addition to about 5 different types of delicious breads, chutneys, and cooked meats. I don’t think it would have been possible to find more gracious hosts. Arun’s 7-year-old cousin even sang us a song (heart-melting). We are incredibly grateful for such amazing hospitality and the opportunity to have spent time with his family. I would have loved to stay and get to know everyone better.


Man oh man oh man we love Southern Indian food.


Jalen said that if he ate another dessert, he “would die”

Arun’s fam + the group!

-Rachel Van Gelder, ’18

Day 2, Part 1

I could hear my fellow Bio 70 members bustling outside my room at 7am. Even without any exchange of morning greetings, I could feel the tension that emanated from those of us who were scheduled to give their presentations today. Today was the day for which we prepared our research proposals over the course of 10 weeks at Dartmouth. Today was the day for our efforts to finally be appreciated by the faculty and scholars at the Aravind Medical Research Foundation.

After a hearty, Indian breakfast, we headed over to the Aravind Eye Care System. In the conference room, we were greeted with rows of tables and chairs, an official-looking podium, and a nicely covered moderator and expert desk.



After we got our name tags and settled into one of the many available seats, we waited for the Aravind faculty and scholars to arrive. We introduced ourselves to whoever came over to join us at the tables and held engaging conversations until Professor K. Dharmalingam drew everyone’s attention and gave his introduction.

Soon thereafter, our first set of presentations began.

Jalen and Maya set the bar very high as the front runners and presented their projects on Leber’s hereditary optic neuropathy (LHON). Jalen’s talk focused on RTA 408 as a potential treatment for LHON and Maya’s presentation concentrated on sex-bias in LHON.


Up next, Kristen followed up with her clear and confident talk on using Ov-RAL2 as a novel onchocerciasis vaccine.


After a quick but sweet (literally) 20 minute coffee break,



Victoria gave her well-prepared presentation on a potential plant-based novel macrofilaricidal treatment of onchocerciasis.


Not losing momentum, Tammy successfully delivered her presentation on the use of SU5402 growth factor receptor inhibitor as a treatment option to prevent steroid-induced cataracts. Although cataract was a topic with which essentially all the Aravind audience members were familiar because of its prevalence in India, Tammy was indomitable.20161202_012449

Next, Emma gave her smooth, “honorary-phD-worthy” talk about the role of folate in sporadic retinoblastoma cases.


And Caroline with her eloquent speaking abilities and professional demeanor talked about spleen tyrosine kinase inhibitors as prophylactic treatment in heritable retinoblastoma cases.


And just like that, the first part of our presentations came to an end.

After a quick lunch back at the Inspiration Hotel, we went back to the Aravind Eye Care System to hear about the research that the Aravind scholars were doing in a poster presentation session.

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From their unwavering eye contacts and constant confirmation questions, we could feel their passion towards their research projects and their desire to share their results with us. We all appreciated and enjoyed this enlightening interaction with the Aravind scholars.

-Christine Park

To eliminate needless blindness

ghandi LAICO

“The vision of what was possible was way beyond what was reasonable”

“It is ourselves we are helping and it is ourselves we are healing”

“ We will have differences. That’s how capitalism works.”

“ We must be efficient capitalists in order to be socialists”

“Intelligence and capability are not enough. There must be the joy of doing something beautiful.”

“This was not meant to be a business model. It was meant to be an ethical model.”

“ To eliminate needless blindness by providing high quality, high volume, compassionate care.”

– Quotes from the welcome presentation by Dr. Prajna (Aravind Eye Care Center)


We ourselves feel that what we are doing is just a drop in the ocean. But the ocean would be less because of that missing drop,” said Mother Teresa when talking about the importance of doing what one can for humanity. Today, December 1st, Biology 70 from Dartmouth experienced this quote first hand, witnessing the many drops in the ocean that Aravind was producing.

The morning began early for many of us as the remnants of jet lag allowed us to experience the early morning cool and calm of Madurai. The mosques started their prayers at 5AM over speakers that reverberated throughout the city and the morning traffic ensued around 6AM. We enjoyed idlis and sambar for breakfast at hotel Inspiration before heading across the street to Aravind Eye Care Center. The morning welcome was warm, as the first thing we noticed when walking in was the following sign:


Dr. .Prajna and his two residents welcomed us into a conference room and began an inspirational presentation about Aravind. Dr. Venkataswamy initiated the eye center roughly 40 years ago in Madurai in order to treat those without access to proper eye care (to treat needless blindness). Today their mission is still to “eliminate needless blindness by providing high quality, high volume, compassionate care.” The presentation highlighted that Aravind’s strength lies in being able to overcome the seeming paradoxes in this statement – that is, the eye care center increases quality and compassion with increased quantity. The care center treats over a 1000 patients a day in its two-tiered system. There is both a paying and a free hospital and patients are given the choice to pick one or the other. Dr. Prajna noted that South Indian culture and social norms dictate that those with the money use the paying hospital and those without use the free hospital.

The Aravind system, at this point in the dayIMG_0824, sounded more like a Ford factory than a hospital serving an under-resourced area. Cataract surgeries were completed in record time, numbers of patients served were stunning and personnel seemed machine-like in their approach to procedures. Dr. Prajna noted poignantly, “We must be efficient capitalists in order to be socialists,” meaning Aravind seeks to operate justly within an unjust system, by using the volume of patients to their advantage.

IMG_0830Following the presentation, we were given a guided tour throughout the paying and free hospitals. The paying hospital was teeming with patients, nurses in white saris (sisters, as they are known here), doctors in white coats, and all sorts of administrative personnel. The hospital was fully equipped with an in-house bank, a couple of cafés, and many subspecialty departments. The tour was thorough and eye-opening (pardon the pun). The hospital was more like a factory than a hospital, and it was entirely patient-centered. For example, in the free hospital, where most patients are illiterate, patients are given a slip of paper with numbers corresponding to each department of the hospital (instead of names of departments) and nurses IMG_0831help them navigate the vast healthcare system from number to number. Signs were in three to four languages, as Aravind serves not only the city of Madurai but also patients across the state of Tamil Nadu, the country of India and as far as the Ukrainian army.

After our tour, we settled down for a hearty lunch of rice and veggies. We have been eating mostly vegetarian food since arriving in India!  After lunch, we all dived in to our presentations. We walked back over to the eye care center and worked in a classroom all afternoon, perfecting and polishing up our presentations.

We came back through the drizzling rain (it hadn’t rained in Madurai for over 8 months and we brought the rain with us!). Our hotel rooms had a generous helping of mosquitos and, annoyed by their incessant buzzing and bites, we set out on a journey into the streets of Madurai in search of mosquito zapping racquets. We walked through the city like a mother duck and her nine duckings following in a single file line, from store to store in search of the perfect zappers. When we found the zappers that would bring a peaceful night, we paid 720 rupees (about $10.50) for four.  We took an auto rickshaw home and debriefed about the inspirational and exhausting day.

This trip is certainly about our research and presenting our work. But I am learning that if that is all what I take away from it, then I haven’t done my duty. I was born in South India and I went to elementary school here. So, I am at least a bit aware of the difficulty of doing most things in India. It’s hard to get a passport in India without bribing someone and it would seem near impossible to do what Aravind is doing while maintaining its mission. ButI was in disbelief today. Dr. Venkataswamy, the founder of Aravind Eye Care Systems, was told repeatedly “The vision of what was possible was way beyond what was reasonable.” Aravind is unreasonable. The number of patients it treats is unreasonable. Its business model is unreasonable. Its ability to maintain quality of care is unreasonable. Its provision of healthcare to all of Tamil Nadu is unreasonable. This is what is Aravind is about – bringing to reality the unreasonable.

I am so excited by this prospect because I too hope to do what Aravind is doing in my professional career. There is nothing more that I want to see in my profession than healthcare for all. And to see Aravind is to see that it is possible. One day, far into the future, I hope to return to this very country. I hope to create hospitals and healthcare centers that treat millions of rich and poor patients, and ones that change the very landscape of healthcare. For this reason, I am so thankful for this opportunity. Thankful for the people of Dartmouth I am with, for the places we are seeing and for the work we are taking part in.


This was just day one at Aravind Eye Care System. Here’s to a great week. Here’s to many more drops in the ocean this week.

— Arun Ponshumugam ’17

(more photos to come!)









Day One: A Moment of Sentimentality in Madurai

Hello All! Let me recount our first day here in India:

Getting off the plane in Chennai was surreal…partially due to the huge sleep deficit I was fighting but mostly due to the realization that these were my first official steps on the continent of Asia.


I came into this class with the expectation that our trip to India would be an incredibly new experience, mostly because I was traveling with people I’d never traveled with before and because we’d be traveling as an academic cohort, fundamentally interconnected through our shared undying love for the subject of biology. Observe Rachel below, photographed  candidly during class back at Dartmouth in a moment of deep concentration:


But in all seriousness, the newness of the group faded within minutes during our first class meeting in September and we’ve quickly formed a family, as cliche as that may sound. It was a privilege today to step off the plane with a group of individuals, all of whom I respect so profoundly for not only their intellectual prowess, but more greatly for their zeal to learn and to love all that surrounds them. There would seem to be no greater group of people with which to travel the world.

Once we thoroughly cleared customs in Chennai and collected baggage, we headed to the hotel for a quick few hours of sleep. A few of us woke up early and headed downstairs to start the day. The highlights of today include the 2.5 hour breakfast, filled with dosas and chutney (beautifully modeled by Tammy)


and effortless conversation with Christine and Jalen,


as well as the plane ride to Madurai when I was sincerely concerned that Arun’s knees would not fit in the seat, pinpointing our exact geographic location on the giant world map on the wall in the Aravind Guest House,


seeing Bharani’s familiar and friendly face, and fitting five people into a tuk tuk intended for three.


Further, the temple was spectacular, bursting with color and ornate details that make you pause to fully appreciate the creativity and diversity of this world’s cultures, expressed so divinely through architectural works of art like this one;


We walked through the surrounding streets at the foot of the temple, only to find ourselves at one of the central markets where I was in awe to find even more color and creativity.


Maya and I wandered through the circuit maybe three or four times, still enjoying our third lap just as much as our first. It was the most sublime feeling to digest everything all at once, from the explosion of color and shining gold to the realization of just how different this culture differs from our own.

We embarked upon yet another tuk tuk adventure. Important to note: those with preexisting heart conditions should under no circumstances keep their eyes open when riding in Indian traffic. We made it safely home to the guest house and powered through our jet-lag to enjoy a fabulous dinner prepared for us and the other guests.

But even with the perfect day of touring and exploring, nothing could compete with the most innocent and genuine joy at the end of our day of being able to look around Emma and Rachel’s (unfairly giant and spacious) bedroom where we all huddled for a team meeting, and feeling so utterly appreciative to be exactly where I was at that particular moment.


I feel so fortunate to be sharing this most enthralling experience with these exact people who have made these past few months of learning together so incredibly engaging, productive, and just downright fun. An excellent first day to a trip that is destined to be a cherished lifelong memory!

Cheers from India!

-Caroline King