In my last post I wrote about the first 2 days of Community Health where one day we visited the Urban Health Center and the next we travelled to a village to survey for disabled patients who needed evaluation. Now, I will let you know how the rest of the week was. Forgive me if I repeat some information Sasha, Jill, or KJ already wrote about after their Community Health experiences.
Wednesday: We spent the day in a village conducting a Geriatric Clinic. The Geriatric Clinic village was about a 20min drive from the main village clinic in Mugulore. In this smaller village, we used a one-room dwelling to see patients. The day started with a lecture on exercise, nutrition, and diabetes care for the older adults. Us students could not understand the lecture but we could tell it was more of a discussion as the patients gave input and asked questions as well. Afterwards, the patients saw either the doctor or a resident at the front of the room. Here they were asked how they were doing and if they were taking their medications. Almost all of the older adults had one or a combination of Diabetes (called “Sugar” here), Hypertension (called “BP”here), gastritis, cataracts, or hearing loss. The doctor would prescribe them medications which the team brought for an extremely low cost to the patient. The patient then took this written prescription to the nurse at the other end of the dwelling who gave them the medication. The patient was then free to go or stay and socialize if they wished. The doctor working this day informed Libby and I the medication is meant to be paid for a very low cost by the patient but if they could not pay the Community Health Department gave the medication anyway and ate the cost. He said last year the department ended up paying 4 Lachs (4,000 rupees) for medications patients could not pay for.
Thursday: This day we travelled to 3 small villages around Mugulore. One of them was named Gundur but we didn't catch the name of the other 2. Here, we provided vaccination to infants given for no cost by the government, and also conducted pre-natal checks for pregnant patients. Each village allowed us to use one of their public school buildings to conduct the clinic. A desk for a vaccination station would be placed outside or out of view from the section of the building being used for prenatal checks. Infants received BCG (Tuberculosis vaccination), Tdap (tetanus, diphtheria), and OPV (oral polio virus) vaccination. The prenatal checks involved the woman lying in a floor mat for examination as the buildings had no chairs, much less beds. Gestational age, expected date of delivery, lab results, ultrasound results, symptoms, fetal movement, etc. were recorded in a pamphlet used for government benefits at the time of delivery. If the patient does not have the pamphlet with 4 visits of information written in it they do not qualify for government benefits. We were taught most pregnant women go alone without their husbands to stay with their mothers in their last month of gestation and a few weeks following delivery so they can have help at the end of their pregnancies and with the baby. We did not see any husbands or other adult males accompany the pregnant women at the clinics.
Friday: The last day of the week we travelled to the Anekal Government Community Clinic on the edge of Bangalore city limits to conduct prenatal checks on pregnant patients. These patients also had the government pamphlets to receive benefits at the time of delivery. As I remember the other girls writing in their posts, the women were mostly teenagers and many had been married only a few months. Here, more Mothers and friends accompanied the patients but still absolutely no men. Here, we used a men’s inpatient ward room with 2 rows of beds and a few inpatients in them to conduct examinations of the women. All patients have a battery of laboratory tests completed at their visit including syphilis, Hep B surface antigen, CBC, HIV, Rh antigen like in the U.S. Unlike the U.S., in India if the patient is Rh negative, the father is tested. If he is also negative the patient will not receive Rhogam but if he is positive she will. This is because Rhogam is over 1,000 rupees. Perhaps in the U.S. we give Rhogam to every pregnant woman who is Rh negative because the ID of the father is not always reliable. Unlike in the villages where every patient was healthy and without pregnancy complications, here there were a few patients with complications including twins, oligohydramnios (decreased amniotic fluid), and fetal bilateral hydronephrosis (kidney enlargement in the fetus). The patient with oligohydramnios was found to be so after the doctor measured a decreased uterine length compared to dates so ordered an ultrasound which was completed within an hour. Since she was also having decreased fetal movements, she was instructed to see the obstetricians in the clinic for further evaluation and management. This was a very busy clinic as between 30-40 patients were seen in 2.5 hours by 2 doctors and an intern.
Funny story: Thursday the doctors wanted the air conditioning on in the van on the way to Mugulore so shut all of the windows and waited for the driver to turn it on. The driver refused. On the return drive back to St. Johns the doctors again requested the AC on. This time the driver agreed to turn it on when we got to the main road and only until we got into town. AC is VERY luxurious in India. I asked if any of the homes in Bangalore have air conditioning. The resident and health worker laughed at me.
Tonight we go to Hampi, a once thriving city in the 14th century, which now has many historical ruins and temples. We will surely report back next Mon/Tues, also the start of our last week in India!! Wow!!
Namaste! -Abby
There aren't enough food pictures on our blog. This is Tali some of us had in Goa. It is like dishes on one big plate! I'm not adept at naming foods but I will take a stab at describing it. There is a chip similar to Papad, Okra, milk-yogurt, and multiple sauces that are spicy, potatoey (Aloo), cauliflowery (Gobi), etc. Oh and rice! You can trust me on that one. Ugh I'm horrible.
Here is a monkey family that was walking right outside the HOSPITAL. Yeah, crazy. There is a baby Monkey next to the first adult. He was quite playful while Libby and I watched him. We can also hear monkey noises outside our windows in the Annexe.
This is the entrance to the operating room at Mugalur (right spelling this time). We couldn't get all the way in to the room but I thought it was interesting it's called a Theatre.
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