Unit of Hope

Today I attended “Unit of Hope”, a multi-specialty clinic for children with disabilities. The clinic has a developmental pediatrician, two orthopedic surgeons, a gastroenterologist, a psychologist, occupational therapist, and early childhood therapist. A family might be there all day (everyone arrives at the same time in the morning and the last patient left around 5), but at least they can see all the specialists they need on one day rather than coming to on several different days. This is particularly helpful for some of the patients who come from outlying areas. Unlike regular pediatric clinic, patients need an appointment for a specific day to come to Unit of Hope. We probably saw about 10 patients all day, far fewer than in a typical pediatric clinic day, where the total is usually between 30 and 40 in a half-day clinic. Like the regular pediatric clinic, Unit of Hope was chaotic and noisy, with two or three patients being seen at the same time. However, I was impressed with how well it was run, and it seemed that families got the chance to ask questions and discuss their concerns in a more relaxed manner than in the regular pediatric clinic.

I saw some interesting cases today. India has quite a bit of cerebral palsy due to lack of access to obstetric care, although today there was only one child with CP in clinic. There were several with clubfoot, some of whom also had other anomalies. I saw a child with the rare disease hereditary hyperphosphatasia, a painful and deforming bone remodeling condition. I also saw a girl suspected to have Rett’s syndrome, a disorder I’ve never seen before but which is frequently tested on the USMLEs since it occurs almost exclusively in girls which is unusual for developmental disorders. Another child had suffered from HIB meningitis at six weeks of age; he recovered fairly well but has learning and behavioral problems now at seven years. Sadly, he got meningitis shortly before the HIB vaccine became routine in India.

I also saw a few interesting cases in regular clinic yesterday -- neurocystersarcosis, several cases of glycogen storage disorders, hemophilia A, and Fanconi Bickel syndrome. I've been surprised at how many rare disorders I've seen here!

Tomorrow will be my last day on pediatrics and then the six of us head off on a long overnight bus ride for a weekend in Goa! We are all excited for a relaxing weekend away from the urban clamor of Bangalore!

-Libby