It has been a very busy three weeks since I last wrote.The first of those three weeks was my last week in Pune and my last week with the Maternal and Child Health program.It was a very interesting week, as we watched a large number of surgeries related to pregnancy and infertility.We also watched another delivery, and this time I was better prepared for the episiotomy.(An episiotomy is a surgical procedure in which the perineum is cut when the baby's head is crowning, so as to avoid tearing of the skin.)It is performed on almost every first-time mother in India, which is something I wasn't aware of the first time I saw it.Thus, when the doctors picked up a large pair of what looked like sewing shears, and started cutting away at this very delicate skin, I definitely felt a little nauseous and faint.However, the second time around was much more positive, and I was able to stay in the room while they sewed the mother up.
For the second of the three weeks, Stephanie and I moved on to Mumbai, where wevisited a leprosy hospital and spent time at a clinic located in one of Mumbai's many slums.We had several interesting lectures on topics such as leprosy, Mumbai's health infrastructure, and HIV/AIDS in India.We also visited a clinic where the medical director, Dr. Gandhi, was treating leprosy patients.I definitely learned a lot about this disease, and realized that the disease's reputation is actually very distorted - more than 95% of people are naturally immune to the disease, and only about 10 - 15% of those who have the disease have the infectious kind.Also, very effective treatment exists for those who have leprosy, and virtually all of the virus is wiped out once the first pill is taken.India has done a great job of targeting the disease, and there are now very few people who have visible signs of leprosy.
I really enjoyed visiting the slum clinic as well. The doctor there was a great guy, very friendly and with a good sense of humor. In fact, the atmosphere around the slum clinic was rather jovial, and I could tell that this doctor, who had been there for 18 years, had a great relationship with his patients. Healthcare - including medication - in these areas is practically free, so it was accessible to almost everyone. Interestingly, a large percentage of the people who came in to the clinic used him more as a counselor than a doctor. One day, a woman came in complaining about the stress in her life due to problems with her mother-in-law.About 20 minutes later, this mother-in-law came in with her son, (the young woman's husband), complaining about problems she had with her daughter-in-law. In fact, any general practitioner I've been to states that a large portion of his/her job is to counsel patients who come in with "psychosomatic symptoms" due to stress stemming from family problems. One G.P. attributed this to the fact that there is a joint-family living arrangement in India, in which a young married couple lives with the husband's parents, along with other members of his extended family, which can often cause familial conflict.
After the week in Mumbai, we traveled up to Delhi on our way to Dehradun, where we were beginning the second half of our program.However, while in Delhi we took the opportunity to take a bus to Agra, five hours away, to see the incredible Taj Mahal.I felt like I could have spent days staring at this magnificent building.It's made of pure marble, and it literally glows when the sun shines on it.It was built as a mausoleum by Emperor Shah Jahan for his wife after she died giving birth to their fourteenth child.We also saw Agra fort and Akbar's Tomb while in Agra, and touring these sites definitely gave me a better understanding of India's complex and extensive history.
Finally, this past Sunday, we traveled up to Dehradun, and then immediately out to a very rural village called Than Gaon, located at the base of the Himalayas.Here we worked with Dr. Paul, a doctor who, for the past eight years, has lived in Than Gaon and spends at least two days each week hiking out to more remote villages to hold free health camps. Dr. Paul also has a degree in Ayurvedic medicine, (a form of medicine native to India, which spans back over 4000 years, involving the treatment of ailments with herbs and other plants indigenous to India). Thus, he prescribes a mixture of ayurvedic and allopathic medications, and it was very interesting to learn more about how he intermingles the two medical approaches. What was great about this rotation was that I was able to work with the patients in a hands-on manner. I checked blood pressure, listened to lungs, and checked ears, throats and teeth. Interestingly, one of the major problems that we came across in these villages was poor dental care.Dentists are not present in many of these rural areas, and toothaches and infected gums are a very common complaint. Many people do not take good care of their teeth, and I was shocked when I was doing general check-ups for schoolchildren, and saw the state that their teeth were in.
After the hectic hustle-and-bustle of Mumbai, it was wonderful to be in a beautiful, rural environment - no honking horns, no pollution, and more open space with less people.We also had yoga twice a day - once in the morning and once in the evening - which was very relaxing and beneficial.
So I am now in the city of Dehradun.It's a nice city - not too big with friendly people and some wonderfully huge bookstores, which I love. :-) I will be here, and in some surrounding smaller towns for the next four weeks.The focus will be on rural healthcare as well as on the manners in which Indian practitioners blend Western medicine with traditional and alternative forms such as Ayurveda, Homeopathy and Rekie Acupressure.
OK, I hope everyone is doing well and enjoying life. Write me when you get the chance.