First trip out of the city

Yesterday we left Pune and went up into the mountains where we were able to see a different side of india much different than life in the bigger city. Several India doctors hopped on the bus with us to help with the screening of over a hundred people for diabetes and hypertension at the only building that people from all around the area came to deal with any health related issue. Inside the building there is a room for dental work, for surgery, for eye exams, for delivering babies, and other general examination rooms. Outside of the building is the "medical waste pit" and there is also a well that people would come to for water from all directions.

Many of the women would carry jugs of water on their heads.

The day ran smooth and many people were diagnosed with diabetes, Kunal will probably update everyone with the numbers later. Thanks for reading!

The Good and the Bad

On Sunday, we conducted a healthcamp for the families of construction workers at Infocity (a new software park) through an NGO called Mobile Creches. We were helped by residents from the H. V. Desai Hospital and Dr. Dilip Bidwe. We saw about 120 people, mostly children and infants. Almost all the children we saw had some sort of nutritional issue, like Vitamin A, B and D deficiencies, as well as anemia. We saw about 30 cases of GI infections, 50 respiratory tract infections and 40 vision problems. Skin infections were also common. Some of the more interesting cases we saw included Ventricular Septation defects (Ona caught it during the physical), Cystic Lung disease(John), Leprosy (Kay), Rickets (Megan), Pica and Progeria. Andrew, Nick and John helped with checking the boys for hernias, while I moved around translating and keeping things in order. I was really impressed with the efficiency that the camp was conducted and wish it was on video so everyone could see the work that was done, but pictures will have to suffice. The success of the healthcamp prompted me to organize an additional one next sunday.

Unfortunately, we lost out on our volunteering opportunity at the Ruby Hall Clinic. We went and checked out the facility today but it was too small to accomodate all eight of us. It also catered mostly to gynecological issues which would prevent the boys from doing much work. The cultural and logistical issues conspired against us on this occasion, however, the experience we will gain through the four health camps should more than make up for what we missed out on.

surgery in slippers :)

The past few days have been amazing, I have seen so many patients and learned so much. Amidst all of this excitement, nothing has hit me as much off gaurd as my first experience in the OT (operating theater). While I was working at the Eye Hospital examining patients with Dr. Seema in the cornea room, the last patient of the day presented with a perforated cornea which had become infected and resulted in the iris touching the cornea. She told me that this was an emergency which she would need to tend to in the OT. As she walked me over with her we took our shoes off at the door, which is nothing out of the normal for me. But to my surprise, as we changed into scrubs and walked into the actual OT, she handed me a pair of slippers! This definitely caught me off gaurd, with all of the rules that we have in America for keeping our toes safely inside of shoes I just wasn't expecting it :) Regardless of our footwear the quick patch up surgery was an amazing experience to watch, and Dr. Seema was a great teacher as she went through the procedure.
I have been so fortunate to be working with such great doctors here, and what is really amazing is that all of the things that I have learned about this past year and read about in books has been presenting itself to me. It's quite a feeling to be able to experience things that I have only read about in theory.
So long for now, and I look forward to sharing tomorrow!

Back in the Saddle Again

After several days of not feeling too well, I was happy to be able to get back into things with the health clinic for the kids at the construction site yesterday. I really enjoyed interacting with the kids as well as practicing my physical exam skills. Anemia and vitamin deficiencies were most common, as we expected, and I realized I need to brush up on heart and lung sounds. We also saw some adults, and that's where the communication barrier became evident, as they had specific complaints that needed interpretation. Before we left, we got a few pictures with the kids (they love to both have their picture taken and take pictures of us!). Hope we can get those up soon.
We had a nice dinner out last night, then we were able to see some of the Cricket game on TV. I am kind of getting the gist of the sport, but mostly I enjoy watching how into it the whole country is!

Pictures!

We've been taking a lot of pictures, but haven't had time to upload them yet. Here are a few, more to come later :)

This is a picture of me observing a pediatric eye surgery. The child had a "squint," meaning that one eye did not align with the other. The procedure for this was to weaken or strengthen one of the six eye muscles, depending on what kind of squint it was. I found the surgery to be the most exciting area. It was really cool to be able to see conditions that I've been studying for the last year-and I'm really finding out just how much I learned or didn't learn in neuro.

Here is a group picture of us eating lunch at the Desai household. I'm really going to miss this amazing food...I've never felt more at home as a vegetarian than I do in India!

Here is a picture of the Desai eye hospital that we've been working at, as well as Ona, Nick, and Kay in front of the hospital.

Today we worked at a health camp for children of construction workers. We did basic exams, mostly of young children. It was incredibly fun to see all of the cute kids, and it was neat just how much you can communicate with a child without using any words --although it was helpful to be able to day "where is the pain?" in hindi. It was a mixed experience, however, because while it was so amazing to see all of the kids, it was also very depressing to see all of the vitamin deficiencies, anemia, ricketts, and respiratory infections. We have a lot of health camps coming up, so we'll be seeing a lot more of these efffects of poverty.

Final Day at the Eye Hospital

Today was our final day at the H.V. Desai Eye Hospital and it was one that everyone enjoyed. I got to work with a pediatric opthamalogist who was very eager to teach us. We saw a variety of cases, ranging from a case of leukocoria, to one of conjunctival nevus. The cases that really stuck out to me were those of children who has just undergone surgery to correct exotropia and esotropia. Esotropia and exotropia are excessive internal and external strabismus of the eye, respectively. They can be surgerically corrected with resectioning and reattachment of the rectus muscles of the eye. It was incredible for me to witness how successful these procedures are and the profound change that they can have on a child.
On another front, I cannot get over how crazy the driving in India is. I am honestly blown away. Never have I seen traffic where lane-markers are seldomly adhered to, with bikes motorcycles, cattle, donkeys, and goats all part of the congestion. I vow that, before I leave, I want to conquer driving here, although that depends upon somebody letting drive their car, which won't happen. Still, I feel like stunt drivers in the states look like beginners to drivers over. The best part is, every single drive is an adventure...

Toast and Pancakes

Friday started with toast covered with cheese spread, chili, and peanut butter. The taste of this triple threat of toppings, even though unusual allies, prepared me for a hot Indian day. After the usual death defying car trip to the H.V. Desai Eye Hospital I found a Cornea specialist’s shoulder to look over. Dr. Pravnav was very sharp and took pride in his work. He also took the time to explain cases to me and see 30 patients in a couple hours. I saw many post-opt Ptygium cases, cataracts, herpes zoster, 2 teratomas, keratitis, and one Dacryocystitis, trigeminal neuroliga, keratonconus, and possible secondary glaucoma.

Lunch was also another American breakfast food covered in Indian spices. Pancakes dressed in peppers, onions, sauces, cheese and dipped into a very un-maple syrup sauce created another satisfied appetite and confused taste buds.

My plan to blend in is taking longer than expected.

...And so it begins

So as my first day working at the hospital here comes to an end I find myself taking some time to reflect on the days events. My first day was great, I was fortunate enough to be working with a doctor who really took the time to show me what was going on with each patient that we had. Every patient that we saw was an opportunity where I was able to learn something new and see something that I had never seen before. I look forward to the upcoming days, and am hoping that as our time here continues I will be able to begin recognizing things without the aid of the doctor.
While we haven't really had time to go out and explore the city yet, this is yet another facet of the trip that I can't wait to experience.....

Work Hard, Rock Harder

A nice chance to take a breath and write some thoughts~
The drive from Mumbai to Pune Tuesday night was an experience in and of itself! And driving around Pune yesterday with Rohan (Kunal's brother), it was nice to be able to see the city, get a sense of my surroundings. I'm continually amazed by what I see. I'm not totally surprised, but I can't get over it, either. Animals (dogs everywhere, chickens, goats, oxen?), people, traffic, everything!
I was with the pediatric ophthalmologist today at the eye hospital, who was a wonderful teacher. He would discuss the patient's case with me, and it was great because we just had all this eye stuff in neuro, so it was fresh in my mind and I actually knew what was going on! He will be operating tomorrow on some of the patients he saw today, so I hope to be able to see those surgeries tomorrow morning.
Aside from teaching me ophthalmologic things today, the physician was excited to talk about his taste in music - hard rock/heavy metal! His outlook: "Work Hard, Rock Harder!" I thought that was funny. And probably sound advice!

-Megan

First day in the hospital

Today we were at the Desai eye hospital. I was with a pediatrician and saw an amazing variety of patients. There were children with lazy eyes, cranial nerve palsies, and congenital defects. The hospital is a charity hospital, meaning that none of the patients are turned away for inability to pay. The doctor was very passionate about his work, and it was cool to see him and be able to learn from him.
-Andrea

India

We are a few days into our trip, and so far I have felt the craziest cuture shock during our car rides. It is like being in a video game with cars overflowing with people, buses, huge truck, and motor cycles with entire families on them zooming by in every direction. People are always driving on the wrong side of the road or off the road as long as they keep moving.

Today was our first day in the eye hospital and the Indian doctors refreshed a few weeks worth of the neuro I have learned over the past few months. It was much different having patients in front of me with different eye problems instead of seeing pictures on a power point slide show. A lot of cataracts, glaucoma, and patients suffering from diabetes problems like diabetic retinopathy.

After we got back to the house we watched a game of cricket and then went in the back yard to play for a bit, I understand the game now and had a lot of fun.

Introduction to CURA India

We will be in India in just a few more days so I encourage all the CURA supporters to follow our trip through this blog. We will post updates as often as we can, through the course of our trip.
The trip members -
John Daly - johndaly@creighton.edu
Megan Davis - megandavis@creighton.edu
Andrew Dickhute - andrewdickhute@creighton.edu
Kay Hurley - kathleenhurley@creighton.edu
Ona Gurney - onanoagurney@creighton.edu
Andrea Schliesman - andreaschliesman@creighton.edu
Nick Townley - nicholastownley@creighton.edu
Kunal Desai - kunaldesai@creighton.edu

Please feel free to email individual members with questions or post your comments online. Thank you for all your support.

Trip Itinerary

May 20: Arrive in Mumbai
May 21-24: Orientation with doctors at H. V. Desai Hospital and Bharti Hospital. Group split into two, half at H. V. Desai and half at Bharti.
May 25-27: Groups switch hospitals. Begin HIV/AIDS work with Ruby Hall Clinic at rural site and slum.
May 28-30: Diabetes and Hypertension Healthcamp at Khed Shivapur.
May 31: Day off in Pune.
June 1-2: Prepare for Kanha Healthcamp.
June 3: Depart for Kanha.
June 4: Arrive in Kanha.
June 5-8: Health camp
June 9-10: Visit National park.
June 11: Travel to Agra by train.
June 12: Visit Taj Mahal. Travel to Delhi.
June 13: Sight seeing in Delhi.
June 14: In Delhi.
June 15: Depart for Mumbai.
June 16: Back in US.

Megan's Reflection

I am looking forward to CURA India for many reasons. Not only is it going to be a trip in which we provide some basic services and education to a wide range of people (those both in the city and rural villages suffering from many different things), Kunal’s expertise and connections will help us make the most of our time there. He knows who especially is in need of our attention, where to focus our efforts, and who to call for help in doing this. Even poor healthcare in the US is exponentially better than that in the majority of the rest of the world, and as an insulated Midwesterner, I know seeing that reality firsthand will be an eye-opener.Apart from my excitement to experience this new place, I do have fears. Emotionally-draining sights and encounters, disease exposure, and yes, snakes, are among them. I am also slightly nervous about how we will be received in India and the cascade of effects from the unrest in the Middle East. Overall, I am comfortable with the planning of the trip, I love the group, and I am thrilled to start the adventure!

John's Reflection

I think an important part of becoming a doctor is learning to be open to the diverse ways of life and types of people I will be interacting with on a regular basis. I cannot think of a better way to familiarize myself with people that differ from me than to leave the way of life I know and provide healthcare to people in another part of the world. Project CURA gives me a chance to learn about a different culture and healthcare system with the classmates I have been studying medicine with all year. In India, I look forward to my service work helping people in the immediate future, while my interactions with these people within their culture influence me as a doctor and as a person for the rest of my life.

Kay's Reflection

I have always been interested in getting involved in medical volunteering, and the CURA program is one of the reasons I chose to apply to Creighton. I feel strongly about volunteering within one's own community, but believe that in order to understand healthcare disparities within my country I need a global perspective on this problem. I feel that by going to India, my experiences will shape me into a better physician.

Documentary Screening

We recently had our documentary screening and it was very successful. Thanks to everyone that came out, and thanks to Nick's parents for setting up the venue and great food! If any would like to watch the documentary again, or was unable to make it, here is the link to watch it online:

http://omc.bc.edu/baldwin/archive/2008/watch.php

The title is "Indian Healthcare: Right or Privilege?"

We'll be arriving in India next week, so more posts to come!


थैंक्स तो एवेर्योने ठाट कामे तो थे डॉक्युमेंटरी स्क्रीनिंग!