February 25, 2012

A fond farewell from wonderland

It’s been quite the adventure for us in India.  We even gained a new member!  Dr. Gera, a pediatric oncologist from MSU, joined us the evening of the 9th.
Sorting supplies

We have been graciously provided with many medications and supplies to donate while here in India.  We wanted to make sure the supplies were adequately distributed in an effective manner.  After separating the supplies we brought some of the supplies to the Pasam Hospital.  Dr. Mascarenhas was more then happy to have these supplies and he will be extremely pleased to see them go to serving the poor and needy within this community.

All these wonderful donations just waiting to be used for those in need!

 Dr. D. Gangatharan, the general practitioner at Pasam Hospital, looking through the donations with Paul

 Shawna, Claire, Emily and Paul (students from left to right), Dr. Mascarenhas (center), Dr D. Gangatharan and some of the dedicated nursing staff of Pasam Hospital welcoming the donations from Heart to Heart and our other kind donors.
From left to right: Sister Marina, Dr. Gera, Emily, Paul, Dr. Ranganathan (CEO), Claire, Shawna and Arun (FOM) with the supplies brought from Heart to Heart at Coley/St. Joseph Hospital in Pondicherry

Dr. Mascarenhas still has strong contacts in Germany and was provided with an inspiring video about his work and his hospital.  He asked Bryant, on of the FIMRC staff, to post the video to you tube as well as create a website featuring his hospital and plastic surgery camp.  Claire had some prior experience with websites and she offered her services to help Bryant complete the website and post the video.  Both can be found at www.wix.com/PasamTrust/Hopsital.

Shawna, Emily, Paul and Dr. Gera had the opportunity to go into the community to administer home surveys.  They had a first hand glimpse of the type of living conditions within the homes.  They gained insight into the type of health care received, illnesses, family structure, and sanitation as they spoke with their gracious hosts.

Speaking with the communi

Dr. Gera, Emily, Shawna and Paul with two of the community members that welcomed them into their home  and gave them valuable insight into the living conditions within their home

Some of the homes visited during the community survey

Within India there are several types of health care.  In addition to allopathic medicine, there are several other systems such as Aeyurvedic medicine, homeopathy, unani, and many more. (http://www.altmedworld.net/alternative.htm gives a very good overview of many of the types of complementary medicine)  Through the dedication and flexibility of our FIMRC staff we were able to have a one on one session with a local practicioner.  After having completed his residency in allopathic medicine he found his passion in Ayurveda and now provides a unique blending of eastern and western medicines.  He gave us a wonderful over view of Ayurveda as well as a demonstration of a special type of stomach massage that can be very therapeutic for many illnesses (almost like a reflexology for the stomach).  He even offers this space twice a week to a yoga teacher who was more then happy to let us (and an unexpected local monkey) to join her during some of her weekly sessions.

Our lesson on complementary medicine:

Within the Kodaikanal area there are several Creches (the day care/school centers we worked with previously).  Each Creche has their own dedicated teachers, kitchen staff and nurse.  The nurse provides the first line screening for any potential illnesses.  There is a local physician within the area that volunteers three afternoon visiting three separate Creches to provide health care visits to the children the nurse has identified for him. The children also rotate through well-child checks during these visits.  Dr. Gera, Shawna, Paul and Emily had the pleasure of shadowing the physician during one of his afternoon sessions. 

Emily demonstrating her impressive ball tossing skills while Dr. Gera observes 
Shawna's turn to try out her ball tossing skills

Who doesn't love starting the day with some yoga!

Dr. Gera getting in the action, helping out all the little yoginis by demonstrating her best tree pose.
Not only are the Creche children amazing at yoga, they have some incredible hula hooping skills!
Go, little guy, go!

A nourishing snack after a busy morning!
A typical weekly menu for the children of the Creches.

Future Jenga champ?
Donating beanie babies to one of the Creches.

It was amazing how well the children shared the new toys

This little one reminded us a little bit of a baby ghandi.

One of the aspects of the culture that our group grew to fully embrace was having tea or coffee many times each day.  The tea or coffee is incredibly sweet and comes in little mini dixie cups.  These are sold at many vendors along many of the streets.  Making coffee or tea for visitors is just one of the many ways that the people demonstrate their hospitality.

We couldn't get enough of the wonderful little cups of tea and coffee that were served to us throughout the entire trip.

Through Arun and Dr. Gera, the students were introduced to a physician with ties to Michigan.  He was originally from a small village close to Kodaikanal, moved to the US and has been practicing there for the past 25 years.  His dream has been to open a hospital in the rural villages surrounding Kodaikanal.  He graciously invited everyone to visit his hospital.  After an intense drive through the backroads of Kodaikanal we arrived at a massive and gorgeous hospital in the middle of a valley of villages.  He provided us with a tour, an explanation of his vision for the hospital and a wonderful lunch.  He wants this hospital to be his legacy and his contribution to the place he is from.  He really is an inspiration and a living example of how big of a difference one person really can make.  Within the next three months he plans to retire from the US, move back to Kodaikanal and start to work on opening the hospital from its current state of solely outpatient visits. 

During our time in Kodaikanal we were also able to enjoy some of the local attractions:
The happy couple enjoying a romantic horseback ride by the lake

Who wouldn't love a nice afternoon paddle boat ride around the lake?

Shawna demonstrating proper safety precautions

Genie pants!  Almost as cool as Ali Baba pants

One of the local domesticated and sacred cows

Mmmm Cafe Coffee Day!  A wonderful place to enjoy a dark passion sundae, a tasty cappuccino, some delightful conversations and a few reflective moments...Alot really can happen over coffee!

The Tuesday of our 3rd week in India, we boarded an overnight semi-sleeper destined for Pondicherry, the little France of India.  After arriving bright and early (3:30 am) we went to St. Joseph/Clooney Hospital (there seem to be quite a few places in India that change name fairly frequently).  We are staying in the private quarters on the third floor of the hospital.  They are even providing us with amazing breakfast and dinner. 

The view from the balcony of our hospital guest room.  Just behind the church (the building in the center) is the beach.

The girls guest room with wrap around balcony.

Coley/St. Joseph hospital in Pondecherry.  Most of the staff are sisters from the convent on the premis.  The hospital consists of a four theater operating floor, maternity ward, inpatient wards (segregated into male and female group rooms and private rooms), imaging/ultrasond and emergency/treatment rooms.  Additionally, Coley/St. Joseph has nearby affiliated centers for HIV, hospice, primary school, and an orphanage.

The CEO of the hospital personally welcomed us to his hospital.  He has been incredibly welcoming and accommodating.  He created a tentative schedule for us based on our interests and specialty choices.  We were given a tour of the hospital and after lunch separated into OB/GYN and Radiology.  Dr. Gera, Shawna and Claire were able to accompany the Dr. Mallapurnum as she completed her daily rounds of all the new infants.  They were even able to see the entire birthing process.  Emily and Paul joined the radiology department for an afternoon of abdominal ultrasounds.

The following day, Claire was able to spend the entire day in the OR.  She was able to see an incisional hernia repair, two cesarean sections and the start of a basal cell carcinoma extraction with skin graft.  Emily and Paul joined the Internal Medicine team during rounds.  Shawna spent the day in the OB wing, watching many newborn exams, births, and rounds.   

The delivery room.  Women, sans epidural, go through labor until they are fully dilated.  They are then walked to one of these two tables to undergo the birthing process.  Shortly after they deliver they are walked to another room to be united with their new bundle of joy. Just a few of the differences noted (from those in the states): there are no family members, the birthing process itself is much quicker, the medical staff is very direct, most women are given generous episiotomies prior to delivery and everyone wears special sterile flip flops

Dr. Gera was able to meet up with a friend (Dr. Rao) from thirty years ago who happened to work at a local government hospital and medical school.  Jipmer houses all the medical and nursing students, the schools themselves, as well as an impressive variety of specialties.  They see 5,000 patients a day.  Dr. Rao graciously gave the students a personal tour of the hospital.  She seems to know many people within the hospital and we were able to not only speak to several residents but also several department heads.  We saw everything from the Emergency Department to the Opthamology Ward to the Embryology Museum.  The embryology museum was interesting for some and disturbing for others.  It was a collection of preserved anatomic anomalies from fetus’ that had not survived.  There was even a fetus in feto, a pregnant fetus that had not survived and was now preserved within the museum. 

The specialty clinics building

Dr. Rao (left) speaking with Emily and Paul about JIPMER hospital while Arun and Claire discuss his training in nursing and midwifery.

JIPMER hospital layout.  

Dr. Rao has been very involved in the Indian equivalent of the "willed body" program.  After bodies are donated they are used in the anatomy lab as cadavers.  Once the bodies are no longer suitable they are buried.  After a certain period of time the bones of the bodies are recovered and treated with various chemicals.  They are then dried in the sun to obtain an ivory color and reassembled to be used as bony specimens in the cadaver lab.

Their last weekend in Pondicherry was spent enjoying the surrounding sites.  Just north of Pondicherry is a little gem known as Auroville.  The village was begun by “The Mother” with the idea that the village would be built on land that belonged to no nation with the intention of realizing human unity.  It was based on the idea of sustainable living and belief in diving essence.  There is no religion, only a golden globe in the center for concentration.  More information at www.auroville.org.  The group spent the morning seeing the golden globe, wandering through the various stores, speaking with several inhabitants and tasting the local fare.  The afternoon was spent at the local Auroville beach.  Bryant, Claire and Arun were even brave enough to swim in the Indian Ocean, attempting to ignore the various items of rubbish that floated by.  The day was ended with dinner in a private cabana and relaxing at a cozy local hangout.

One of the many signs in the visitor center expressing the objectives and ideals of Auroville

Some stats for those interested in the numbers

Paul, Emily, Shawna and Claire posing with some of the floating branches under one of the banyon trees (unfortunately, not many people are allowed to visit THE banyon tree that acts as the center of the village).  These floating branches grow from the central tree branches themselves into the ground and form the support columns for those massive central branches.

The golden globe in the middle of the village.  The ball reflects natural light coming in from the top and focuses it through a glass sphere within the globe itself.  This globe is said to be for concentration, rather then meditation.

The next day was spent exploring Mahabalipuram (previously Mamallapuram), known for its collection of various temples and sculptures carved out of single large rocks.  One of the more famous temples is known as the “Shore Temple”.  The group was able to see some Russian dignitaries and their families, who were also visiting the temples at the same time.  Shawna and Claire had a little taste of fame as many of the Indians asked to pose with them as the “foreigners”.

One of the temples carved out of a single large rock.

Panoramic views of some of the temples.

Butter rock...somehow this large boulder manages to teeter on it's edge....

Shore temple

The beach near the shore temple.

The group spent their remaining days in the hospital on medicine rounds.  Each day they saw close to 30 or 40 patients.  They saw patients with TB, malaria, Salmonella typhi, dengue, typhoid fever, viral tynosynovitis, rheumatic heart disease, ameobic liver abscess, diabetes, hypertension, stroke, myocardial infarction, filarial lymphangitis/elphanatnitis, post viral arthralgias, and liver cirrhosis with extrahepatic manefistations.  There were many textbook images seen.  The physician was very efficient, spoke to each of the patients attendants (family members) and was still able to teach the students.  Very high yield rounds.

The group also was able to visit the HIV compound that is associated with the hospital.  There are living quarters, jobs and medical services for its inhabitants.  Currently, there are approximately 40 patients living with in the compound.  The inhabitants are adults and children, most of who had been orphaned.    The compound emphasizes education about disease process, management, transmission and importance of treatment.

The garden just inside the entrance to the compound

One of the childrens wards within the compound.

The welcome sign outside the compound.

A proud demonstration of the art work of some of the inhabitants.

Not only was February 22nd the day that rank lists were due, it was also the day we were going to being our trip back to the US and the birthday of Bryant.  We were given a lovely send off on the night of the 21st to commemorate all these important events, complete with a traditional cake “facial” for the birthday boy. 

Our last dinner together!

It was a tearful goodbye as we boarded our sleeper bus on the 22nd to begin our 50+ hour journey back home.  The caregivers we worked with, the patients we saw and the variety of settings we worked in gave a very well rounded view of the Indian medical system.  The hospitality and kindness of the people we have met will not soon be forgotten.  India is an amazing country, filled with its own unique sense of time and chaos that somehow works.  From the struggles to the payoffs, it’s been one incredible journey, one that will always hold a special place for each one of us.  To everyone that has made this trip possible, especially Arun and Bryant, thank you for everything you have done. 


Justin said...

Very cool! Thanks so much for sharing all of this. It's great to get a glimpse of how healthcare is done in another culture. I can only imagine how incredible that trip must have been... Thanks for a great post!

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