Tuesday, August 9, 2011

Arrival In India (July 14-18th)

By Folu
My trip overview.

12 of us embarked on this 4 week trip to India in order to get an insight into the socio-economic aspect of healthcare, which is often overlooked. There are 9 medical students from my school including myself, two premed undergraduates and one of our wonderful professors Dr. Chandy, who is originally from India. Dr Chandy would take us to various parts of India. We would go on to observe healthcare at various levels in India from the town of Vellore, to the rural, jungle and tribal population in Guadalore, to state of the art, world class hospitals in the big city of Bangalore and finally in the rural area of Jamked. We also had two research projects to conduct in India. One is an electronic stethoscope developed by engineering students we are working with at Caltech in Pomona California to help in diagnosing heart problems in individuals, fetus, children in rural areas, so that the recordings can be transmitted to physicians anywhere in big city hospitals. The second project is cancer research and even employing portable devices for taking photographs, with the ability to be sent to a doctor elsewhere like the stethoscope project. And of course do some touring/sightseeing.

Thurs July 14 and 15.

Aboard a Cathy Pacific Airline Flight, myself and 7 friends: Morgaine, Martin, Kimberly, David, Christina, and Patrick left LAX. We arrived in Hong Kong about 13 hours later after a flight full of a lot of good food (lamb, chicken, desserts and the list goes on), and a great entertainment system. The Hong Kong airport was huge and very busy, and after touring it for a while we all sat down to eat some authentic Chinese food (I think) and wait for our connecting flight to Chennai, India. We all wished we had more time to leave the airport and explore the city of Hong Kong since we had heard so much about it and saw how nice it was as we landed, but we had only about 3 hours for our lay over. I had never seen as many sky scrappers in one city in my entire life as I had seen in Hong Kong, despite the fact that I have been to New York City a lot of times.

During the flight, I was excited as we approached India. I was looking forward to seeing India, the people, lifestyle there, cultures, food of course, the tourist sites, healthcare system there which is the main reason I was travelling there, and of course maybe star in a Bollywood movie. Since I was born and raised in Nigeria before moving to the US, I was eager to see how it compared to India. Both countries have a few things in common: both were British colonies, both are countries with one of the largest population in their respective continents, both are countries which a huge variety of traditions, ethnic groups, languages & dialects (over 150 in Nigeria and over 30 in India), and both countries have citizens all around the world especially in western countries who are in search of better opportunities or even to attend institutions of higher education (myself included).

Sat July 16th.

At 130am local time in India, we arrived in the City of Chennai. India is 12.5hrs ahead of Pacific Time in the US (California time) or GMT plus 3.5hrs. The additional 0.5hrs in Indian time was something that really confused us for a while till we got the hang of it.

The 8 of us who flew from the US together had to meet up with 4 other people who were part of our India team and but were meeting us in India from their vacations from other parts of the world or from the US. We quickly saw Molly and Dawn both UCI medical students, Dr. Chandy our professor from UCI who would be taking us around India, Jonathan a UCSD premed undergraduate, which meant we were missing one person Siobhan who was supposed to have arrived from Sri Lanka before all of us. Since we could not call each other upon arriving in India, we agreed to meet in the waiting room with our various arrival times. We were all worried she wasn’t there but maintained our composure and somehow found out that she was coming on a later. We finally saw Siobhan and were ready to exit the airport about 6 hours later.

I walked out of the air conditioned airport and as the first drop of sweat dropped from my face as I stood in the sun, I thought I was back in Nigeria for a second, because the humidity and hot weather in Nigeria was similar in India. One of the first things one notices right of the back is the huge amount of people waiting outside the airport (not surprising since the country has a population of 1.1 billion), some waiting on friends, relatives, and some trying to make a quick buck by volunteering to carry luggage to taxis for newly arrived travelers. The 12 of us got into our arranged van, but before we left, the driver had to load a lot of our luggage on the roof, put some plastic sheets over it and tie it down, which was a sight to see. It is monsoon season in India, so it was to protect our luggage.

Our trip from Chennai to the town of Vellore, which was our first destination in India took about 2 hours. The scenes from the streets, animals roaming around (though there number of cows is astonishing), the mixture of wealth and poverty reminded me of Africa again. As we drove, I learned something about the City of Chennai. It is the home of automobile parts assembly of about 60% of most of the World’s major automobile companies. These range from Mercedes to Toyota, then the parts are exported to the rest of the world for assembly. We also drove past a number of cell phone and computer manufacturing plants such as Motorola and Nokia, which were huge and spread out, each almost like its own little town. I did notice the Indian automobile company TATA was a powerful force in India from day one as I saw a lot of TATA vehicles ranging from SUVs to sedans, trucks, and bus. I also learn that TATA owned two huge car companies: Jaguar and Land Rover.

We soon arrived on the campus of the Christian Medical College (CMC) in Vellore , which is one of the top medical schools in India. It was a beautiful, green, and spread out campus with lots of facilities including a lot of guest houses for foreign physicians or student rotating there, a couple of canteens, volley ball, nice swimming pool and even basketball courts. A few days later, there would be a huge basketball tournament there which was interesting to watch. There were also so many monkeys on the campus which just roamed about freely, and if one isn’t paying attention, they could steal your food.

I looked forward to our first meal. It was good but I was still looking for the meat on the plate. By the next day, I learned the cafeteria to go to which offered dishes with meat and I was a happy man. We all settled in our rooms, which has great with internet access, AC, and my room was lucky to have a working shower and hot water heater. Some of my friends had to use a combination of a bucket and a smaller one to pour the water on themselves.

Sunday July 17th.

Breakfast was great. One of the best things about India to me was how cheap food was. For that reason, each time we ate, we were able to get multiple dishes, and within two weeks we had sampled lots of Indian dishes. For breakfast, I had an egg dosa, some toast (for something familiar), and some idly. After breakfast, we explored the campus and found “The College Store”, which was a supermarket that did everything. They have groceries, deserts, cell phones, sim cards, arranged travel tours, plane tickets, and just about anything. We soon met up with our professor Dr. Chandy at the swimming pool and his fellow CMC medical school graduates the Matthews, who were great and welcoming to all of us from day one. They would eventually host us for dinner at their home twice within our one week stay in Vellore.

The pool was beautiful, there were plants all around, which gave one the illusion that one was at a Caribbean beach or resort. We even learned they had great pizza there. We would later on have pizza (Indian style) at the Mathews’ residence which I admit could put Papa Johns, Pizzza hut, and Dominoes out of business. As the fellas and myself got in the pool we meet a number of other international students from the U.S. temporarily studying or rotating through CMC. Between the pool and walking a round campus, and the CMC hospitals we would eventually meet other international students from Germany, Austria, Holland, Oman, Russia, and Malaysia among others by the week’s end. The pool was refreshing because it was very hot in Vellore, but of course the ladies were all shopping and having tailor made clothes the entire time we were swimming.

After the pool, we went shopping in town for clothes we would wear during our hospital rounds. For the male medical students and even many male doctors in the CMC hospital, the attire consisted of some khaki or slacks, a button up short sleeve or long sleeve shirt, and sandal. Shoes were not required because the sandal were more comfortable in the heat.

From shopping, we went to Darling restaurant at the Darling hotel, where we eat some delicious Indian dishes like garlic and butter naan, tandoori chicken, mutton Biriyani, various curry dishes, and a mango lassi (somewhat like a smoothie). Among the 12 of us, we ordered a lot of food and shared it but the amazing part was we each paid maybe the equivalent of $5 for it, which would have been about $20 per person in the U.S.

Monday July 18th.

After breakfast, we attended a seminar on Ulcerative Colitis and the use of antibiotics in caesarian surgeries. We were introduced to Dr. Bose Anu, a pediatrician from CMC’s CHAD hospital. CMC is the biggest hospital in Vellore and has a number of hospital there. There is the main CMC hospital with over 2500 patient beds, the CHAD hospital the Low Cost Effective Unit Clinic) LCEUC, and an Eye clinic. At CHAD we learned some history behind the hospital and their mission. It was set up about 100 years ago to be a missionary hospital whose mission is to cater to the poorest of the poor. Since then it has grown to be one of the great teaching hospitals with a medical school in India to provide primary, secondary and tertiary care to patients. CMC allowed patients to pay for their treatment on a sliding scale. This means that the poor paid only as much as they could afford and their healthcare was covered by the hospital which is able to do this because they charge the richer a little more for their treatment. CMC as a whole also receives million in donation from all around the world. They also rely on the large volume of patients seen, which allows them to charge less. This is an impressive model because I saw how the poor were able to receive life saving healthcare without worrying about death because they can’t afford it.

We saw a few pediatric patients and we able to test the newly developed electronic stethoscope and we used it to record some pediatric heart sounds as we heard a few murmurs and heart problems. Another interesting approach CHAD employed for medicine was to send nurses along with village health workers (who are elected by their villages to represent them) to visit the nearby villages and provide care. We accompanied them and were impressed by this approach because it eliminated the need for poor patients to come all the way to the hospital for care unless if it was something serious. Many of them are so poor that taking a day of work to travel all the way by public transportation wasn’t an option, It was cost a lot to travel, they would lose a days pay of 100 rupees a day (for a farmer), which isn’t much but a lot for these poor villagers. We checked on a few pregnant women, and an epileptic young girl. It was very interesting to see how young the village women got married. By 18years, many were married.

During the course of the day, about 3 of my friends had to return to the bus to rest as some suffered from dehydration or upset stomach which was a combined result of the hot weather, eating new unfamiliar foods, and just being in a foreign environment. But the day’s end, we were all tired.

Look out for more post coming soon.

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