Erumad Village Visit - May 6th

Night of the 5th

So yesterday I was invited to dinner at one of the hospital staff member's (Durga) house. They were throwing a birthday party for Dan who is a research student that's been working here at the hospital for the past 7 months. Durga's house was amazing. It is a stone cottage (literally) that looks completely out of place given the typical architecture here but it's gorgeous inside and outside.  

 

High ceilings, gorgeous decorations, and just a very homey feel

We had a great dinner of chappati and noodles and birthday cake and then watched a Woody Allen movie: A Purple Rose for Cairo. I had a hard time staying awake since it was 9:30pm when we started the movie and that's technically when I go to sleep but it was a really good movie and it was the first Woody Allen movie I've seen. Needless to say, I completely passed out when I got to my room at 11:45. Had to be ready at 8:30am to leave for the village of Erumad for the monthly doctor visit.

May 6th

Woke up at around 7am in the morning and got ready for the day visit. I was kind of dragging in the morning since I didn't have as much sleep as I wanted but I was good to go by the time we left. We all crammed into a jeep to make the one hour trek to the village clinic. In addition to me, there was Dr. Menon and Alice, the doctor from England, a hospital staff member, the driver and three other hospital patients that we were driving back to the village. Time-wise it was a relatively short trip but I could swear that the jeep hit every single bump and pothole there was. It was such a rough trip to get to the village and I was glad to be done at the end. 

We pulled up to the clinic and there were already over 30 patients waiting to be seen. The clinic that we went to today was one of the eight sub-centers that are located around the main Gudalur hospital. They are staffed by health advocates, volunteers in the community,  and nurses that see patients throughout the week and dispense the needed medication. The doctors from the main hospital try to hold a clinic at the centers at least once a month to perform regular checkups and the mobile van will also visit the village from time to time. If the patients need to be admitted they are brought to the main hospital. 

The Erumad Center

I got to help Alice translate today. In some ways it was the blind leading the blind because the village of Erumad is very close to the border of Kerala so more people spoke Malayalam compared to Tamil. However, between the two of us we managed to decipher what the patient was telling us to give them the right information and medicine. 

  

Alice examining a patient with abdominal pain and Dr. Menon speaking with Vinitha a sickle patient

 

Alice examining a very ticklish sickle patient on the left and a girl that came in with complaints of fever

 I also got to talk to the sickle cell patients that came through. There were about 10 total that came to the clinic today and one of the boys came back with us in the evening so that he could be admitted to the hospital because he had been in pain for quite a bit of time. Pretty much every single person I talked to that had SCD knew that they had "sickle" but didn't really know what that meant. They just said that they had sickle and they took medicine to stay healthy. It was a very different attitude from what I was used to. I'm used to people wanting to know every single that about their condition, what they have, why they have it, what happens to them, is there a cure, what do they have to do but there was none of that here. They just seemed to accept that they had sickle cell and didn't really think about learning more. Dr. Menon gave me the task of teaching all the sickle cell patients about sickle cell which was interesting. I had to keep everything very very basic because the general science knowledge is very low if not completely absent when it comes to genetics in India. Even something like inheritance is something that goes over people's heads. The first step was to tell them that sickle cell was a disease of their blood cells. I ended up drawing pictures and describing how most people have "round" blood cells but those with sickle cell have blood cells in the shape of an "aruval" which is the name of a type of knife that is used here. 

This is an Aruval (it has a similar shape to a sickled cell)

Then it was explaining to them the importance of their medication and that they needed to drink a lot of fluids especially since the weather is getting hotter and hotter. I think the only that they all took away from it was that they had to drink a lot of water which I guess is better than nothing but it's amazing to see the vast disparities in general knowledge across different populations. 

At the end of the day I think around 60-70 patients had come to the clinic. 

 

Alice and I made a friend today :-) 

Her name was Kavitha and I believe she lives near the center so she just came in and out of the room all day long

 

This is basically the main room of the clinic. It's were the initial weight and BP check is done along with medicine dispensing at the end of the patient visit. 

The center consists of a main room, a side room for patient consultation, a small kitchenette, and an extra room. 

This isn't the clearest picture but I actually got to see a baby with a cleft lip which was really cool since my actual student job is with the Craniofacial and Dental Genetics center

We wrapped everything up and headed back to the hospital around 3:30 in the afternoon. 

Our lovely transportation back. 

By the time we got back to the hospital I was completely exhausted and just wanted to sleep for the next few days but a shower woke me up a little and I got to hang out with the new German student that is visiting until Sunday. Her name is Isabel and she is a pediatric nurse that is doing a public health practicum in Bangalore and is visiting the hospital to see how it is run. Alice suggested a walk into town so the three of us headed out and ended up meeting up with Dan to grab something to drink. We went to this bakery where Dan and Alice go to everyday to drink mango shakes and ended up staying there for over an hour chatting. It was nice to head out from the hospital and walk around for a bit. Drinking mango shakes spoiled my dinner appetite so I just came straight back to my room to finish the blog and go to sleep. It's about 9:30pm here and I am just about ready to go to bed which is perfect since I am done writing about today. Tomorrow I head out on the mobile van to visit a few of the villages and see how they do the sickle cell prep tests.