Time for the First Clinic Visit in Gudalur - May 4th

         Waking up at 5:30am is no fun and it's even worse when you know you've got a five and a half hour car ride ahead of you. But that's what I had to do so that I would be in Gudalur around noon. My uncle offered to chauffeur me to the hospital today so he picked me up around 7 am and we picked up another cousin so that she could keep him company on the long car ride back. Driving in India is always an adventure and it's even more so when you have an uncle that loves speeding up and overtaking other cars. I can guarantee that if my mom had been in the car with us she would have been scolding him the entire way about his driving and that he was driving too fast. The entire trip was full of turns and hair pin bends since we were basically going up one side of the mountain only to go down part way of the other side to get to the hospital. Although it was a long trip it certainly wasn't a boring. The scenery is gorgeous and there were so many monkeys and baby monkeys throughout the entire stretch.

  

Driving up towards Ooty...

No one really cared about the traffic lines. People drove wherever they felt like doing so

Eucalyptus Trees on the right. We passed a plantation full of them. 

 

We passed quite a bit of tea estates as well. The picture on the right is of the estate workers gathering the tea leaves. 

  

This is right when we entered the town of Gudalur. He was just sitting there looking at everyone passing without a care in the world. 

Finally after quite a bit of twists and turns and going up random hills we reached the Gudalur Adivasi Hospital. After finding Dr. Menon who is unofficially the head of the entire hospital and talking to him he took me to the "Doctors Hostel" where people visiting the hospital in some sort of academic/official capacity stays. It's a nice place too. There are about 15ish people staying here right now. Two doctors and a bunch of nursing students from Christian Medical College in Kerala.  

This is the outside of the hostel. There are quite a few rooms inside. 

I believe there are three floors. I haven't gone exploring yet. 

 

         Hallway/Living Room & Kitchen further in (Left)       My Bedroom (Right)

           After getting settled I went back to see Dr. Menon to learn about what I'm going to be doing for the duration of my visit. Dr. Menon, a surgeon, originally had a practice in West Chester, NJ but then decided to move back to India along with his wife, a gynecologist, to help develop the Adivasi hospital and has been here for the past 20 years. I learned a lot about the history of the hospital and the community it serves. 

          The Adivasis are a tribal population that are a minority in the Indian population and unfortunately displaced from their land when the government declared the land that the Adivasis had been living on as government land. This was followed by non-tribal individuals and tea estate groups setting up shop and buying the land that the Adivasis had been living on. In some ways there is a lot of similarities between the Native American population and the Adivasis. 

           This community of Adivasis were not the type to back down and sit complacently. While they certainly are not aggressive they decided to take matters into their own hands and help develop a community where they could feel accepted and flourish. Health care was a serious problem in the area. The mortality rate was high because the Adivasi population did not feel comfortable or safe going to hospitals run by the non-tribals because of how they had been treated thus far. This prompted the development of the Gudalur Adivasi Hospital which has been around for over 20 years now. The entire hospital is owned by the Adivasi community. The population is separated into different groups and fractions and these groups all came together and raised the funds necessary to build the hospital. Through the years, 8 sub-centers have been created in different villages throughout the area to provide quick and accessible services along with a mobile van that travels to the different villages throughout the week. (More information about other developments they have made can be found at http://www.adivasi.net/history.php ) 

        As I said before the Adivasi population has a high prevalence of sickle cell because they were the original "inhabitants" of the land and malaria rates were high in the area. Because of this, the doctors and nurses in the hospital do field visits and screen the villagers for sickle disease. As it currently stands, the hospital staff has screened 10,000 individuals out of a total of 16,000. They are screening every individual under the age of 30. Why 30? Because most individuals if affected with Sickle Cell Disease would have had some sort of pain crises by this point and 30-year olds also tend to have families by this point so screening does not provide any beneficial or necessary information. I get to go on a few of the field visits this Friday, Saturday and Monday so I'm excited to see how the screening is done and how the results are explained and disclosed. 

       From what I understand, the better part of tomorrow will be spent at the hospital observing the general routine and learning how the sickle cell cases are handled. I'm still amazed at how the hospital and the community have come together to help make health care affordable. Dr. Menon explained that inpatient care is free, outpatient care is fee is small compared to other hospitals no matter what is done. If a patient needs to be referred to a larger hospital then the hospital takes care of all the bills not the patient. The Tamil Nadu government has given the hospital funds to accomplish this along with donations from the community and other individuals. 

      After talking with Dr. Menon today I was astounded at how much the community has accomplished in the 20 odd years that the hospital has been open. There are currently plans for a building that will house an operating room in between the hospital and the hostel. The majority of individuals that work in the hospital are all part of the Adivasi population as well. The hospital staff trains nurses themselves to work in the hospital. So to sum it up, the hospital is open to the entire community both tribal and non-tribal (kind of a nice pride point for the Adivasis), owned by the Adivasi community and run/staffed by the Adivasi community. 

     I'm looking forward to seeing the inner workings of this entire hospital and how it works with the community.