I have just returned from a two day trip to the deep
interior of India, which is full of jungles of lions and tigers and deserts of
camels and cacti. No just kidding, but its really, really different from the
city of Mumbai and even Pune. It’s in the rural area where I’ve learned the
most so far about healthcare conditions and social issues in India.
But back-tracking, since my last post, on Friday we had the
opportunity to see an orphanage that was attached to the government operated
Susoon hospital. This orphanage runs mainly off of donations. We were able to
talk with one of the directors. It was sad to see that many a time, baby girls
that are one or two days old are abandoned on the street because the mother
wanted a boy child, or the family of the mother pressured her so she gave her
child to the orphanage. Other times, the parents of a child died due to an
accident. But most often poor children are abandoned and many are brought to
this orphanage. We also were able to play with some of the children. It broke my heart that so many kids were left
by their parents and they were so cute. It was eye opening to be able to see
children like this but also good to know that they were being taken care of at a
fine orphanage.
Saturday our group went to a zoo and snake park not too far
from our guest house. There we saw lions, Asian elephants, every sort of snake
that you could ever imagine, and all kinds of birds and other Indian wildlife.
I have never seen so many animals, of all shapes and sizes. After 4 hours of
walking around this snake park, we were hot and exhausted but we had a great
time.
The next day was jam-packed with Pune sites. We started the
day at 6am with a three hour trek in a fort, called Singahagad fort. It was
beautiful but we were slipping on rocks like a group of untrained wild bafoons
wearing incorrect footwear and climbing into clouds and being soaked to the
bone. We came down alive and stronger then ever, it was physically tiring but
very fun. After we went to visit these beautiful Japanese gardens full of
beautiful greenery and lakes. We then went to a restaurant called Vasheli where
we ate Dosa and Udapi until we couldn’t move and were suffering from food comas.
We went to a museum that displayed beautiful work from different states in
India. After we visited the Aga Khan palace, which was really great for me to
see Sultan Muhammad Shah’s palace. He built the palace for himself and once
Gandhi was arrested, Aga Khan gave the palace to Gandhi for him to stay in for
house arrest. Gandhi’s wife died in the palace; it was a gorgeous palace and I
really loved seeing it. It makes me so proud that Aga Khan played this role in
helping Gandhi and his movement. We ended the day going shopping where I found
some beautiful gifts- India Chai tea leaves, incents, scarves and shawls, and
jewelry boxes.
Monday was another
day at Siddhi hospital, a private hospital close to our guest house. There we
were able to see another Medical Termination of Pregnancy and Tubal Ligation.
Random fact #5: Here death is referred to as “expiration”.
So when an old women dies, she is said to have expired. I’ve always heard this
word in the context of food like milk. So upon hearing someone “expired” I think
of curdled stinky milk.
Tuesday we left for our rural visit. We travelled about 150
kilometers outside of Pune to a village called Pawana where we stayed in a
little cabin-like place that housed plenty of little flying creatures to sleep
with us. After a good bit of screaming when flying beetles sat on our food or
huge hairy spiders were chilling in the bathroom, we adjusted. This two day
trip taught me about the conditions that many people in poverty face and how
the city of Pune and Mumbai may seem like an urban American city, the rural parts
of India are nothing like that.
The first day of rural clinic we had the opportunity to see
tubal ligations. After seeing tubal ligation in the private hospital in Pune, I
was eager to see how it was performed in a rural setting. Tubal Ligation is a
preventative surgery; birth control and contraceptive methods are not widely
practiced here, so tubal ligation serves as a way to prevent more children in a
family that already had two or three children. It’s unfortunate that
contraceptive methods are not used more often- condoms, Intrauterine devices,
Hormone rings, Diaphrams, etc. Even male often refuse a Vasectomy (male
sterilization) which is a much easier procedure to preform, because of cultural
views of male dominance. It is however great that preventative measures are
being taken to keep the population growth rate down and prevent women from
bearing children that they cannot afford to keep.
The conditions of the tubal ligation in the rural clinic
were much different than the few I saw in urban Pune. By the end of 4 or 5
surgeries, I was emotionally drained and was teary eyed; many of us had to
leave the room for some air because of the tension in that small room. The
rural clinic was a government run clinic so they do not have a laparoscope to
preform the easier tubal ligation procedure. Nine tubal ligations were
preformed in the span of 90 minutes. Women were brought in after being sedated
30 minutes prior. Then they were put on an unclean table where after 10 seconds
of receiving local anesthesia, they were cut open using tools that were just
placed in a bowl of lukewarm water that was pinkish. The surgeon never changed
his gloves and often yelled at the nurses. The surgeon had two patients on the
tables in a room that was half the size of my freshman college dorm room (which
was tiny). There was only one small fan going so everyone was sweating. A cup
of chai was next to the bowl that held the dirty instruments before being used
on the next woman. One small lightbulb illuminated the room and that’s all the
surgeon used. It was when the women screamed out in pain as the doctor cut open
the patient or when they yelled bloody murder as the doctor moved the
laproscope inside the womens’ bodies that I was beginning to cry seeing the
terrible conditions where surgery was perfomed. Seeing women younger than me,
after bearing two children, having tubal ligation in semi-public conditions,
with no support from their husbands, and the worst part- the pain they endured
because the doctor did not have enough time to allow the local anesthesia to
flow though their veins before he cut them open because the laproscope was
needed at another rural clinic that day. There simply were not enough materials
to supply the clinic and this is what led to the environment in which surgery
was preformed and the way the Indian government is able to provide to their
clinics.
If a more complex procedure has to be preformed they are
sent to the Public, government run hospital-Susoone hospital in Pune, but often
times, there is a car available to take them and no driver in the middle of the
night, or no gas for the car, and that is how women die of complications.
Much of the system results because of the generally
uneducated population in rural areas. When they come to the clinic once in ten
years they demand the doctor give them injections otherwise they say that
doctor is a “quack”. These doctors end up giving physicians saline injections
to satisfy the patient. And these patients are referred to as “psychological
patients” by physicians because they are uneducated and do not understand that
often simple medication can cure their infection or lifestyle changes can improve
healthcare.
After spending time in the clinic we were able to walk
around the small village that was very community based with a beautiful temple.
The clinic covers several small villages like ones we stayed, overall 30,000
people. We were even able to plant trees to see how farming works in rural
areas. It was an incredible trip and I learned so much.
My next blog I will post about some amazing procedures I saw
and my weekend trip to Aurungabad to see Ajenta and Elora caves and mini Taj
Mahal; so stay tuned!
Namaste, I miss you all!
