Rural Sites and Escapades

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!