153 Kids For Well Child Clinic

May 12th, 2010 by INMED
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Tuesday, I again reported to the CHAD (Community Health and Development) Hospital and am continuing to work on database development for them.  Went with the OT on rounds in the nursery today.  Wow, there were about 6 babies, in clear sided bassinets like used in the States.  BUT, the mothers of the sick babies slept on the floor next to the bassinets.  I don’t mean with a pillow and blanket, just on the linoleum floor.  Some of the babies had been there over a week.  I cannot imagine just having had a baby and then sleeping on the floor.


On Wednesday the immunization clinic is held.  Today I weighed the babies and recorded the weight on the card each mother had.  The card has the weight for age grids developed by the World Health Organization already printed on it so we could graph progress and percentiles easily. We had 153 children for the clinic (most under the age of 3).  Imagine an open air room, full of 153 children, their mothers and often their grandmothers.  Everyone is sitting on the floor in the sweltering heat.  Few babies have any kind of diaper.  Most are just bare-bottomed laying on a piece of cloth, some have a small rag tied around their bottom.  There are accidents everywhere on the floor but the mothers just wipe them up with a blanket or the end of their sari (I always wondered what those extra yards of fabric were for).  It was quite a sight, sound and smell adventure.


Today I met some interesting people at breakfast.  One young man from Sweden is a medical student who will leave this week after 3 months here.  He had lived in LA for a year while his mother did a post-doctoral fellowship.  Interestingly, he realized how prevalent that the Spanish language was in LA so he decided in order to learn Spanish he would go to Peru and volunteer at an orphanage for a year to learn the language.  Another fellow joined us-he has been here for 3 years but had just returned from the UK for a one month holiday.  He works for the Cochrane Institute-I learned a lot at breakfast about medical research and the Institute.  All in all it was a good start to the day, very stimulating conversation.

Quadrapelegia In Rural India – Not Good

May 6th, 2010 by INMED
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Sam OT, Preethi OT intern and I visited several persons with disabilities over the past few days.  It is interesting, one young man with quadrapelegia – good looking kid about 21 years old, 2 years after a road traffic accident, is so unmotivated and content to lie on his bed.  He had a couple of cell phones he looked at, hot dark room, fan not on…only a shirt on and a towel over his bottom (lying on his stomach) in a filthy room.  Sam OT really gave him a what for about getting up, going to rehab, getting a job… He said it hurt too much to sit up. Don’t know if Sam will be able to motivate him but what a depressing lifestyle.


Another man, about 40 years old, also had a spinal cord injury from a road traffic accident.  He has a small hut with dirt floor but at least he can pull himself in and out with his arms.  He has several small children that a neighbor comes and cares for while his wife does coolie work in the fields.  I can’t even imagine what life must be like just sitting day after day.  He has a beautiful spot to sit…looking a the hills, near a stream, banana trees and fields all around but I am afraid it is not much of a life.


Today I made the trip to Darjeeling.  I have so been looking forward to this but it was a tough journey…2 ½ hour cab ride from Vellore to Chennai…plane to Calcutta then a second flight on to Bagdogra.  Then I had another one of those “adventures”, I took a shared jeep (guidebooks recommend-they are wrong but one more thing checked off of my “I think I’ll try that” list).  I shared the jeep with 12 other people (ok, one was a small child but still, that’s a lot of people in one jeep) for 3 and one half hours(!!) around hairpin turns and steep drop offs on the roadsides.  I was in the very back seat-shared the bench seat with 3 men.  The seat had been well used, there was almost no padding and I spent most of the time holding on with my fingertips of my left hand and bracing myself with my right leg so I didn’t fall over on the guy next to me..my bottom was so sore!


Amanda and I came to Darjeeling 5 years ago so I had good memories but tonight I am so done.  I can handle most anything but dirty sheets on the bed.  Tonight there is no top sheet-just supposed to put the comfort over me… I can’t stand this.  I am going to sleep wrapped in a shawl and will go in the morning and buy a big blanket to sleep in.

Villages With The Physician’s Mobile Unit

April 30th, 2010 by INMED
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Today we set out for the rural villages in the physician’s mobile unit.  I had wanted to meet persons who had disabilities so Sam OT went along with me to the villages. In the first village, Salamatham, we visited a woman with 2 daughters in their 30’s, both were deaf.  They had their own sign language system and verbalizations that they understood.  The daughters were both married and had children of their own.  They were pretty well integrated into their community and functioned with minimal assistance.


The mobile physician unit is interesting.  We pulled into the front yard of a house-under a tree for shade and they set up shop.  There were about 10 women sitting on the porch waiting for the van.  One doctor sat outside of the van at a table and saw anyone who walked up.  Everyone has a medical card and it is obvious that they guard this card… They carried the card in old woven plastic rice sacks for protection.  The doctor outside takes the person’s blood pressure and talks with them about their complaint.  Another doctor inside examines anyone that the outside doctor refers.  There is also a health worker (she wears a pink sari) who hands out vitamins to pregnant women.  And there is a nurse (she wears a blue sari) who dispenses medicines from a window in the back of the van.  It is a very efficient operation.


After about 2 hours, everyone had been seen who wanted the doctor’s services so we moved onto the next village, Perumalaipet, where the doctors again set up shop.  Sam the OT and I walked to the home of a young man who had severe disabilities.  His mother had had rheumatic fever while she was pregnant.  This young man was 17 years old and in the 5th standard (I think that is equivalent to our 5th grade) and was making excellent grades.  He had not been allowed to start school until he was older because of his childhood illnesses.  His older brother has mental retardation and carries around the younger brother.  The younger brother wants to do computer work when he finishes school…but the family is extremely poor.  Sam OT was hoping I could find them some financial help…this boy has an opportunity to learn a skill that will allow him to be independent.  He is really a poster child of sorts.  The father climbed the palm tree in the yard and brought down 2 green coconuts for us to drink from and then cut them open so we could eat the coconut meat.


Sam OT and I rode the city bus back to CMC campus-another adventure!  Hot, crowded (VERY CROWDED) but a gentleman did give me his seat.  The children stare, of course, but it was interesting…they would try to get near my seat and hold onto the seat back and “accidently” touch my hand with a finger.  I was a real curiosity on the bus.

Visit To Rural Villages

April 27th, 2010 by INMED
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Today I went along with a nurse and community health worker to visit rural villages.  CMC has a mobile rural nursing unit and doctor unit that go to 82 different villages on a rotating schedule.  The nurse, driver and I started out at 8:30 and drove to pick up the health aide.  We visited 3 villages in the morning.  They pointed out that most of the villagers performed coolie labor (agricultural work in the fields) and these were very poor villages.  The health aide is usually an older lady who knows everyone in her villages.  She keeps track of who is sick, who has died, babies that have been born.  Each village has a “crèche”- preschool that is free for the children of that village.  Many of the homes, really small compounds with several low brick or mud buildings with thatched roofs, surround an open space where there is often an open sided building for the animals.  In the center there is also a cooking area-several homes used wood cooking… seems to be a good method for keeping the heat out of the house.


I did get to go into a few small homes, had to duck low to get under the thatched overhang.  Often they had a hotplate hooked to a small propane tank for cooking in the one room of the home.  Mats were rolled up but served as bedding during the nights.  Pots, pans and utensils were hung on the walls.  Most had a small television, a fan and one electric light bulb.  Everyone was very nice but often the villagers (especially children) followed us to look at me.  Most homes offered me a plastic chair to sit in…no one else sat.


We visited one village that is considered a model village, Kattupudhur, with a communal toilet and bathing building.  Most homes do not have a toilet, showers are taken with clothing on at the village pump.  Kattupudhur was very clean, the streets had no trash and there were no open ditches for sewage.


On Wednesday, I observed the immunization clinic. Imagine 180 small children along with their mothers, and often grandmother and siblings sitting in the HOT open air hall.  All were registered, the child weighed and their reflexes tested.  If a problem with the reflexes was noted by the OT, they showed the mother exercises to use with the baby.  One child with Down Syndrome was identified…the parent had been told to bring the baby in for assessment but had been to busy to do that.  The OT talked sharply to her and stressed the importance of bringing the child in while she was young…he was not encouraged by her motivation.  I was told that often the family believes that if they have a child with a disability it is because they have done something bad and are being punished.  It was a busy morning and all was quiet by about 1:00.

CHAD (Community Health and Development) Hospital

April 26th, 2010 by INMED
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I was at the Occupational Therapist’s office bright and early (8 am).  His office is located in the hospital, where about 100 patients were lined up before I arrived waiting at the cashier’s desk to pay for their visit.  Many looked like they had been waiting for a long time.  It was a little cooler this morning, probably mid-80s.  Today is the pediatric clinic so there were many children.  Most mothers and children (some fathers there also) held listless children, sitting on the floor.  Several children were referred from the clinic to the OT, so I observed his evaluations, they acted like typical children, crying when a stranger took them.  Some had developmental delays so the therapist showed the parents exercises to assist with sitting or walking.


Sam, the OT, then gave me a tour of the hospital.  The ICU had 4 patients-many had family members that sleep on the floor beside them.  They had 15 children in the pediatric ward-the family stays with them at all times.  It appears that any food received by the patient is brought by the family.  They have 200 beds in the CHAD (Community Health and Development) Hospital, most are occupied.


He also took me to the leprosy ward-a separate group of old buildings around a central courtyard.  Though their leprosy is not an active disease, they don’t stay with other patients.  This ward was very primitive.  They sleep on stainless steel gurneys…no mattresses, just the stainless steel bed.  They did have something that looked like a placemat for their head.  There were 6 women and 4 men there – separate quarters but the same compound.  They have been trying to find something productive to do.  In the past they have made candles to sell but for some reason that has stopped at the moment.  They are going to start making doormats in an Irish Knot fashion from rope.  The women were very chatty and wanted their pictures taken…and wanted to see on the camera afterwards.


One lady raised her saree to show me her prosthesis-below knee- the foot was carved from wood, and looked surprisingingly real.  All of them had foot or hand ulcers that were being treated, some who still had fingers were playing cards.

Leprosy Clinic

April 24th, 2010 by INMED
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I have had a few days to rest and adjust to the time change.  I met with Dr. John yesterday and the occupational therapist, Sam, about my work here and we have several ideas for a project.  Today, Saturday, I went to the
CHAD hospital to see the diabetes clinic and leprosy clinics. The hospital is open air with lots of people everywhere-and no AC. In patients have beds in wards with 4-5 other beds and there are always several expectant mothers and fathers walking the halls and waiting for new babies.


Today I will work on my “plan”.  The other American student, Jason, left yesterday  and many of the Indian students left yesterday on their summer break so it is very quiet today.  I am staying in an international student dormitory with a cafeteria attached.  So far, I have had all of my meals there.  You receive a round stainless steel tray and there are usually 2 pots of vegetables. At breakfast you get either a pancake like item or a puffy bread item and dip it in the vegetables that are on your plate.  No utensils are used, everything is eaten with your right hand.  At lunch and dinner there is rice and the 2 types of vegetables to add to the rice.  Also at lunch and dinner there is a small bowl of yogurt…that seems to help with calming the really spicy things.


Yesterday I took a short walk outside of the compound.  It is all so overwhelming with many people, cars, auto rickshaws, motorcycles, dogs and goats.  All are using the same streets and sidewalks with lots of horn blowing.  Of course, the heat doesn’t help.  I am wandering only in short doses until I used to things.  Today I am going to go in search of fruit… there were several stands outside of the gate.

Culture Shock

April 20th, 2010 by INMED
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I am going to try to document my impressions on this trip. I first noted the “culture shock” as I stood in line at Eithad Airways in Chicago. In fact you felt it when you entered the international terminal… the sense of being different from everyone else, in the color of my skin and hair; the language that I spoke, even the amount of luggage that I had with me. Many of the families and couples had 5, 6, 7 huge hard sided bags piled on trolleys. I had two small bags to last for a month, and most of those were filled with books and crayons for the school that I planned to visit.


On the plane I sat next to a couple, older couple from Chicago of Indian descent, that were travelling to Mecca. They were interested in where I was going, what I was going to do and why I was travelling alone. They twice told me about the poverty in Chennai, my destination. After about 13 hours of travel we arrived in Abu Dhabi…a beautiful airport, mosaic ceilings in blues and greens. I am looking more out of place here. I feel very self conscious…a little like wearing shorts to a formal banquet. Very out of place in my western slacks, and pink flowered top. There is quite an exotic feel to the airport…sheiks in flowing white robes with white head dresses. I haven’t seen this before. Of course, lots of women in salwar suits and sarees, and children, especially very young children everywhere.


Made it through India customs without event. When you exit customs into the world beyond, it appears like a gauntlet, a long line of faces, all eagerly looking for someone and curious about someone who looks like me. A young man holding a “Beth Grubbs” sign was easily located and we made through the crowd to the cab. Left the airport at 4:45 am and arrived in Vellore at 7 am. The first part in the dark, lots of people sitting on curbs waiting for buses. Interesting small closet like “snack shacks” that had bags and bottles of hanging snack and it looked as if they were selling chai. All had a few men lingering around, some reading papers and others talking. It was an interesting ride…lots of horn blowing and fast traffic. There was a small delay with my room when I arrived so I went to have coffee in the mess downstairs. Met Jason Kimm, another INMED public health student from Kansas City.

Introducing Myself

March 22nd, 2010 by INMED
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grubb-bethHello! My name is Beth Grubb. I am a healthcare administrator, and I’m starting my INMED service-learning experience at Vellore Christian Medical College & Hospital in India during April – May, 2010.