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.