February 28th, 2010 by INMED
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I got the chance to be a tourist for a few days last week. The two med students, the therapist from Australia and I went to Agra to see the Taj Mahl and the Agra Fort. It was a long trip, but well worth it! We rode the train for 6 hours to Delhi on Wednesday night, then joined a tour group on Thursday morning that took us to Agra. We were on the tour bus all morning, then went to the Taj, ate lunch, went to the Agra fort and returned to Delhi arriving back at midnight. Then, we caught the 6 o’clock train the next morning back to Dehradun.  The Taj Mahl is amazing! It took 22 years to complete and it is made entirely on white marble! For those of you who don’t know, the Taj Mahl is a tomb that was built by the king to honor his wife. Both the king and his wife are buried there. They carved very intricate designs of flowers, leaves, etc. using precious stones from all over the world! The Agra font was also pretty interesting. It is where the king lived (the same one who built the Taj Mahl). I will try to post pictures on facebook when I get the chance.

Nothing much exciting has happened since we got back, but last night we made Mexican food at one of the young couples’ house on campus. Celina, one of the med students, is mexican, so it was the REAL thing. We even had homemade tortillas!
Today is a big festival called Holi. Everyone throws powdered color on each other that is filled in a tube. Everyone said that it’s not safe to go out of the hospital because people get pretty crazy! But, we may have our own color-throwing party tonight at someone’s house on campus. It should be fun! I just hope that it washes off! 

I leave the hospital this Thursday and will ride the train to Delhi. I will be in Delhi over the weekend and then my plane leaves on Tuesday. I can’t believe I am leaving so soon! It’s going to be very hard to say goodbye to everyone I have met!

February 26th, 2010 by INMED
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So, once again, I can’t believe that another week has gone by! It seems like I have been here for several months instead of a few weeks! Each day is packed with a new adventure or learning experience. Last week, I attended a disability awareness conference. About 20 community health workers from different parts of northern India attended the conference. The main purpose was to discuss ways in which services for the disabled could be included in the projects that these organizations were already doing. It was amazing to see these people become passionate about including persons with disabilities in the planning and implementing of community projects. I was so blessed to be able to talk to many of them and hear what they are doing in their communities to make a difference.

This weekend has been a little bit more relaxing. A group of us went to a Tibetian restaurant and we ate Momos (sp?). They are a kind of dumpling with meat inside a pasta shell. They were so good!!! (It was nice to have something that is not rice and not spicy!  ) Then, we went to this gorgeous river with the mountains in the background. It was so peaceful!

Today, I got the chance to visit another village that has a small learning center with about 10 children. Most of the kids go to a regular school, but attend the learning center for a few hours or a few days a week to get extra help. They asked me to give a few suggestions for a child that had some fine motor difficulties. It appeared to me that he had some intrinsic hand weakness and some visual perception difficulties. We also visited a few other children in their homes. The child psychologist from Anugrah was also there. I was so glad that she was there to discuss ideas with her! Together, we were able to make a few suggestions that the parents come do. We also suggested that they have a modified chair made for one of the children with cerebral palsy.

Here are a few requests that you can lift up!

K. – She is one of the staff at Anugrah who works with the early intervention children. Please pray for her mother- she is very ill and has very severe rheumatoid arthritis. K. is also very involved in her community. I went for a walk with her in the village and it seemed like everyone knew her. We meet one lady who is very poor and has end stage cancer. She has spent all her money on chemotherapy and is unable to pay for anymore. Her husband is also very sick and unable to work. Please pr*y for her healing and that the money for her treatment would be provided!

A. and D.- This is a young married couple that I met at the disability conference. They travel to different villages doing evangelism. They said that it is often hard for them because people are not very accepting of Christianity. They believe that it is “polluting” there culture to convert. They said they sometimes have to run away because people want to beat them up. But, they also told us of the blessing that they have recieved through this work. The L*rd is working and a small group of believers has formed. Please pray for their safety and boldness as they visit these villages. They also requested pr*y for a motorcycle to make it easier for them to reach the villages. They also need funds to rent a larger building to meet in. The one were they currently meet in too small.

Thank you so much for your prayers! I have been so humbled by the stories I have heard of the Lord’s faithfulness and the faithfulness of his people here!

February 23rd, 2010 by INMED
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I can’t believe that I have been at the hospital for over a week and in the country for almost two weeks!!! The time is going by so quickly. I’m so glad to be here. This experience has challenged me in so many ways and taught me so much. The Lord has been so good to me and is so faithful. He’s teaching me what it really means to serve and give of yourself, even if you are doing seemingly insignificant tasks. I have been doing alot of things to just help Sharon in her office. We have been doing some things like organizing the splinting materials and so forth. I also helped with making decorations for a Valentine’s Day party that they had for all of the married couples that work at the hospital. I was actually one of the servers for the meal, along with the other two American med students who were here. But, I also have done some more OT things as well.

 
On Friday, I got the chance to go with one of the staff to a village to see some children for an informal initial assessment. These children had been identified by a community health worker. Our main purpose was to meet the kids and their families, identify the problem, assess whether the children needed further treatment and if so, if they live close enough to recieve treatment at one of the centers. We also made a few simple recommendations to the parents.

During this visit, I felt so inadequate. I made a few suggestions such as some stretching exercises or weight bearing, but I mostly didn’t know what to tell the family. We mostly recommended that they see a doctor. I’m not used to taking the role of “the expert” without having someone else there to bounce ideas off of or at least talk these through. I’m also not used to seeing patients that are undiagnosed and have medical issues that have not been addressed. Healthcare is not readily available here like it is in the U.S. When we were leaving the village, several people came up to us and wanted us to address their medical issues. We listened to their problems, but were unable to do more than recommend that they see a doctor.

I’m learning that in a country where there is so much disability and lack of healthcare, you have to just do what you can. You may not feel like you have enough training to effectively meet people’s needs, but you use what you know because you can provide more to people then they would have otherwise.

On Saturday, the other med students and I rented a taxi and went to a town nearby which is up in the Himalayas. We rode for about one hour up a very steep, winding road. It was a fairly clear day and the mountains were beautiful. We ate lunch at a little outside restaurant and ate grilled cheese sandwiches and french fries! It was nice to have some “American” food.  We also ate at Pizza Hut for supper.  Sunday, we fellowshipped with local believers in the morning and then helped with the Valentine’s Day party all afternoon and evening.

Today has been alot slower day and I’m really glad! I helped with the early intervention group again today and treated the same child that I had last week. But, the rest of today I have spent checking email, talking to Sharon and helping her clean up from last night. Tomorrow I’m going to the nearest large town to attend a disability awareness seminar. About 30 different community health organizations will be attending. The purpose is to teach community health workers about disability and how to integrate a program to reach the disabled into the work that they are already doing. One of the staff from here is going to present about the work that they are doing in this community. We will be there until Saturday. It should be fairly interesting. I’m hoping that alot of it will be in English and not Hindi 

February 11th, 2010 by INMED
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Sorry I haven’t written anything in so long. I have been staying really busy. On Monday, I got the chance to do some home visits with Sharon, the OT, and two physical therapists from Switzerland who were here for about a week. We visited two children. The first was a girl about 14 who has Rett Syndrome. The second was a 8 year old boy who is undiagnosed but the parents reported that when he was younger he had seizures and may still occasionally have seizures. We made some suggestions about positioning, weight bearing activities, stimulation and transfers. It was interesting to see how the entire family was involved. Everyone come into the bedroom where we were treating, including the grandmother, grandfather, siblings, mom and dad and maid that cares for the girl.

On Tuesday, Sharon was out sick, so I worked on some projects in the office. I completed a summary of the observations and recommendations we had the one of the children we had visited. I also started making a sensory board for the girl with Rett Syndrome. For those of you who don’t know, a sensory board has several different kinds of materials, textures, colors, etc. in order to provide stimulation. Sharon has a trunk full of materials that she has saved or have been given to her. On my sensory board, I put some old ankle-length stockings, straws, velcro, some small bells, felt, and some soft shapes that Sharon had. I also made some other activities out of film canisters to be used for children to practice counting and identifying numbers.
On Wednesday, I visited the two other learning center that is in smaller villages close by. They are much smaller and have less children than the main learning center. I was really impressed by these two centers because one started last April and the other in October. They are planning to open three more soon.

Today I got the chance to help with an initial eval of a child and then participated in giving treatment to a child in the early intervention group. The early intervention group are kids under age 5 (I think) and they come to the center twice a week. Their mothers bring them and also help with the treatment.  Basically all of the children recieved individual treatment, but in the same room, at the same time. They did alot of stretching, weightbearing and activities in the standing frame. They also have some fine motor activities.

I have already learned so much from Sharon, the OT. She graduated only 1 1/2 years ago from an OT school in south India. This is her first job right out of school. She has a huge number of responsibilities. She rarely provides individual treatment, but her main job is administrative. She is basically in charge of the entire main intervention center. She trains all of the workers and helps them to assess the children, develop goals and make sure that they are providing quality treatment.  She also is in charge of writing grant proposes for their donors and reporting to them every three months. She takes care of all the financial responsibilities. In addition, she often spends alot of time making activities that can be used in the learning centers and intervention center. It seems like a hard job to do directly out of school. But, she does a great job.

Sharon told me that her view of OT has changed so much since she has been here. She said that in school, they greatly emphasized following a certain protocols and not much freedom to make treatment client-centered. They basically are taught the mindset to have a plan and to implement it despite client factors. But, she has learned that this approach often does not work in this setting. If your attitude is not client-centered and holistic, you can’t be effective at all. You can, for example, give a family a home program, but if they believe that their child is cursed in this setting. If your attitude is not client-centered and holistic, you can’t be effective at all. You can, for example, give a family a home program, but if they believe that their child is cursed and will never improve, they will never do the home program. Also, Sharon has a lot more freedom to be client-centered and holistic. She does not have to worry about being denied reimbursement from insurance companies or making sure that everything she is does is considered “skilled” or within OT framework or even within a certain timeframe. She said that one time a family brought their child for the initial assessment and she spent 2 hours just talking to the parents and addressing all of their concerns. The parents had the misconception thought that the child had a disability because he was not breastfeed at birth. Sharon spent along time explaining about the child’s deficits and the physiology behind the child’s disability. She then rescheduled the initial assessment with the family. In a hospital setting, or a more traditional OT setting, she would not have the freedom to reschedule and in her documentation, she would at the very least have to be very creative in her wording to make it sound like skilled therapy was administered.

The overall concept and drive on this organization is to transform the communities view of disability. They developed these two new learning centers recently because they found it to be more effective if they keep the children in their natural environment. Before, they were busing kids to the main intervention center. Children were improving, but the people in the communities were they lived still viewed them the same. In India, (especially in rural areas) people believe that if you have a disability, you must have done something wrong in your past life to deserve it. So, often they let the child die and don’t care for him/her. Or they may just hide the child so that no one else will know. There is also the belief that if you get close to someone with a disability, then you will also “catch” that disability. So, there is alot of stigma around the disabled and the Anugrah project is trying to change those attitudes. They are slowly changing communities by building relationships with the community leaders, educating people about disability,  meeting people and talking with them and advocating for the disabled. I’m so amazed by all that they are doing!

I have learned so much even though I have only been here a week. I look forward to sharing more with you!

February 7th, 2010 by INMED
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So much has happened in the last few days! I arrived at Herbertpur yesterday morning (Saturday). Our train arrived at Dehradun about 7 am and a driver from the hospital picked us up. Sharon, the occupational therapist showed me my room and we went to the “mess” to get breakfast. Then, morning devotions was immediately after that and then I went to see the Anugrah Center. So, it was a really busy day! Sharon she showed me around the intervention center and introduced me to the staff at Anugrah. The center is only open Monday through Friday, but the staff spend Saturday planning for the rest of the week. Sharon’s main job is an administrative role at the center. She coordinates all of the projects and supervises/trains the staff. The staff are trained to administer assessments and then Sharon helps to interprete the results and coordinate with the staff to develop goals for each child. Sharon told me that I can help her with intepreting assessment results and writing them in “parent-friendly” language so that we can give them to the parents.

Anugrah has one main intervention center and then too smaller centers in villages nearby. They also do home visits for children that are too low level to be able to come to the center or the parents don’t want to bring them. These children are visited twice a week. At the main intervention center, the children are divided into three main groups: vocational group, literacy group and early intervention. They also have activities that all the children participate in together. I will find out more details tomorrow (Monday). I am so excited about what I have heard so far! The staff here are so creative to use the limited resources that they have. It’s so fascinating! I saw alot of adaptive equipment (such as standing frames, wheelchairs, swings, etc.) that they made themselves with available materials. They have a workshop where alot of things things are constructed.

Today, I attended church that is on the hospital campus. It was so amazing to be able to worship with local believers. Most of the songs were in Hindi but the preaching was in English and then translated to Hindi. After lunch, a group of us went into town.  The nearest town is Vigas Nagar which is about 5 minutes away. We walked down the street and took a bus. It was alot of fun. I bought some oranges and a shaw.

There are a couple of med students and a lady from Australia who are here for a short time like me. I have really enjoyed getting to know them. I also have an Indian friend who lives next door to me who has been so nice to me. A group of us watched a movie in her room last night. We watched a hallmark movie that I brought (Thanks Tyrell!). Well, that’s all I know for now. I will write more details about Anugrah later in the week.

February 4th, 2010 by INMED
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I arrived in Delhi, India last night (or yesterday afternoon for all of you). I am very happy to be here and have been well taken care of. I am staying with Zarema who is the contact person for INMED. She provides all the short-term students with a simple orientation to the culture and also coordinates travel arrangements.

Today, Zarema and I went to a mall in Delhi where we met another student for her “debriefing” time who just finished her rotation. It was really nice to hear about someone else’s experience. She is a med student who worked in a hospital that is in the eastern part of the country. The mall we went to was very westernized. As soon as we stepped inside the building I thought that we were back in the states. I even ate pizza in the food court.

The roads and the way people drive reminded me alot of Kenya. People are much more aggressive drivers and don’t obey all of the “rules” that we have in the US. It felt very weird to sit on the left side in the front seat! (They drive on the opposite side of the road and the driver’s seat is on the opposite side of the car). Tomorrow, Zarema will take me to buy some Indian clothes that I will wear while I am at the hospital. I leave on the train for Herbertpur on Friday around midnight. Zarema will be traveling with me and we will probably get a sleeper car.

I heard that there are some other students that will be a Herbertpur part of the time that I am there, so I was very excited to hear that. I might be able to ride the train back to Delhi with them.I will try to update you more whenever I get the chance. I do not know yet what the internet situation will be like once I get to Herbertpur. I hope you are all doing well! Talk to you soon!

January 20th, 2010 by INMED
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I am very excited about this opportunity for me to travel to Herbertpur, India. Herbertpur is in the northern part of the country near the town of Dehradun in the state of Uttaranchal. I will be visiting a community-based rehab center called the Anugrah Center. It is affliated with Herbertpur Christian Hospital and provides services to children with disabilities. The center is named after the founder’s son, Anugrah, who has cerebral palsy. Anugrah means “grace”. My plan is to leave on February 2nd and arrive in Delhi on February 3rd. The INMED contact in Delhi, will pick me up at the airport and I will stay with her for a few days to get oriented to the culture and purchase Indian clothes called “Salwaar Kameez”. This is what I will wear while I am at the center and in the community. Then, I will take the train (approximately a six-hour trip) to Dehradun. Herbertpur is only about 30 miles from Dehradun. I look forward to updating you more in a couple of weeks!!!

January 15th, 2010 by INMED
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Hello! My name is Emily Smith. I am a occupational therapy student at Texas Tech University Health Science Center, and I’m starting my INMED service-learning experience with Emmanuel Hospital Association at Herbertpur Christian Hospital in India beginning in February 2010.