Thursday, May 26, 2011

Old Age Home, Geriatric Clinic, & Random Thoughts

5/25/11

First I wanted to remark on my last post: I’ve had a few people tell me that I sounded a bit anti-Indian in some of it, especially when talking about not wanting to get on an elephant with 15 Indians. I must apologize for this poor choice of words- I am really not anti-Indian at all, or I wouldn’t have decided on my own, completely free will to come to India, a country I’ve been fascinated with for years and a place I’ve been dreaming of spending my two-month international field experience in for the past two years. In fact, I am enthralled with the people, the culture, experiences, and whirlwind that is India and Indian people. I merely said “with 15 other Indians” in my last post because that’s what they are- Indian! I guess I should have just said "people" instead. I hope no one took offense and apologize sincerely if anyone did.

The last paragraph of my last post contained an error as to what I was doing Monday. I actually went to an ‘old age home’ (nursing home) called the Krupalaya Old Age Home, run by nuns. The government really doesn’t have any type of old age home setup, so it falls to private organizations. In India, children are supposed to take care of their parents in their old age. Old age homes are a relatively strange concept here. These homes contain “destitute elderly” who have nowhere else to turn. I was told that one of the women residents flew down to Bangalore from Northern India with her son and her son purposefully abandoned her at the airport. This sounds insane to us but it happens here more often than people like to talk about. It was a very sad afternoon at the old age home. The elderly were so excited to see our young faces and their faces lit up when they saw us. There is a room for the 11 men and a separate room for the 9 women. Each room is dormitory style and all the beds are lined up (think “Madeline”) in a row. All of the elderly were laying down resting or sleeping but as soon as we arrived they mostly all popped up in their beds to see what was going on. I’m not quite sure of their daily schedule but it did not look like a very active one. St. John’s visits once a month to examine each resident and make sure they are healthy, and also to replenish the medicine supply.

Tuesday and Wednesday were spent in Mugalur at the rural clinic. The final Tuesday and Wednesday of each month are reserved for the Geriatric Clinc. The criteria to attend this clinic include: you must be at least 60 years of age, and if you are coming on Tuesday, you must live in one of the surrounding 6-7 villages, and if you are coming on Wednesday, you must live in Mugalur. The total population of the rural areas served by the Mugalur clinic includes about 4,500 individuals. About 10-12% of this population is defined as elderly. This is higher than the national Indian average of about 6-7%. There are more elderly in rural areas as opposed to urban. The preceding Saturday to these clinics, patients can come in and have blood drawn for ordered lab work. The results are then ready by the time they come in to the clinic either Tuesday or Wednesday. The doctors saw 61 patients Tuesday and 52 patients Wednesday. I would say nearly all patients seen have chronic medical problems, and probably 99% of the patients I saw had type II diabetes. Since this is one of my main research interests, it was so great to see effective control of diabetes in rural India first-hand. Dr. Arvind commented to me that sugar levels were quite high on average because the diabetics coming in are “feeling the effects of wedding season!”

There are so many random things I think of all the time that I’d like to jot down in my blog, but they really don’t necessitate entire paragraphs of explanation. So, I’ll just post a “random list of thoughts:”

- Cutest sandals here!! On Monday morning I went to the Oasis mall to explore, and I fell in love with about 100 pairs of shoes. They are all fairly cheap too. Too bad I don’t have infinite room in my suitcase!

- I have to bring my own toilet paper everywhere because most places (99%) do not have TP.

- A cow charged me yesterday- literally! I was walking down a sidewalk with Liz and in the very last possible half of a second, saw the cow storming towards me and jumped out of its way (and accidentally pushed Liz almost into the street…but I had nowhere else to go!), narrowly missing being pierced by its horns.

- Raju, the tea-wallah or tea/coffee/snacks man that works in the Dept. of Community Health is so sweet. He is always bringing everyone tea and coffee. He noticed me sitting in the hallway on the bench today and goes “you come sit inside, why you sit out here?” He also asked if I drink coffee and has told me today he will start making me some each day.

- Yesterday while heading out to Mugalur in the school van, we had to shift to the other side of a major road because the one side was completely closed due to a HUGE tree that had fallen on a bus! We went by too quickly for me to get my camera out.

- I met a monk from Tennessee, who now lives in Rome, at Mugalur (the rural clinic) who is staying there for two months. In such a rural area it’s cool to run into another American and talk about our experiences thus far in India.

- Everyone speaks a mixture of Hindi or Tamil (Or Cannadha, not sure if I spelled that right) and English. So even if they are speaking another language there are usually enough key words in English that I can follow along and get the gist of the conversation.

- Last night I went with the German girls and Liz to the KR market, which is supposed to be one of the must-dos in Bangalore. Maybe because it was the middle of the week, around 6pm, and raining, but the market trip was a bust. Nothing really that great there and it was a much more scary, dirty part of the city than where St. John’s is. Not sure if I should attempt to go back again on a weekend to see if the market is any good.

- I’ve become a huge fan of chai, the tea everyone drinks that is made of about half tea, half milk, and a tablespoon of sugar and served in an itty, bitty cup. Most cups, plates, and bowls here are made of metal so steaming hot chai in a metal cup gets quite hard to hold! Everyone has chai at least twice a day, both between breakfast and lunch and between lunch and dinner at a minimum. I think I'll have to keep the chai drinking to a 1-a-day maximum because of all the sugar. I hope I don't get fat here :( but the food and tea are so good!! Coffee is also pretty popular here.

- Everyone here is obsessed with knowing if you’re eating. They are always asking, “have you taken your lunch?” and “where are you finding your meals?”

- I asked for some Neosporin for a cut on my leg when I was at the Mugalur clinic. One of the residents gave me a tube and told me it was OK to open it, so I did, and applied a bit to a bandaid. I was putting the tube back when another resident asked me what I was doing, and I told her not to worry, that I applied the Neosporin to the bandaid and not to my cut. She proceeded to tell me I used a tube that was for sale, and asked me why I didn’t just ask her for the tube they use on the patients. I had no idea! I felt terrible, and she didn’t really help matters. I offered to pay numerous times (it probably wouldn’t have been more than 10 rupees ($0.25) because of how subsidized their drugs are), but they wouldn’t let me. I even came back ten minutes later with my wallet but they still wouldn’t let me pay and wouldn’t tell me how much it costs. I know this doesn’t seem like a huge deal, but in a country where I am trying to fit in as best as I can and respect people properly, I didn’t like making a mistake like that.

- Two bicycles were stolen in Mugalur- one yesterday, and one today. This is a huge scandal at the rural clinic because these types of things just don’t happen. I was present when the staff and the head of the department were discussing what to do and they decided to wait it out a few days and see if the bikes turn up. If they don’t, they’ll figure out some way to make things right and “beef up security.” This place is literally in the middle of nowhere and things like this shouldn’t happen, so it’s hard for the people of the community to hear about this.

- I’ve had terrible heartburn the past 24 hours! I’m not sure what from, either, because I’ve been eating roughly the same spiciness level of food throughout the trip and have not experienced heartburn until now. I woke up around 2am last night to this fire in my throat and chest, and took a few tums before falling back asleep. I’m not sure what exactly caused it, but it’s been frustrating. Liz is going to give me some ranitidine to help suppress the stomach acid. If it helps, I’ll be buying some tomorrow.

5/26/11

Last night after dinner at Gramin , a lovely Indian restaurant nearby that was recommended in the Lonely Planet book, Janine, Liz and I went back to my room to try a bottle of Pinot Tage from South Africa. My heartburn had been so bad all day and Liz gave me some ranitidine to take before bed that seriously worked wonders…heartburn completely gone this morning! Woohoo!

Today will hopefully be a busy, but great day. At 9am I am meeting Liz and Janine to go on rounds on the pediatric unit and explore the rest of St. John’s Hospital. I have yet to go in the hospital and am really curious to see what it’s like. We should be done around 11am or noon, at which point we will probably have lunch and then I’ll head to the Department of Community Health in the medical college for my first official day of “work.” I really hope they have found something for me to do in which I can utilize my epidemiology skills, as that’s the point of the internship! I started my communication with this department back in October, so you would think they would have thought once or twice about what I could potentially do here. I’ve found that Indian culture is pretty laid back and nonchalant about a lot of things that Americans are usually pretty uptight about. That being said, we’ll see what happens today! I will hopefully also get some workspace; I’ve been sitting in the hallways on a bench to use my laptop, but obviously this is not ideal.

Tonight the German girls and I will be getting on an overnight bus to Gokarna, a beach town on the west coast of India. The ride will be about 12 hours, and we each have a bed. I’ve never been in a sleeper bus before so I have no idea of what to expect. As bumpy as the roads are and as crazy as the driving/traffic is, I highly doubt I will get more than an hour of sleep total. There are no trains to Gokarna and bus is really the best and cheapest way to get there from Bangalore. The beaches there are supposed to be gorgeous and from my research, it seems like it’s a sleep little pilgrim-town, so I hope it’s a nice getaway. We get on another overnight bus home Sunday night to return by 7:30am Monday morning.

This is a health education session taught by one of the residents. She is teaching a geriatric class on COPD (chronic obstructive pulmonary disease).

This was super cool- this lady is holding up her EMR (electronic medical record)!!! There is a research project going on in Mugalur to give about 100 patients these USB cards with their health record on it. They can also access their records on the web and if that isn't convenient or there's no computer around, they can send a text message to a number and give their patient number, and all the records are texted back. Awesome!!!


This is Namo- he was a birthday present to Liz from some girls from Oman staying in the guesthouse. Pretty ridiculous looking, and scary too. He comes out with us for dinner sometimes.


I won’t be posting again until at least Monday or Tuesday, so check back then to hear about the trip! Hope everyone has a great weekend.

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