Urban Health Centre (Slums) and Gov't Primary Health Centre (MCH)

5/19/11

I went with Dr. Avita, my host country supervisor, to the 5 month-old Urban Health Centre in the slums yesterday, about a 20 minute drive from St. John’s. The clinic is staffed Monday-Saturday from around 10am-1pm. The faculty in the Department of Community Health at St. John’s rotate to staff it. For the slums, the clinic was actually very nice. It had 4 rooms- the wash room, the main room where the patient sits at a stool and talks to the doctor, and two exam rooms. There were only a handful of people that stopped by yesterday—the real value in the trip was what I did, which was actually go out into the slums with one of the sisters from St. John’s.

We talked to many people and asked them all sorts of questions such as: what are the main occupations of the people? What is the average monthly salary? (answer: the U.S. equivalent of $40/month), etc., etc., etc. It was certainly an eye-opening experience to see how these people live, and definitely made me quite thankful for what I have and how I grew up. These children don’t know any better, but it is still sad to see them live this way. Children just pull their pants down and relieve themselves anywhere they feel like it, and with open sewage throughout a large part of the slum, this is really the only thing to do. No one wears shows, either, so just imagine walking around in all the sewage. We walked over to what looked like a ‘river’ or ‘stream,’ but it was really just the sewage, and it’s incredible to see that peoples’ actual homes are lined up right along it. The smell was almost unbearable and to think people live there and cook while smelling that smell- unbelievable. I’m sure the smell gets 1,000 times worse during the heat of the summer and during the monsoons, in which the sewage all floods the streets and homes. Despite the sad conditions, there seemed to be a lot of happiness and productivity. There were men using tools to pound metal, a lot of construction, women doing laundry on their front steps, shops selling food and even a pharmacy. The kids seemed happy too and were playing games in the streets. I saw one little girl doing some construction (she must have been around 7) and got into a conversation with the sister about how prevalent child labor is and how so many kids are taken advantage of and hardly paid. Most kids in the slums do not go to school at all- their families see no value in sending them, even though the school is free. I must have had at least a hundred kids come up to me as I was walking through the street and they just yell “hi! Hi! Hi! Hi! Hi!” and smile and wave. It’s hard to tell if these kids were in school or not though because it is summer vacation here.

Pics from the slums:

Here is St. John's Urban Health Centre, opened about 5 months ago.

This is a daycare in the slums. Just a small room with 0 toys and some rugs on the floor. The kids were having a blast, though. Far cry from any Goddard I've worked at!

I thought this little kid holding a kitten was adorable.

Here is the sewage I was talking about. On the far right side of the picture, those are all homes with their front doors facing this mess.

That night was a drastic change from the way I spent my day. I went out to dinner with some new friends from the guesthouse to celebrate Liz’s birthday the next day. We stayed up having birthday cake, some beer, and champagne at midnight outside of the auditorium in the back, where there is an open seating arena. It felt like I was in high school again, being somewhere we technically “weren’t supposed to be.” Although, we didn’t know that, and security guards occasionally passed us and said nothing. Alcohol is strictly prohibited on campus and visitors are not allowed in the Annex (where I live), but I never got a rule book and no one ever told any of the foreign students these things. Well, eventually the security guards kicked us out! They told us that between 6pm and 6am, you need special permission to enter. We played dumb and apologized, and the security guard told us we could stay “twenty more minutes,” so we did.

Thursday I went with Dr. Rashmi, plus another doctor from the department, and 15 nuns to a government run primary health clinic In Dommasantra. While the clinic takes general patients, they specialize in prenatal care and normal (not high-risk) deliveries. They also have an immunization clinic—it seems as if the mothers really understand that immunization is a necessary evil. They see their babies have huge needles stuck in each leg and the babies scream and cry, yet the mothers comfort them and are on their way. It was so awesome to see such great public health in action!!

The immunization clinic

We got back very early—around 11:45am, so I spent the rest of the day meeting more faculty in the department, having lunch at the Hospital Canteen, and working on starting the research for my special project. The Hospital Canteen was pretty good. I had chicken biryani and sat in the doctors/staff dining room…it’s way less sketchy than the general public dining room. I’ll keep eating in that room until someone kicks me out, which I don’t think would ever happen!

I always get to the department before most of the faculty and then watch them leave around 4:30pm too—I’m there longer than they are! I try to get in around 8:30am so I have some time to check email and take care of things online before we leave around 9:30 for whichever health clinic. The wifi worked very well today and I found the signal is still strong even just outside the department in a common area with comfortable sort-of-reclining benches. The power outages were minimal today too. When the power geos out no one even blinks an eye…it’s extremely common. Computers, I think, are on generators. I don’t have a desk (yet? Maybe I’ll get one eventually?) or a computer, so I just kind of mosey around with my laptop in the hallways and hang out in the conference room if it’s free.

I have a 3-day weekend this coming weekend, as I have Monday off. I really wanted to visit my friend Marc in Mumbai. He is traveling there for work for two weeks, and he arrives Friday night. The only problem is I would definitely have to fly there and flights are about $250 roundtrip, which I don’t think is worth it for a weekend. I can just stay here and explore Bangalore, work out, and work on my special project. The school will be open Saturday for half a day (most people work in the mornings on every Saturday) and of course it will be open Monday too, so I could potentially get a lot of special project work done.