Tuesday, January 24, 2006

Doctors Without Orders

For the past week, I served as a volunteer (“Assistant Doctor”) at the 32nd annual Shree Bidada Sarvodaya Trust medical and surgical camp in Bidada, Kutch (see www.bidada.org for details). From January 2 to the 22, the camp provided free services to 29,594 patients from the underserved villages of Kutch. This was my first experience of camp medicine, which is a different beast altogether than regular inpatient or outpatient care…the sheer number of patients is astounding, the pathology springs straight from the pages of obscure textbooks, and from somewhere in the sickly swirls of chaos a charitable heart steadily beats.
I was asked to assist in the Child Health Care Project, which seeks to offer basic medical, dental, and vision screening as well as preventive health education to school-age children in the villages surrounding the Bidada medical center. Every morning, I went with a group of professionals and student volunteers who left the main camp in a van and drove to a village school to set up clinic. Feeling a bit rusty on my clinical skills after months of essential denial that I’m in medical school, I alternated between volunteer and doctor, sometimes helping with logistics, and sometimes donning the stethoscope identity. In one day, we would screen anywhere from 200 to 400 kids, and leave them with toothbrushes, toothpaste, multivitamins, and anti-parasite pills. As the van drove away from each school, a crowd of giggling children would run after it to wave bye, and this was often the best part of the day - even if we hadn't been able to treat all of their medical conditions with our limited resources, we had made them smile.

At the main camp, I was housed with the other foreigners in a facility facetiously dubbed The White House. I roomed with Mike, the only white guy that Bidada has apparently ever seen. He was an absolute celebrity among the camp grounds - children, workers, patients, and shopowners all lit up with grins and ran up to give greetings when he walked by. While he shook enough hands to make a politician jealous, I laughed and marveled at the scene - somehow, I don't think if I showed up in a small village in rural Europe, I would have quite the same effect on people. White skin holds a sort of power in the developing world, which may be the history of globalization at work. In any case, Mike handled his status with an easygoing charm that could win over anyone, even those unimpressed by the symbolism of his appearance. He's simply that type of guy.

Being executive director of a nonprofit organization in the bay area, Mike has some grant-writing experience, and this came in handy as our group fumbled through writing a grant proposal to the World Bank for expansion of the Child Health Care Project. From our meetings, it became increasingly clear that medical camps such as these need people from all walks of life - though a dire need always exists for more physicians and medical personnel, a camp also must have people with organizational, financial, and managerial skills to survive. During the first day of the pediatric camp, overwhelming numbers of patients converged on the campus, and without sufficient organization, chaos would have reigned for days. Luckily, Vaibhav, a consultant from North Carolina, provided some needed management outside the building while his wife Shefali performed medical checkups inside. (So for anyone who has the idea that medical camps are only for medically-minded volunteers, please discard that notion and come save us management-illiterate science people from the madness.)

I met many other inspirational people at the camp, and Mike and I agreed this was unexpectedly the most enjoyable part of the experience. Tarak and Sharvari, a couple of young doctors fresh off residency, have inspired me to think of following their lead and taking a(nother) year off to travel the world before starting the long stretch of a career. Tushar and Monty, environmentally-minded Jains from Canada, have me itching to join them on yearly Jain youth camps near Niagara Falls.

I also got to know my cousin Ritu from New York, someone whom I'd only barely spoken to in the past, as our interaction had been limited to sporadic family get-togethers. She joined us for a celebration of my dad's and Shaktimasa's birthdays at Roopamasi's farmhouse near Bidada, where a group of Gujarati poets provided the evening's entertainment (although I could hardly understand the poetry, their style was something to behold - it was the proud spirit of gospel in guju guise).

The week was sprinkled with unique clinical experiences, intriguing conversations, trips to Mandvi beach, and loads of freshly made chikky. I've omitted writing about most of the medical nitty-gritty here, to avoid boring the 95% of people who don't care about that stuff...but if you're interested, send me an email and we can talk more about the differences between practicing medicine in the U.S. and in rural Gujarat. (Briefly, I observed the strange factory-like nature of camp life, where one's "humanistic medicine" values taught in socioeconomically advantaged bubbles are not always applied, and where individualized medicine takes a hit in the name of mass treatment. A paradox lives between the very humanistic charitable approach to medical care and the reality that where funds are scarce, individuals are not given priority over the group. Due to lack of staff, checks and balances are visibly absent, and a trainee's medical decisions are often the last word. This is sometimes scary and sometimes gratifying, because the amount of difference you can make is suddenly truly proportional to the amount of effort you're willing to put in, even as a student. This is the reason for this blog entry's title.)

I'm forcing myself to stop writing, lest I continue philosophizing for another three pages. I'm back in Ahmedabad now, fighting off some strange stomach bug that hitched a ride back with me from the village, and letting the sad realization sink in that I have only three weeks left in India. Time is more valuable than ever, so I'm going to go play cards with my grandmother.

(Explanation of pics: 1. Woman patient from village, 2. Sharvari and Tarak seeing patients at schools, 3. Mobile clinic group in van, 4. Children waving bye to us, 5. Ritu and I at Vijay Vilas Palace in Kutch, where Hum Dil De Chuke Sanam was filmed, 6. Dad and Shaktimasa's royal birthday celebration at farmhouse)

1 Comments:

Anonymous Anonymous said...

Rishi,

1. I'm glad we met and I can't wait to kick it in the Bay.
2. I have Tai Chi super early tomorrow and didn't have your email on me, so I googled your blog to say "what's up?" (Sorry so brief).
3. How are you? What are you up to?
4. My email is mikedelponte@gmail.com...hit me back.

7:48 PM  

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