Well, its good to be back in Delhi.
Aligarh, even though its technically a city of 1 million, feels like a small town in comparison to the booming metropolis that is New Delhi. We got off the train on Tuesday morning and just taking in one breath made me realize just how POLLUTED Delhi is. The sore throat I'd developed while here disappeared in a matter of hours and it actually smelled pretty pleasant taking walks down the street. Delhi is officially (in my eyes) pretty disgustingly polluted. Aligarh is a city built around Aligarh Muslim University, which houses about 40,000 students, studying everything from engineering to modern medicine to Unani (traditional) medicines, which we got to take a look at as well. Aligarh is definitely much more traditional though- we had an opportunity to interact with female students in one of the hostels (dorms) to learn that they had an evening curfew of 6:30 every single night. Even weekends. (!!!!!) And, they were not ready to protest this in the slightest. COMPLETELY different. That would just not fly for me, at all.
Our trip centered around exploration of the Government Health Delivery System. We looked at the system starting at the top - the JLN Medical College on the Aligarh campus, to the District Hospital, then the Community Health Center, the Primary Care Center, the rural Sub-Center, and finally all the way down to the ASHA delivering care and services in a local village. Each level presented its challenges, mostly equipment being an issue as the centers got smaller, but the over-crowded and under-staffed problems seemed to be predominant throughout.
This visit has opened my eyes to a personal priority I didn't realize I valued so highly: privacy. The great thing about being with a program such as SIT is that we had the connections of our program director and our professors, and were able to get tours through each health facility and got to experience village healthcare delivery first hand. This involved visits to many OPD wards (out patient delivery), In-patient wards, a delivery room, a women's hospital, and into a woman's home in Jawan (the village we went to). Being a group of 24 + instructors walking around already crowded hospital wards can suddenly make you feel very out of place and intrusive, even if you are being led on a tour by the Deputy Superintendent of the Facility. Our group tended to travel as such throughout many of the facilities, breaking into small groups when we could, but for the most part parading (for lack of a better word) through the wards observing patients clearly not well, and sometimes in very vulnerable and open positions. I realize it is the work of a doctor to be intrusive, but as a student it was a new feeling to me to suddenly be in a room crowding around a small girl receiving an IV for fluid loss. And to top that, the ethical issues of pictures inside these facilities became a major pressure point for our group. As I've clearly stated, I felt pretty uncomfortable to begin with, so obviously, taking pictures was just out of the question, at least where patients were receiving treatment. If I were in a hospital in the states it would 1) Be Illegal for people not related to be in the treatment room and 2) be OUT OF THE QUESTION to be photographed. Even though there are different privacy norms culturally here, I don't see that as an excuse to change my moral values and 'take advantage' of the fact that these parts of my trip could be visually documented. There were some that hold different views than I, and thus, a large debate on cultural and ethical differences ensued this week, resulting in us all learning a little bit more about ourselves, and about the issues that we are just not willing to compromise on.
This trip also exposed us to a whole new part of India: the rural village. The group spent a whole day travelling out into a village, examining their to be desired healthcare facilities, and we had the opportunity to meet an ASHA and an ANM (Auxillary nurse midwife), which are women from the village community working to help mothers who are pregnant and their children for up to 1 year after delivery. A large part of our health care study focuses on Women's health and family planning, so this visit was SO helpful in understanding how healthcare is delivered on the most primary level. The ASHA I had a chance to shadow was currently overlooking 36 pregnant women in the village, 27 who were due to deliver this month. Their work is never complete! We went on rounds to meet a 15 day old baby, where the ASHA did a primary examination, talking to the mother about the importance of vaccination and strict breast feeding for the first 6 months of the babies life. They also refer women to the larger hospitals and care facilities, and they receive a small commission for each women they send to have an 'institutional delivery' to cut back on the rate of child/maternal mortality during the birthing process. The rural villagers of India were extremely hospitable, running around making sure we had seats and once even fanning us as we listened to the ASHA examine (this was excessive in my opinion, but my instructor said it was pretty normal for things like this to happen, even when she went back to her village).
There were so many things I could write about from this trip, those were just a few that struck me as pretty important to share. It was an extremely educational week, about the health care system as well as about myself. After 4 days of traditional living, with literally nothing to do after dinner (sorry Aligarh, night life is kind of lacking) it was nice to get back to Delhi, regardless of the smog.
Today Emily and I took a trip out to the Qutab Minar, one of the 3 World Heritage Sites in Delhi. It was beautiful! It is was the first city center of Delhi way back when the Mughals were ruling, so it is a complex with the Minar as well as a series of other ancient ruins, mosques and mausoleums. The rest of our day has been pretty low key in preparation for our trip to the TAJ MAHAL which is happening tomorrow, bright and early!!
With that being said, its a little past my bedtime...
Aligarh, even though its technically a city of 1 million, feels like a small town in comparison to the booming metropolis that is New Delhi. We got off the train on Tuesday morning and just taking in one breath made me realize just how POLLUTED Delhi is. The sore throat I'd developed while here disappeared in a matter of hours and it actually smelled pretty pleasant taking walks down the street. Delhi is officially (in my eyes) pretty disgustingly polluted. Aligarh is a city built around Aligarh Muslim University, which houses about 40,000 students, studying everything from engineering to modern medicine to Unani (traditional) medicines, which we got to take a look at as well. Aligarh is definitely much more traditional though- we had an opportunity to interact with female students in one of the hostels (dorms) to learn that they had an evening curfew of 6:30 every single night. Even weekends. (!!!!!) And, they were not ready to protest this in the slightest. COMPLETELY different. That would just not fly for me, at all.
Our trip centered around exploration of the Government Health Delivery System. We looked at the system starting at the top - the JLN Medical College on the Aligarh campus, to the District Hospital, then the Community Health Center, the Primary Care Center, the rural Sub-Center, and finally all the way down to the ASHA delivering care and services in a local village. Each level presented its challenges, mostly equipment being an issue as the centers got smaller, but the over-crowded and under-staffed problems seemed to be predominant throughout.
This visit has opened my eyes to a personal priority I didn't realize I valued so highly: privacy. The great thing about being with a program such as SIT is that we had the connections of our program director and our professors, and were able to get tours through each health facility and got to experience village healthcare delivery first hand. This involved visits to many OPD wards (out patient delivery), In-patient wards, a delivery room, a women's hospital, and into a woman's home in Jawan (the village we went to). Being a group of 24 + instructors walking around already crowded hospital wards can suddenly make you feel very out of place and intrusive, even if you are being led on a tour by the Deputy Superintendent of the Facility. Our group tended to travel as such throughout many of the facilities, breaking into small groups when we could, but for the most part parading (for lack of a better word) through the wards observing patients clearly not well, and sometimes in very vulnerable and open positions. I realize it is the work of a doctor to be intrusive, but as a student it was a new feeling to me to suddenly be in a room crowding around a small girl receiving an IV for fluid loss. And to top that, the ethical issues of pictures inside these facilities became a major pressure point for our group. As I've clearly stated, I felt pretty uncomfortable to begin with, so obviously, taking pictures was just out of the question, at least where patients were receiving treatment. If I were in a hospital in the states it would 1) Be Illegal for people not related to be in the treatment room and 2) be OUT OF THE QUESTION to be photographed. Even though there are different privacy norms culturally here, I don't see that as an excuse to change my moral values and 'take advantage' of the fact that these parts of my trip could be visually documented. There were some that hold different views than I, and thus, a large debate on cultural and ethical differences ensued this week, resulting in us all learning a little bit more about ourselves, and about the issues that we are just not willing to compromise on.
This trip also exposed us to a whole new part of India: the rural village. The group spent a whole day travelling out into a village, examining their to be desired healthcare facilities, and we had the opportunity to meet an ASHA and an ANM (Auxillary nurse midwife), which are women from the village community working to help mothers who are pregnant and their children for up to 1 year after delivery. A large part of our health care study focuses on Women's health and family planning, so this visit was SO helpful in understanding how healthcare is delivered on the most primary level. The ASHA I had a chance to shadow was currently overlooking 36 pregnant women in the village, 27 who were due to deliver this month. Their work is never complete! We went on rounds to meet a 15 day old baby, where the ASHA did a primary examination, talking to the mother about the importance of vaccination and strict breast feeding for the first 6 months of the babies life. They also refer women to the larger hospitals and care facilities, and they receive a small commission for each women they send to have an 'institutional delivery' to cut back on the rate of child/maternal mortality during the birthing process. The rural villagers of India were extremely hospitable, running around making sure we had seats and once even fanning us as we listened to the ASHA examine (this was excessive in my opinion, but my instructor said it was pretty normal for things like this to happen, even when she went back to her village).
There were so many things I could write about from this trip, those were just a few that struck me as pretty important to share. It was an extremely educational week, about the health care system as well as about myself. After 4 days of traditional living, with literally nothing to do after dinner (sorry Aligarh, night life is kind of lacking) it was nice to get back to Delhi, regardless of the smog.
Today Emily and I took a trip out to the Qutab Minar, one of the 3 World Heritage Sites in Delhi. It was beautiful! It is was the first city center of Delhi way back when the Mughals were ruling, so it is a complex with the Minar as well as a series of other ancient ruins, mosques and mausoleums. The rest of our day has been pretty low key in preparation for our trip to the TAJ MAHAL which is happening tomorrow, bright and early!!
With that being said, its a little past my bedtime...
rachael what an informative trip you had im glad you chose you chose not to photograph those that are sick we have the best health care in the usa i pray those people get the care they need its amazing how visiting other countrys has a way of putting life in its proper perspective i love you and am proud of you come home safe remember the purel love gramma and leroy xoxo
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