Today was our last full day as a group. Christine and Keiko went to the government hospital in Kerula with the visiting surgeon yesterday, so today, Kristen, Gina, Derick and I went to the hospital with the anesthesiologist, Dr. Guru. He came to pick us up at 8:30 am and we headed to the hospital. Dr. Guru told us that the hospital provides care for uninsured tribal members not only for free, but also that they provide free food for inpatient and monetary incentives for coming to clinic appointments so that they will actually come to receive care rather than relying on alternative/naturalistic tribal medicine only. I'm not exactly sure how much funding the hospital receives from the government or how it is sustainable, but I was very impressed by it. It was actually a legit hospital -- more fully equipped than Bethany Medical Centre. After we got there, we changed into scrubs and went to the OR with two orthopedic surgeons. The first case was a guy who had a broken arm from last year and had to have the plate taken out. The surgeons explained everything for us, so it was a good experience. We asked them afterward whether one of us could scrub in, so Derick scrubbed in on the next case. It was a more complicated case where the patient had a huge break in his ulnar bone. Derick got to screw in the plate and also suture for the first time. We got a chance to talk to one of the ortho surgeons and we found out that ortho is also a very competitive specialty in India as well. In India, you don't get to choose your specialty. You take an exam after you graduate from medical school and depending on your rank from the exam, you are given three choices from which you can choose from. To get into ortho, you have to be top of the top in the nation. Interestingly enough though, the other two competitive specialties in India are internal medicine and peds. It's interesting to compare as they are not considered the most competitive specialties in America.
Another interesting is their sterile techniques. I've had a chance to scrub in on a couple of surgery cases at Rush and know what our sterile techniques are like. Of course, there are only limited resources here, so things can't be done the way they are done in America. But, after seeing the standards taken in America and how things are done here, I'm not sure if I would want to have any surgery done here. It would be interesting to see how things are done at a better-funded hospital in India as well.
On the way back to Bethany from the hospital, Dr. Guru told us that the hospital actually pays the patients to come to their appointments. The tribal population mainly believes in alternative medicine/tribal medicine and does not like coming to the hospital. As a result, the hospital incentivizes hospital visits with actual cash and provides free food and beds for admitted patients. I was very impressed when I heard this as something like this wouldn't fly in America at all. It made me wonder whether the initial cost in providing these monetary incentives is actually less than the cost that would be needed to treat conditions that could've been prevented. I wouldn't be surprised if it is and that's why the hospital has this system for the tribal population.
After we got back, we wrote thank you cards for all the staff that took care of us. It's been especially helpful to have Sanil with us as his English is excellent and he translated for us when we saw patients. He also had us do procedures and made sure to get us in the middle of the night for ER cases (although I woke up only once for this and it was just gastritis). He wants to do a family medicine residency in America, so he's studying for Step 1 right now and has been pointing out high-yield Step 1 clinical factoids from different cases for us.
In the evening, we sent off Derick, Gina and Jen, and then there were four of us. We'll be heading to Delhi tomorrow to travel for a week before heading back to Chicago.
Overall, this was a great experience for us and will be a great trip for those who are finishing up their M1 or even M2 year. I personally learned and saw a lot and this trip has reaffirmed my passion for global health. This trip serves as an invaluable reminder as to why I'm in medical school and why I'm studying a lot. I hope that I can gain the knowledge and the skills to be able to one day travel to wherever I am needed and serve those in need. Thanks for reading!
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