June 9, 2011
After successfully being in India for a month, I've loved adjusting and getting into my new routine, taking in the fresh air from the hills and learning more about what I can now handle and how my tolerance and boundaries have been expanding, in many respects.
For the first two weeks of my internship I worked at the primary health center in Gumballi which is 24 km from BR Hills, and worked on putting together an application/checklist for the National Accreditation for the Board of Healthcare Providers/Hospitals (NABH), so that this PHC could become accredited under national standards. Generally in the past, accreditation has only been given to hospitals and larger scale health centers, but the NABH recently created guidelines for PHCs and Community Health Centers (CHCs) to follow. After putting together what I could in terms of highlighting what needs to be done/how/by when, I started working at a First Referral Unit (FRU/trauma center), a little past Gumballi, where Karuna Trust is in charge of the labor and deliveries ward. It’s an awesome place to work and I’ve learnt so much so far – I’m now working on the application for accreditation for the FRU as well, but for the past few days I’ve been getting acquainted with the services offered there by sitting in with the doctors in the outpatient clinic where there’s a fantastic gynecologist/husband-pediatrician/wife duo that sees 50-60 patients per day, each. So essentially I get to see 60 pregnant (or want to be pregnant) women each day and at least 50-60 babies, which is such great exposure to the women of the community. I help out with anything that they need, taking BP/weights, helping set up sonograms, and for each patient, when I can, I ask a few questions about their pre-natal and post natal care, access, what they would want to see in the field health workers and the doctors that they don’t already get, if they breastfeed or not/intend to, and a few other things regarding maternal and child health. I’m getting a better sense of how these women are treated and how community health work is integrated into emergency situations. Also, I’ve been able to see a number of normal deliveries and a few C-sections so far and have spent a fair amount of time with some babies in the NICU as well, and the only way for me to describe it all is intense and well…visceral. Overall, I really enjoy working for Karuna, and even though I’ve been here for some time, I think I’m still trying to figure out my role and finding a balance between doing what I want versus what is necessary for Karuna, or also filling my days with temporary relief to understaffed workers versus keeping the overall vision of what I want to get out of this in mind.
One of the downsides is that most people here only speak Kannada, which I knew and expected coming in, especially since I’m in rural South India. Since I’m Indian, and don’t look foreign necessarily (although everyone stares anyway), people assume I know Kannada and in general it’s really hard to convince them that I don’t know Kannada or communicate in general. For the most part, I end up talking in Telugu so that they’ll understand somewhat, but I have a goal of learning a new Kannada word every day, although I’ve learned most words related to giving/receiving food (more, no, less, food is good, etc.) and words like ‘coming/going’ for the buses so that I can find out about timings for those with little assistance. Other than that though, it’s always a struggle, but I’m able to get by.
Since I have to take two buses to get to work every day from BR Hills to Santhemarahalli where the FRU is located, I've spent a lot of time studying bus culture and dynamics. I find it hilarious that when the buses are so overfilled that people have to climb up to the top of the bus to ride, that the ticket collector also goes up after finishing collecting the money within the bus. It just makes me laugh that no one rides for free. Also, since they’re so overcrowded and it’s hard to get a seat, people often throw in towels or bags so from the window so they can save a seat for when they get on. I saw someone do that with their child yesterday, pushing them through the bars. That was a sight.
If you’ve watched Blood Diamond, you’ll know that Leonardo DiCaprio often says ‘TIA’ for ‘This is Africa’ whenever something crazy happens or something is out of his control in such a way that it would only happen in Africa. Along the same vein, I often find myself saying ‘TII’ for ‘This is India’ whenever I’m in a situation where I need to rationalize something completely out of the ordinary, or is just straight up ridiculous. And those moments are what make this experience all the more interesting and all the more fun.