Day 11

Day 11

April 21, 7:28 pm, Vellore

Okay I'm doing tonight's entry on the computer. I think it would take me too long to write on the iPod and I don't want to be typing all night. I have laundry to do tonight! It has been a really great day though! Really, it was terrific. Definitely the best day I have had here in India thus far. I got to go out on nurses rounds with CHAD today. I guess I should explain about CHAD here.

I learned quite a bit about it today from the doctor that came with us. Yes, even though it was nurse rounds, there is this doctor (Dr. Sharon) that wanted to come along too. She was super super nice, and so was Olive, the nurse. Anyway, so the way CHAD works is that you have levels of health care workers. At the base you have your health aides. These are people that actually live out in the villages. They have some training, but apparently it is only like a year's worth of medical training. They are responsible for a population of about 5,000 people. So they are going out every day, house to house visiting with these people and finding out their problems and needs and whatever they are able to take care of, they take care of. They also keep good records of the people. They then report to a nurse. I hope I am remembering these numbers right. Even if I'm off, though, you get the idea. A nurse oversees the areas of two health aides. I guess that means they cover a population of about 10,000. They told me that a nurse will visit each village about every other week. They also take care of whatever they can and keep their own records. I lot of what is done is prenatal and postnatal care, and then chronic conditions. They seem to do a very good job of making sure that babies are delivered in an appropriate facility and home deliveries are seen as a failure of the system. Next up, you have doctors. I am not sure if there are different levels of doctors, but Dr. Sharon said that she covers the areas of, I believe, five nurses, or a population of 50,000. The doctor will visit each village about once a month and hold a clinic. I will be going out for a doctor run clinic on Thursday, so I'll get to see how that works.

Overall, I think this program covers 80 villages surrounding Vellore. It seems to be a very good program and works well. Dr. Sharon said it is difficult though because you have to find workers that are very motivated to do the work and keep good records and know what needs to be referred. Apparently the Indian government has a similar organization in other areas, but it does not work as well because the workers are not that motivated. They just take the money but don't do the work very well. To me, though, it seems like a very effective way to take care of a large rural population that has very little means. Of course, it takes a lot to get motivated and educated staff, but if you can do that, then this program should work well in other areas of the world as well. And maybe there are similar programs in other places that I just don't know about.

So anyway, I spent the day with Dr. Sharon and Nurse Olive and the two health aides. I wish I could remember their names. They were all so nice, it just made for a really wonderful day. It was nice, too, that I was the only student, so I could really talk with them a lot and learn a lot. We had a vehicle and we basically just went from house to house, visiting the people that the health aides and nurse decided we needed to see. It isn't exactly time-effective, which makes me wonder if it is cost-effective. But you know, these people are important too. And even if it is not cost-effective, they deserve care. That's what is so great about this program.

The people we so very kind to us. They see it as an honor for us to visit their homes and so they treat us very well. They would all give us something to eat or drink. We drank a lot of coconut water and ate a lot of coconut flesh. It was so good. I ate pretty much everything they gave me, even a little of the water. They were just too generous and I didn't feel that I could turn them down. I expect I'll probably get sick again, but at least if I do I'll feel that it was worth it.

We went and had lunch at the home of one of the health aides. Her mom fed us a lot and Olive also had brought quite a bit of food that she shared. They taught me how to eat Indian style, and again I couldn't refuse. They eat with their hands only. Actually, their hand. Only their right hand. Apparently the left hand is used for wiping and so even though they wash their hands and everything before they eat, they still never use their left hand to eat, only the right. I felt like I got the hang of it pretty well after a little bit, and they said that I ate very nice. haha. They told me that none of the students from the U.S. will ever eat with them, eating their food and eating the way they eat. Some of the other students from Europe and such do, but they said that the U.S. students never do, so they were impressed. The food was great though and her mom was also very nice. We actually spent a couple of hours there for lunch and had a good time. They are fun people, very happy and laughed a lot.

All in all, I'm not sure how many people we actually visited in the course of the day. Maybe 10? Maybe 15? We didn't actually visit that many houses, but we would always run into different people along the way that needed something and we would stop and talk to them and see what we could offer. The cases themselves were nothing too unusual. Like I said, prenatal, postnatal care, depression, a guy with some new psychiatric disorder, COPD, evaluation of weight loss. I didn't always know exactly what was going on, but I was more interested in the big picture of the program than the specific details of each case.

The areas we went to today were also very beautiful. Most all of the people were farmers. Rice, eggplant, chili's, fruits, tamarind, etc. And they live out close to the moutains, which are very pretty too. It was just so nice to be out in the country rather than here in the noise and madness of the city. I'll take the rural areas over the city any day.

I talked with Dr. Sharon about so many things! I feel like I could sit here all night and write them all, but I know this post is already getting way too long. We talked about the caste system and what a huge role it still plays in Indian society. Marriages are all arranged, except for rare cases such as Dr. Sharon's. Even for them it was difficult. Her husband was beaten by his father for wanting to marry her... I guess they are not of the same caste... but they persisted until both families (extended families) agreed. She said it was only possible because both families are educated. Otherwise, it would never happen. It amazes me that the caste system is still so integral. Muslims, apparently have no caste system, but even the Christians here follow it, which was a big surprise to me. That just doesn't seem to fit with Christianity. She explained how whenever there are elections, people just vote for whoever is their caste and their religion and speaks their language. Or else among the poor, they vote for whoever comes and picks them up in a bus and takes them to the polling station and pays them Rs 100 to vote for their candidate. She feels like the only time that India was close to being united was with Ghandi, but that didn't last.

There is just so much about this country that remains a mystery to me. It is so complex and amazing and astonishing.

I also learned a bit about CMC. What a great place! Their philosophy is that they don't want their students to have any debt when they finish school, because they don't want them to have to work for money. They want them to be able to serve. For that reason, tuition is insanely cheap, even by Indian standards. CMC actually puts in a lot of money for the training of each student. That's awesome.

Okay I really should stop. This is getting way too long. I'm just grateful I was able to have such a great day with these wonderful people. Their kindness inspires me.
day 11 photos