Inauguration and a free lunch

Almost a month has passed since I arrived here and although I have started to find my feet there are many days on which I am still aware of my inherent Englishness. An interesting example of this is the way in which I have embraced the recent change in the weather here. In February it is usually hot and entirely devoid of even the smallest cloud on the horizon, however in the last week we have experienced extremely unusual amounts of cloud and on most days a shower of rain, this has given the general sense of English summer time and I must admit I am enjoying the slightly cool dampness of it.

On Wednesday of this week, despite the slightly damp weather the charity had plenty to celebrate. Three new area centres for education and community health care were inaugurated. The buildings had been standing empty for a little while waiting to become useful because the funding had been received from a Japanese government grant for grassroots development. This meant that using the facilities was out of the question until a Japanese ambassador had come to our rural setting to cut some ribbons across the thresholds. We were quite literally waiting for the red tape to be out of the way…

So Wednesday dawned in all its cloudy glory and the celebrations begun. Streamers made of palm leaves lined the pathway down to the nearest building behind the school. A large bamboo and bright fabric tent was erected in the grounds for the inevitable speeches. Tribal men were wondering around in traditional dress with drums and pipes. It was really quite a show. The Japanese ambassador (looking rather hot in his suit) even managed to deliver a couple of lines in Tamil during his address to the crowd which had gathered. After the cutting of the ribbons, the lighting of some candles, grand speeches and tuneful singing by the school choir the time came for a massive communal free lunch. I have attached a photo of the children lined up to receive their veg biryani.

It was a lovely day and in true British form despite the clouds I managed to get sun burn on the back of my neck.

This is only a short blog for now but I am in the middle of writing a much longer one. I hear all of your cries for more photographs so here are a few.

The mobile van we do clinics in

a child in one of the villages playing with a spinning top

Love you all, more writing and pictures very soon!

A x

Lazy Sunday afternoon

It’s a quiet Sunday today, the sun is warm here and there is enough breeze to wave the palm trees lazily. In contrast to the week that I have had (it’s been a busy one) everything seems very calm. 

On Tuesday I went on a mobile clinic visit. I clambered in to a huge white hospital truck with a driver and two jolly tribal matriarchs in brightly coloured saris and off we went careering around the extremely treacherous mountain roads. We were stopping on route near the tribal villages to see patients, a serious test for my rather ropey Tamil! Luckily with some very inventive sign language I managed to work out the problems they wanted me to fix (or at least I think I figured it out). It seemed to me that most of them had minor coughs and colds. Therefore they mainly got a prescription for paracetamol and the advice that if it didn’t get better in a few days that they should make the trip to the hospital. It was great to be out in the rural countryside and to get a change of scene from the hospital.

My life here has settled into a bit of a routine already with ward rounds followed by busy outpatient clinics followed by lunch. The afternoons are spent helping out with cleaning wounds and changing dressings, more ward rounds and sporadic opportunistic Tamil classes. Fitted around this general frame are the flurries of excitement brought by acute admissions and obstetric cases. We also regularly have visiting specialists from all over the country and indeed the world.

On Friday again I escaped from the hospital, this time to go to a busy clinic in one of the area centres. It was quite a distance from the hospital and we made the journey in a jeep which as far as I could ascertain had next to no suspension. By the end of a day including jeep travel too and from the area centre and a house call thrown in for good measure I felt very much like my behind had been turned into tenderised steak.

A recent addition to my routine here is that I have started to go running a couple of times a week. This is mainly on the suggestion of the two very sweet American research students who are working here. We go out at dusk and run along the country roads, trying not to get flattened by the passing rickshaws, bitten by the angry dogs (who seem to take our running very personally indeed) or teased too badly by the local children, who quite rightly think that we must be utterly insane. The Americans are both much fitter than I am as you might imagine but I like to humour myself that I go at a slower pace to better enjoy the scenery of the Indian evening with the sun setting and the big honey tinted moon rising over the fields of banana trees.

Although I enjoy writing to let you know how things are here I must admit I find it very difficult to know what to put in and what to leave out. As you can imagine I can’t write about it everything because it would be very boring for you to read. However there is one thing that has really made my week and I felt that it would be a good note to end this on. A little less than two weeks ago a little tribal boy was admitted here. About 18 months old he was already suffering from his second episode of pneumonia. He had been to another hospital nearer to where he lived and had not been making any progress so his mother had brought him here. A chest Xray showed severe infection in his right lung and he looked tired, like every breath was hard work. Whenever we saw him on the ward round he would look so upset, you could tell that he wanted to cry but he was so dry and hoarse that nothing came but a pitiful squeak. So this week on the ward round, after treatment with intravenous fluid and antibiotics you can imagine how ecstatic I was when this gorgeous little guy looked up at us and gave the biggest gummiest smile ever. His lungs are clear and he has made a full recovery. Just thought you might like that, it has certainly made me happy.

I will be in contact soon but for now its time for me to go. Hoping you are happy and well. All of my love,

Ax

More from India

Happy Valentines Day, I can’t believe it is Monday again so soon! It has felt like such a short time and yet such a long time since I last wrote.

The end of last week was busy but good fun, on Thursday I went back to Ooty to finish my registration with the visa office so I am now fully legal, which is a relief. I took the opportunity while out of the hospital to spend some time walking around and just looking at things. I managed to go to the Tibetan market and buy myself a rather nice woollen shawl to keep me warm in the evenings, which can have a bit of a chill at times. I also managed to wander into the municipal market there which was really staggering, so many sights and smells, all the fresh produce so colourful with branches of green bananas and oranges, bright pink radishes and these really massive cauliflowers. Walking past the flower stalls the smell of Jasmine is just intoxicating. By the evening I was worn out from all the walking, and the long bus journey there and back along windy roads, as you can imagine I slept well that night!

On Friday, after a busy day in the hospital I walked into town to pick up the outfits that I had ordered, see picture attached for the more vibrant of the two! Talking to my friend the midwifery teacher and some of the nurses it became apparent that a plan was afoot to visit the circus which had been in town all week, so I decided to shell out the 20 rupees (28 pence) for the cheap seats in the gallery and see what it was all about. Well, the cheap seats in the gallery turned out to be some very rickety wooden benches arranged in a slope stadium style and threatening to give way at any time. The dusty old big top certainly seemed to have seen better days and as my friend pointed out the most nerve wracking and adrenaline rush provoking aspect was not so much the bored looking acrobats or the knife thrower with the slightly poor aim but rather the generally unstable appearance of all of the equipment used. Being in India I had rather assumed there might be an Elephant or some other exotic creatures on display but in actual fact the grand finale involved a slightly more domestic performing animal. A tightrope walking goat, I kid you not! No pun intended. Still a good time was had by all and it was brilliant to have a night out.

The rest of the weekend had highs and lows as you might experience in any other hospital in the world. A couple more entrances into the world with two extremely beautiful little girls who were thankfully delivered safe and sound by the nurses, and one very sad exit as I experienced my first patient death here on Sunday. Despite the extremely hard work of the very talented doctor on call and the support of the nurses we just didn’t have the resources here to save our young patient or the time to transfer him out. Births and deaths, the unavoidable currency of human life on whatever continent you find yourself.

So here I am at the start of a new week, looking forward to what it might bring, as always missing you folks back home and really thankful for all the exciting messages I have been getting keeping me up to date with news from my lovely, rainy homeland.

I will try and write again soon, but for now signing off with love,

A x

From Fireflies to Tamil lessons

Hello again. This weekend unfortunately there was no electricity in the town. Thankfully the hospital and a few other places have generators so were safe from the black out. On the plus side I saw my first fireflies while walking back from town in the darkness, really beautiful. There is a lot of really great wildlife here and on my next trip to Ooty I have sort of promised myself that I will drop in to the book shop and buy a guide to the birds of India. One of the doctors here has already pointed out a few gems to me including a hornbill.

I just wish that I was not so much of a sore thumb in terms of appearance. I look so out of place here with my milky bar white complexion and mop of straw coloured hair. Walking to town and back I get mobbed by little children wanting to practice their primary school English. Although I always said how embarrassing it was to see British gap year types dressed up in Indian fashions I must admit I have gone into town and had two outfits made. Look I know what you are thinking, I can almost picture the raised eyebrows! But you try being the only woman in town dressed in western clothes, I feel more daft dressed like this than I would in Indian clothes (I think).

Work in the Hospital here is fascinating, the variety is just brilliant. It changes by the minute so that even if at the moment I am mostly just an observer I never get bored. From surgical bits and pieces like debriding diabetic foot ulcers or skin grafting, to medical emergencies like acute viral myocarditis or cerebellar stroke.

The obs and gynae teaching is great here, and there are experiences that you just don’t get anywhere else. For example assisting in tubectomy under local anaesthesia and helping out delivering these tiny babies who never fail to surprise me, they are just so hardy, they really fight for survival!!

Today a whole class full of school children from the tribal school came to have their general health check up, so that was a crash course in paediatrics for me! Also a chance for me to practice my Tamil, I had my second lesson today and I am starting to enjoy the bits that I can say, even if they are limited. My pronunciation leaves a lot to be desired, apparently the way in which I say Ear in Tamil sounds exactly like the Tamil word for forest. So in the future there may be some rather confused villagers with otitis media presenting with ear pain who wonder why I am asking to examine their forest.

Hope this update is satisfactory. I am of course missing you all. Love as always,

Ax

The First Week

Right then, Wednesday was my first day in the hospital and I spent it relatively productively following people like a lost sheep and trying to understand Tamil (which is a very complicated language by the sounds of it). My main take away message was that I am going to need to develop some serious linguistic skills and also just learn a whole load about rural medicine!

Compared to these Indian doctors I feel rather dim and certainly spoilt! Things have developed dramatically here but obviously we are still constrained by cost and availability of investigations and I will need to develop much better clinical skills to compensate. In the Western world we get so used to seeing a patient in brief then arranging a huge battery of tests, which is really not an option here.

On Thursday I spent my day traveling to Ooty to register my visa with the local Superintendent of Police. This was quite an experience, trying to wrestle with layers of bureaucracy India style. Suffice to say my visit involved a lot of travel to and from the Xerox shop, requiring 5 copies of every document and using my entire stock (that’s 7) of newly purchased passport sized photographs.

I traveled to and from Ooty with a brilliant retired couple from the UK, she was a midwifery teacher and he a GP. They are currently part of the family of amazing volunteers here at the hospital. So in the afternoon I joined in with their sightseeing trip and reminded myself how beautiful the countryside surrounding me here in the Nilgiri Hills really is.

Today I have been the rather conspicuous shadow of the lovely senior registrar here, Ward rounds followed by out patients and admitting any new arrivals. The more I learn about the way things work here the more confident that I am that I will be able to practice here in a useful fashion, after all the human condition is not that unfamiliar no matter what area of the world you are in.

So this is all for now. I will update you again sometime next week, lots of love,

A x

Arrival, in detail!

Arrival- this is the blog bit I wrote then could not upload earlier in the week! Now in all its boring glory...

I am really not that adventurous so it was with some serious trepidation I left my family at Heathrow and, looking every bit the 19^th century explorer, I headed towards my flight. By a massive stroke of coincidence/ luck there was a lovely doctor who was in my year at uni on the same plane, so we spent some time catching up.

 After 9 long hours of airplane food and recycled air I was very glad to find myself in India at last, and even more glad to find a very smiley man holding a cardboard sign with the name of the charity written in multi-coloured biro pen. This was my very charming driver. One of the other doctors working at the Hospital was also driving back with us so in the gaps between sleeping quite heavily and eating a very large Masala Dhosai for breakfast at a road side cafe I quizzed him on some useful Tamil phrases, most of which I have forgotten almost instantly.

By Lunch time we had arrived, to a very different hospital to the one I left in 2007. The hospital has grown and developed a great deal and I am really looking forward to learning the ins and outs of the system here, on my great and rather ambitious journey to becoming a useful part of things!

Anyway this is enough waffle for now, I am here, I am safe and sound and that is a start at least!!

Lots of love,

A x

Arrival

This was going to be a longer post but I am having a few technical glitches trying to organise my internet so in brief: I have arrived, it is beautiful here, to keep you all happy here are some pictures. My small but perfectly formed hospital accommodation room and the view from my window.

Love to all,
A x