The rural-urban health gap in India is an inconvenient truth – one which we may not acknowledge exists, but it does. The fact remains that even students who come from interior villages, once they get their degrees done, hardly tend to return to their roots. The Newspaper Headlines today reminded me of my memories of working in a community health center in rural West Bengal.
A lot of my contemporaries are saying that they have managed to escape this “unfortunate” rule just by the skin of their teeth but I think this is a positive step, provided that the GoI and MCI keep an eye on development of infrastructure as well. But more of what I think about this ruling in a later post. In this post I will ruminate fond memories of spending a short and enjoyable stint in a rural hospital where, for the first time, we tasted what it feels like to work on our own (since during most of our internship, except ER postings, we were basically doing scutwork for the residents).
The place where we get posted is a pilgrim town and has a number of temples in close proximity. But thankfully, we were not there during the “pilgrim season” when there are literally hundreds of thousands people pouring in from all over India everyday (which means all the more emergency cases to deal with).
However, we saw a number of cases, we had the experience of working on our own (which might be a tad dangerous for the patients) and for us city kids, it was great to be out there in the countryside for a change.
The community health center we worked in was attended by a large number of patients in the OPDs every morning and though there were limited inpatient services (almost exclusively confined to Obstetric cases), the work load was pretty heavy. Amongst the patients I dealt with, there seemed to be a profusion of diarrhea, scabies, upper respiratory tract infections and UTIs. They were pretty simple to treat and results were pretty good on follow up. We had an attending who took care of the obstetric cases and we were glad to have that off our hands… or at least I was! True, I did miss my laptop and mobile connectivity and the buzz of being in the city (the folks there seemed to go off to sleep by 8PM and be up by 5AM! Unthinkable hours for me!)… but that said we did have a lot of fun!
There was a small kitchen garden of sorts behind the rooms we were allotted to stay and though none of us wanted to do any cooking, it was pretty cool to know that we had the option of doing so if we wanted to!
We had a lot of fun exploring the locality! I do have a family farmhouse in a village-ish place (I hope to go there this Mango season – we get an awesome crop every year – will post pics then), but this was an entirely new thing for me. AND my city-loving friends. It was still wintery and it was a brilliant experience to walk around with the sun on our backs!
We hired two rickety bicycles and went off exploring the countryside once we had closed OPD. Though we had achy calves the next morning and sore backs from all the bumpy rides, it was a joy to go out cycling once again. It not only made me realize how unfit I had become, but also showed me the unspoilt beauty of the Indian countryside!
The people were simple, trusting, hard working and honest. And when they heard that we were the new doctors in the hospital, they accorded us respect that we were hitherto unaware of! They literally invited us into their homes and hearth and made me feel, for the first time, what it meant to be a doctor. In this age of consumer-provider relationship, we are on the brink of forgetting the romance and social privilege that was once given to a doctor.
In order to reach the place we had to make a train ride for several hours and since we chose our travel times to avoid the office rush hours and traveled in a pack, it was great fun for us all. In Indian local trains, people hawk a lot of junk food and we ate a ton of them (without falling ill – kudos to our secretory IgA!). I ate a dozen or so HUMONGOUS bananas on a bet!
And of course, one of the things we insisted on was to eat the spicy, totally unsanitary yet mouth watering guava-mix (the very thought of it is making me salivate as I type this out. Thank you so much Pavlov!) that one guy sold on the railway station. We ate it on our ways in and out and I believe one who has had that will not be forgetting it in a hurry!
The real pleasure was in being there with people who were great friends (and still are) of mine! One of the most difficult times in the career of a medical student is Internship. The work hours are long, the bosses are (more often than not) crabby residents, the work itself is almost always unrewarding and menial… but a lot of these issues can be bypassed if one gets good friends to work with in course of Internship. And I was lucky to be in the best of company when it came to internship. Not only did I have friends to work with, I had them to laze off and spend leisure time with as well. I am sure few intern groups have bonded as much as ours did. This was also instrumental in making our rural posting a fun stay. What otherwise may have deteriorated into a boring, uninspiring post where one worked all day and spent almost all the off-duty hours in a drunken haze (booze was cheap in the place… come to think of it booze is cheap in almost all religious hotbeds. Coincidence?), became a raucous fun riot thanks to them.
I would like to tell Dr. Sujoy Chatterjee (Surgery resident, AIIMS – guy in blue tee), Dr. Manidipam Chatterjee (Anesthesia resident, CNMC – guy in red stripes) and Dr. Sitangshu Chatterjee (Co-perspirator in PG toils – the third guy on the pedal-van) that with me in tow, we formed the most awesome intern group ever. Thanks for the memories. I hope the joy of those days never fade.
Well, sorry for the sappy, nostalgic post. It will be back to regular programming from the next post onwards – where I dissect the latest plan to send post-internship MBBS doctors to villages for a year and thus extend medical training by one more year. Stay tuned.