Last day in Vellore

So yesterday, I went to a special hospital where I thought we were going to see leprosy outreach programs, but I didn't see any leprosy patients at all! Apparently, the scope has expanded to um, just about everything, and even though I didn't get to see leprosy like I did at CHAD, i did get to see lots of everything else! In four hours of clinic, here is a glimpse of what came through the door:

A homeless man with Parkinson's Disease

Two children with Scabies

Two working adults with Fungal Skin infections (hands of a clothes washer, and abdomen of a diabetic man)

Rheumatic Heart Disease (loudest mitral murmur I've heard to date) in a young mom

Uterine Prolapse in an elderly woman (she had 6 kids)

Vitiligo from vitamin deficiency in a young boy

The differential for a child with tummy pain #1 is worm infestation here! (hookworms enter through the feet, and everyone here is barefoot!)

Pulmonary TB

Discoid Eczema

Then in the afternoon, I went to Infectious Disease Clinic, where I saw patients with pulmonary TB, extrapulmonary TB (those are some scary looking lesions), HIV, or both. I learned alot about the government programs for those epidemics here. First, and most angering, the most common new diagnosis of HIV is in women that got it from their husbands who had extramarital affairs or homosexual relationships. One man was diagnosed last august and was taking medications, but did not tell his wife or bring her in for treatment until yesterday (he's crusin' for a bruisin'-- he's lucky he's not my patient or he never would have heard the end of it, thats all I have to say) and apparently, it is not all that uncommon. For the past two years, the government has provided HIV and TB therapy for free across the nation. They use directly observed therapy with pretty good compliance results. A community member, that is not a relative, observes them take TB medications everyother day and keeps a record that the patient brings in for visits. And when therapy is started, the entire 6 months of medications are given so there is no shortage or break in therapy! Just like everywhere else in the world, there is much stigma and ostricizing of those with HIV.

The doctors were excellent teachers yesterday, the outreach clinic doctor was a real talker. He also explained local politics and customs in Tamil Nadu. For example, the politica parties here, basically rotate every five years. During election time, the party comes through and pours out tons of free alcohol, which many people would never be able to afford normally, and gets everyone drunk to vote for them. They also buy votes, apparently, a vote is going for about 2,000 rupees, which if you read my previous post, can be about a years salary for some of these folks....*Sigh*

There are also many local traditions, one of the villages that we were in was going to have a function for a goddess of the town, where they WALK ON FIRE/hot coals to appease her/keep her happy. the other village, they grow children's hair out, boys and girls, and cut it off when it is long as an offering to the goddess. Lets just say im glad im not going back to that clinic AFTER the fire walking.

So yesterday daytime was fun, then Carla and I went to eat at our favorite restaurant in town for our last dinner and pigged out big time--our own dishes, lassi's, and sundaes.

So tonight we are off to Banglore to catch a flight to Goa in the morning.

I think that now that I have had a small glimpse of the health and poverty in India, I will never look at it the same. The difference between rich and poor here is... I mean a party being able to pay each man a year's wages for a vote?

I am so thankful for being blessed in this life and for the opportunity to see what is being done for those less fortunate, and perhaps one day soon, to also try and make a difference.