RUHSA

stands for Rural Unit for Health and Social Affairs.

That is where I have spent the last two days.

So I think I figured out what fourth year of medical school is for... besides applications, and interviewing, and long long bouts of painful waiting for some one to hand down the verdict on the next three years of your life and what not. I think it is a time to just chill out for a second, stop the craziness, and slow down the pace... to the point where you are just bursting at the seams to actually get to the next step. That has all been exacerbated here in India. You see, for visa purposes and what not, we are observers--sometimes we listen to a finding or do a minor exam--but after learning to take care of patients, it is soooooooooo hard to just watch! The gift that is given to a medical student, is that you take care of the patient. You do a full history, and physical, and you take time to read about what can help your patient, and you talk to the family, and you ask questions to those that more than you and you just get to take it all in--I don't think I fully realized the implications of all this, till now, when I have to sit back and watch! Well I guess it's a good thing I'm aching for some clinical work, cause I hear motivation through intern year is a neccessity.

I think it has also been difficult to just be an observer due to the sheer number of patients that we have seen in a short time. I mean, this could be medical student heaven (and intern hell) with the number and variety of patients you can chose to follow. Yesterday, in one hour, 54 patients walked through the mobile clinic. And then today, in about 20 minutes, 30 pregnant woman received check ups. In the US, I have only rarely seen a doctor see 30 clinic patients in one day--but that was over a WHOLE day, not 20 minutes. In this amount of time, the baby's heart beat was heard, mother's blood pressure was taken, size and dates were estimated, position of the baby was estimated, anemia was screened for (stick your tongue out), and vitamin and folate supplements were given. This was achieved with one doctor, one nurse, and one health aid. It was just crazy.

I am surprised at the amount of obesity, hypertension, and diabetes that I am seeing! And some of the patients are still vitamin deficient. I wonder if it has always been there and is being documented and treated now? I mean, this is not the city, there is not fast food, many of these families have very poor diets. This is rural villages. Also there is a huge number of seizure disorders here. Yesterday I asked the intern what the etiology was... birth asphyxia or trauma? no, most of it is post infectious-after meningitis. There is alot of it. Lets just say I'm glad I had that vaccine.

And then Carla had a very interesting run in in clinic with MEASLES! Crazy?!?! Not everyone here is vaccinated, and the doctor freaked out and asked if Carla had her vaccination since she was near the patient, because THE DOCTOR DID NOT HAVE THE VACCINATION! I mean, really--educated, adult person in the field of medicine in India. I guess I'm just silly, but I thought at least measles was routinely vaccinated against.

Today we also got to see some of the socioeconomic devel0pment programs that are run through the program. We saw people making brooms (not the kind in America, the ones everyone in India uses), incense (2000 sticks per day per person), and dried coconut leaf weaving (used to cover thatched huts and what not). These folks spend alot of their day doing this and make an average of 20 rupees a day (that equals 50 cents).

I got some great pictures again today, but you are going to have to wait till I get back. I am just too impatient with the slow connections and lack of USB ports here. This is something else carla and I have been discussing--don't we outsource our computer stuff to India? Isn't there a major software industry here? All the connections are slow and computer's old. I ran into the director of pediatrics the other day, and he was taking a seminar on biostatistic's computer modelling. He said he really wanted the software, but his department couldn't afford it. So I guess there you have it. It is produced here in India, and yet a private hospital department can't afford it. We export our fatness through fast food. They export their genius, textiles, hand crafts.

Well, one of the other things that I am thankful for and very aware of while here--is that I am American. I am proud to have a culture and ethnicity so beautiful, but I just think how different my life would have been as a female in India--whatever social class. I can't even imagine me being me.

I think that is about it for now, tomorrow I might go wander around the ER. I'll keep you posted;)