Wednesday, May 11, 2011

Civil Hospital Patients!

Our favorite visitors from Madhya Pradesh came this week. Sonu, the clubbed foot case, and Preeti, the spina bifida case, both came to get admitted, since the doctors said there were vacations going on before, so to come back in 10-15 days to get admitted. Of course they came this week, and the doctors said they still have vacations going on, so no elective surgeries will be done. These surgeries need to be done, but there is no urgency in doing them. Thus, we were out of luck. The Indian system is very frustrating that way - if they would have said things will be like this until July, we wouldn't have wasted a trip up here! So they all went back empty handed.

Basanti, our favorite terror, was brought as well, to get her eye looked at. She has intermittent ptosis, which basically means her right eye lid droops sometimes. It's something she has had since birth. The eye doctor tried to get her to open and shut her eye, open her mouth (the muscles are connected so moving the mouth affects the eye), but of course she was uncooperative. So the doctor said have her eat something in front of me after I get out of my surgery. So we waited, kept her hungry until 1pm, and then showed the doctor. Of course the rugrat refused to eat in front of the doctor. I asked the doctor if we could video tape her eating, but the doctor proceeded to get upset with me because she thought I didn't want to wait, and thought I was asking for special treatment. I tried to tell her it's just because Basanti is a stubborn child and will do the exact opposite of what you ask her to do, but she didn't listen and just got mad at me. So I sent the other volunteer with her after the lunch break to show the doctor. They were doing a bunch of tests, and then in the middle, the doctors all left, so we were out of luck! She'll come back next time to get the tests completed, though it looks like they are not recommending surgery - but they think there may be some other problem with her vision. She has come up with mechanisms to clear her field of vision due to the drooping that are compensating just fine.

And of course while Basanti was being stubborn, everyone else was waiting in the heat for her to finish! We rented them a car that took them back to MP, since it was too much to have them all go in a general class train. I had the driver come over and look at a map on googlemaps to look at, since they didn't know how to go and were planning on just winging it. I really want to buy them a roadmap...I don't know how drivers function here without maps!!

Anyways, the families are going to come get admitted in July, and Rahul and a few others will come next week just for OPD follow-up visits, which still are running during this physician holiday season!

Nauchandi

There was a nauchandi at the mandir right outside of our house this week. They have one every year on the date that the mandir was started. My Masi and cousin sat in the pooja all day - it was too hot for me! It was amazing to see all of the people come together, take time off of work etc just to be there for this celebration. In India, religion and faith tie people together. Pictures are here.

Mount Abu Trip!

Two of my dear friends, Pooja and Nishma, and I took a trip to Ambaji and Mount Abu for the weekend. It was a good break away from the craziness! We left early Saturday morning, of course the driver slept in, so we were up earlier than necessary, but that should be expected in India! We went to Ambaji first - boy was it hot even at 10am! Then we went to Mount Abu - the roads are crazy driving up! Then we ate, took a nap, which ended up being a few hours long, but worth it...then we went to sunset point, and hung around the lake, did some shopping...the next day we walked up to Guru Shikhar, and went to the Om Shanti garden. We were exhausted by the end, probably just because our sleep was so all over the place, but it was a good get-away! There are pictures here if you guys want to see the fun :)

Wednesday, April 27, 2011

Civil Hospital Patients - Rahul's update

I got the most amazing news today that I felt I had to share. For those of you who remember, Rahul is the 3 year old boy that had tuberculosis meningities and was admitted here. He got better, but was still malnourished, and his parents were not very concerned about making sure he gets better. One of the field workers at the Real Medicine Foundation emailed me an update. Below is a before and then two after pictures that explain the transformation better than my words can describe. I literally did not recognize the little boy as Rahul! He is interactive and trying to talk and grab things and he is holding his own weight up...it is simply a miracle to see his transformation. A little bit of love, communication, and effort very clearly goes a long way. It is so inspiring to see his transformation into a healthy 3 year old boy!!

Before:



After:

Thursday, April 21, 2011

More patients to Civil Hospital

I had lots of visitors from Madhya Pradesh this week! A car literally full of 5 patients, their parents/caretakers, 2 staff, and driver all came up. I met everyone on Monday night, got everyone settled in and tried to figure out what was what and who was who along with logistics with the team since it was their first time in Ahmedabad. After that we got started bright and early on Tuesday morning. Here is who was here:

Apsiba - This is a pre-teen aged girl who needs a heart valve replaced. They already took her to a doctor in Indore and now just wanted a second opinion on what the situation is. The civil hospital doctor did another echocardiogram and then said that 2 of the heart valves need to be replaced. I can't imagine how scary it is to be old enough to understand what is going on and then to go to millions of doctors to try to hear about this surgery over and over! The parents want a third opinion, and then will decide, especially since everyone is giving them a different answer.

Basanti - If you remember, is the rascal of a child who had the clubbed foot, had surgery, and then broke her cast several times. Well she broke it again, this time in record time - 2 weeks! Originally the doctors had said that she would wear the cast for a month, get it off, have another surgery, and then another cast, after which she will get special shoes to wear for about a year.
The doctors saw her and decided to take off her cast and put her in these special shoes right away. So this means for now, no second surgery. The doctors took the cast off, and were very upset about the duct tape and wiring that the volunteers there had done in order to prevent her from ripping up her cast again - which obviously didn't work. They said it wasn't appropriate and could mess with the correction (I doubt it, but whatever) . They even made me take a picture before taking the cast off in case there are liability issues. Smart to make me take that picture on my own phone! After that we took her to the Spinal Institute and got her fitted for both her scoliosis brace and her shoes. The brace and shoes need to be worn at all times, except when she showers. I feel so bad seeing her in all of this gear - it's crazy hot here and I know she's a huge pain so I'm sure she will be extra annoying and fussy about being hot in all of this! But hopefully she and her parents are compliant, it will save her a lot of trouble in the long run.

Sonu - This is another little girl with a clubbed foot. The doctor saw Sonu and said that she will need surgery. After she gets admitted they will do x-rays, do the surgery, more x-rays, and then we will know how long she will need the cast, second surgery etc etc. She came with her uncle and grandma because her mom is about to deliver. Her uncle and dadi did not want to stay and get admitted right now because Sonu's mom is waiting to deliver and the dadi needs to be there. I didn't push them because I didn't want them to keep trying to leave or rush things along to get back. Her uncle said he doesn't mind staying but that he can't handle Sonu when she'll get upset, in pain etc., that he thinks she will need one of her parents. I think we all agree that the parents need to be involved in the care and decision making of their children as well. I told the uncle to take their time and come once they know they can commit and stay, in addition to come for follow-ups etc.

Preeti - Preeti is an adorable little girl with spinda bifida. She is 4 years old. She was seen and assessed when she was first born, but the doctors didn't tell them to do anything. Now the spinal protrusion at the base of her back is much larger and is affecting both her ability to walk and control her bladder. The neurosurgeon got an MRI and then assessed that Preeti needs surgery. He said with the surgery there is a chance she will walk and her bladder control will get better, but without the surgery there is no chance, and it's a we'll know once we do it type of thing. When I went to get the MRI, it was 11am, and the lady told me that the child will need anesthesia because she won't stay still, but the time is up for the anesthesiologist so come back tomorrow. I was like what hours does the anesthesiologist work that they are "done" at 11am. She said there are already too many patients in line and by the time they are done the time will be up. I was being very stubborn, telling them that these people came from so far away and are leaving tonight etc etc. The receptionist asked if I was a doctor. I was like well it wouldn't hurt to say yes, right? So I said yes. Then she was like well if you want to administer the anesthesia we have no problem. I was like whoa, I can't take that kind of liability, and I'm thinking in my head what type of regulations they have if they just let me self proclaim myself capable of doing such a thing! Finally the receptionist was like well you can go talk to the anesthesiologist if you would like. So I went back there and waited...I was guessing it would have been some young male and I would use my charm, maybe flirt a little, talk about the organization and convince him. But it was a young woman...I am thinking, okay I am screwed. I went in and talked about the organization, said that I'm from America here to volunteer for a year etc etc...she was actually really nice and said look we stop giving anesthesia at 1pm and it's already 12p and I have 3 more patients, but I will put her in the line and see what we can do. But apparently what I said had an effect on her because she came out in 5 minutes to assess Preeti and get her in! We could not get her admitted right away because apparently there is "vacation" within the department for the next 2 weeks, so no non-emergency cases. Crazy, huh?!

Pankaj - Pankaj is a young teenage boy who slept on the roof with his friends in the village and has a habit of sleep walking and oh what do you know fell off the roof straight on to his head. It was a really bad gash - took a chunk out of his scalp - hair, skin all gone. The local hospital took a look at him and said to get an MRI done. He got an X-ray and CT scan, both of which were normal. The surgeon looked at him and said that the hospital he went to looks like they gave him stitches, which we were unaware of. They cleaned the wound and dressed it.
I lectured him and his father a lot on how this was really stupid and should not ever happen again, and tried to scare them into how much worse this could have been.

We managed to get all of these patients in and out within one day which was absolutely nuts! It was me, this local worker, one of the directors, and then a poor student at the spinal institute who got stuck with us. We were one worker short for the 5 patients, all of whom ended up needing different things on different floors at the same time (before lunch, because after that, good luck finding someone who will talk to you). The local worker I had to be careful what I had her do because while she was great, she got pushed around easy and when the nurse said you can't come in with the patient, she said okay and stepped aside. So I couldn't, for example, have her wait around to sweet talk the anesthesiologist. It took lots of coordination and some patients were more complicated or had more questions to ask so we kept meeting up and switching patients, regrouping them, it was like a field trip! It went very smooth overall and I really felt like I know the hospital and its system pretty well to know where to go, when to push, timings...and I even figured out what things could be put in the afternoon priority and which had to be done right away in the morning to save us from needing another day. It worked beautifully. I tried to talk to the parents and families as well and educated them about their child and what they needed to know, and just bonded with them with general chit chat. A few will come back with their children and will be here with me, so I figured if they knew me and realized I am pretty nice, they would not be so scared to come back! Plus it was good Hindi practice ;)

The families were great as were the adorable kids, and I am so grateful to be a part of this organization and get to help these families and children get healthy and become mobile and free of disability!

Sunday, April 17, 2011

Flowering Tree

The name of the Jamalpur (Manav Gulzar project) sponsors is an organization called Flowering Tree. They are based out of New York and basically visit and find organizations that do good work with women and children in Asia that is in line with their own organization values. They are funding our Jamalpur project. The way they decided to fund this project was very interesting. They were in Ahmedabad working on a different project, which fell through. They decided since they were here, they might as well check out the Gandhi Ashram. So they were visiting and stumbled into the Manav Sadhna hub while wandering. They loved it there, met everyone, saw all of the projects. They didn't do anything then though. They came back and visited every year for 3 years. Then in the 3rd year they were in the same van as some of the leaders from Jamalpur going to prathna. They started talking to this leader, asking him how they maintain such peace and harmony in a mixed Hindu-Muslim area. The husband started explaining...when he was newly married, he loved bossing his wife around. When he wanted to have people over for dinner, he would order his wife, make dinner for 10 people tomorrow. He quickly learned, however, that she maybe would not be able to go against him, but all she had to do was put extra chilly in the dinner, and his guests would never return, not to mention his image would be tainted. Instead, he learned that if he asks his wife, I want to have these people over for dinner, she might reply and say well today I cannot prepare that, but if you have them over tomorrow, I can make a good dinner. That way they work together, listen to each other, and everyone is happy. His wife was giggling in the corner listening to this story of course. So the leader said, I applied this same principle to the community. We listen to each other, ask what our thoughts are, and thus communicate well and live in harmony. Flowering Tree obviously heard this and thought what great and understanding leaders are running this area! Then they went to prayer, and afterwards these same leaders were talking to Jayeshbhai and Virenbhai saying they would like Manav Sadhna to help build a community center in Jamalpur. Flowering Tree heard this request, and afterwards in private, asked if they could help with this project. It was ironic since the Manav Sadhna philosophy regarding fund-raising is that whenever a need arises, someone who can meet that need comes along on their own - case and point! Thus started their relationship with Manav Sadhna.

I went to the airport to pick them up on Wednesday. It was a man and woman, middle-aged, very friendly. They were very excited to meet us and be here to see the project. They were very happy with the project, since they really were missing one thing in the project, communication and written reports, which I was able to fulfill. Also being from the states, I knew what type of stuff would be helpful for them to read, and thus was able to tailor the monthly reports to fit that. I gave them the annual report I wrote, which was a summary of all of the projects, reflections from the teachers, summary numbers regarding enrollment, nutrition etc. They literally could have kissed me, mainly because they didn't ask for this (they hate asking people who already are so active and busy in the field to do such stuff) and it had literally everything they needed. The next day we went around seeing everything, but they told me they were so at ease having read my report that they could just sit back and see everything without worrying about getting all of their questions answered etc. It felt good that something that wasn't painless, but relatively so, and definitely something that taught me a lot and helped Manav Sadhna also was such a big help for them. We went and visited Jamalpur - they loved everything they saw - and they knew a lot of the background so they felt like they knew what they were looking it. They saw thee construction, had pictures taken, songs sung to them..it was great! After that we went to the Leper Community to see that. They walked around and were shown the community - I sat aside and hung out with some of the little kids since I was exhausted (as was everyone). This was the middle of the day in full summer weather - I literally drank at least 1 liter of water over the 10 hours we were out, and did not have to use the bathroom, even when I got home. That tells you how much I must have sweat for that to happen! But it was great to meet and see them, and also see that they are working so hard on such projects, no only to provide funding, but have a genuine interest in helping and being involved however they can. It was heart-warming to spend time with them and a relief that my efforts on my largest project this year was beneficial to someone else besides me :)

Tuesday, April 12, 2011

Ram Naumi and Preparation for Visit

Today was Ram Naumi or the birth of Ram, which apparently happened at noon (yes, Indians know these things). So there was an arati at the mandir at noon. And things were mostly closed - surprise, surprise. I can't believe the number of people though that come to arati at these occasions. I don't know if people here are more religious, but I feel like they have more of a blind faith that things like visiting the temple once a day or wearing nice new clothes and visiting the temple on religious occasions. Anyways, once again it felt very homely to be squished like sardines in the tiny temple where everyone and their moms (literally) showed up. It was fun :)

Flowering Tree, the organization that is sponsoring the Jamalpur site, is visiting tomorrow and the day after to see how things are going firsthand. I wrote up a nice, colorful, long annual report and made a video slideshow of the children/events/etc. I'm excited to meet them tomorrow, help answer any questions they have about what we are doing, and hear their feedback on what else we can and should do!