Week 4 – Final Week in Delhi

For our last week in Delhi, we wrapped up the program with visits to the Venu Eye Institute, Medanta the Medicity, AIIMS, Sahara Women and Children’s Home and Apollo Hospital.  Descriptions of each are below:

Venu Eye Center and Research Institute

A comprehensive eye care delivery network comprising of a Referral and Teaching Eye Hospital in Delhi, 7 Satellite Hospitals, 25 Primary Clinics and 15 Community Based Programmes covering 9 States in North India, serving over 3,00,000 patients and rehabilitating 300-500 persons every year. Serving the general community, regardless of inability to pay, the Institute also offers Community Rehabilitation programs focusing on developmental, education, social and economic rehabilitation, having served over 3,000 people with vision, hearing and motor impairments. Other community based projects offers diabetic patients screening for diabetic retinopathy.

At Venu, we were able to sit in and watch some cataract surgeries.  Pretty amazing how fast an experienced surgeon can restore a patient’s eyesight.  Venu also runs three satellite sites that oversees smaller outposts.  From these outposts, Venu practices teleoptometry, where a patient from a rural area will have their eyes checked by a technician who sends images of the eyes to a doctor based in Delhi.  The physician then sends back any observations to the technician who relays the message to the patient using local language.  Here are two advantages of teleoptometry: the patient does not have to travel hours to get to Delhi and because the technician is a member of the local community, visits can be done in the patients own language and not just in Hindi.  This is especially important because each region, state and even village will have its own local language and some patients may not be able to understand Hindi very well.

Venu’s primary mission is to provide eye care for all regardless of socioeconomic status.  Therefore, the majority of Venu’s work is based on charity, charging a nominal fee for their services (about 10 INR).  When I talked to one of the staff members, he said that it is important to still charge this fee because doing things free of cost removes value from the service.  I guess it’s the same when using a pay toilet as opposed to a free one.  You respect the space a lot more if you have to pay to use it, and in the same way, you take the procedure much more seriously if there’s a fee.

Next stop in the rotations was Medanta, a private hospital located in Gurgaon.  I was blown away by how beautiful and clean the hospital was, especially compared to the government hospitals we visited before.  I’d say it was just as nice as some of the best hospitals in the US.  At Medanta, we visited the Ayurvedic Medicine department.  Though there’s still a lot I have to learn about Ayurvedic Medicine, here are some things I understood from the conversation we had with the director of the department:

Ayurvedic Medicine centers on the idea of holistic healthcare.  To treat any ailment of the body, one must also be able to treat the mind and soul.  Practitioners use a personality assessment to find general trends in a patient’s physical, mental and spiritual health.  They also rely not only on medicine, but also yoga, massage and herbal remedies as part of treatment.

My brief description probably doesn’t do Ayurvedic medicine any justice.  When we met with Dr. Krishnan, he showed how Ayurvedic medicine was being used in many scientific studies.  I think the idea of holistic care is very interesting and maybe more effective than just limiting yourself to treating what you can see with your eyes.  But a lot of the negative attitude towards alternative medicine comes from the fact that it is not based on science the way that modern medicine (biomedicine) is.  Science is based on observation, so how can you study something you cannot observe, like the soul or spirit?  However, I like to think that the book of abstracts Dr. Krishnan showed us proves that Ayurvedic medicine can be studied scientifically.  Overall, the visit to Medanta reminded me that medicine is much more than just treating the body.  Health encompasses the mind as well, and maybe even the soul if you believe that we have one.

In between our rotations to private hospitals, we had a short visit to AIIMS, a government hospital.  Because our tour was so short, I only have a few things to say about AIIMS.  First off, it was very crowded with patients lining up and waiting for treatment from the door of the hospital to the main street.  It was also dirty and chaotic.  No wonder why no one wants to go to the hospital until his or her condition is unbearable.  If I could only afford government services, I’d probably do the same!  It’s scary to see the difference between government and private hospitals and to realize the difference in healthcare that the poor receive as opposed to the rich.  I wonder if this system of government/private hospitals are only helping to increase the gap between rich and poor.

Apollo was the second and last private hospital complex we visited.  We also had the chance to shadow Dr. Nalin Nag, an HIV/AIDS and Allergen specialist as well as visit the OPD and ICU.  Dr. Nag is a very experienced doctor, one of the top experts on allergies in India.  Though Dr. Nag sees many patients each day, he always treated each person with a professional friendliness.  He remembered personal things about them, took the time to assess their condition and always left the patient smiling.  This is the kind of skill I admire in doctors, doctors who can make a patient feel like somebody important, somebody worth taking care of.  I got the feeling that Dr. Nag was trying to maximize his limited time without rushing the patients.

The main idea I took away from week 4 was that private hospitals and clinics offer a very different kind of service than at government institutions.  Care is personalized and the patient is treated like a valued customer, not just another number to diagnose and distribute meds.  Dr. Nag pointed out something very important at the end of our visit: most doctors are too quick to diagnose and unnecessarily prescribe antibiotics, creating resistant strains of bacteria among other problems.  He said that if we take time to really sit down with a patient and exhaust all possibilities before prescribing treatment, we could achieve an overall better state of health.

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