Thursday, September 24, 2009

Snapshots of a doctor in rural Tamil Nadu

A few days ago the our health minister announced that that doctors will get better pay and 10% extra marks in competitive postgraduate entrance exams for every year spent working in a rural areas up to a maximum of 3 years. The proposal may not address to problem of the severe shortage of healthcare personnel in rural areas completely but it is indeed welcome news.

But what does working in a rural area actually mean? I spent two years working and taking pictures at the Tribal Health Initiative in Sittilingi in the Dharmapuri district of Tamil Nadu. Here are some snapshots.

Rural Tamil Nadu is beautiful.

This is the view from the kitchen window of the cottage I stayed in while working for two years at Tribal Health Initiative in Sittilingi, Dharmapuri District, Tamil Nadu as part of my rural service. Students from St. John's Medical College in Bangalore have to spend the first two years after graduation in one of the college's 400 recognised rural bond centres or pay Rs. 3,00,000 (Rs. 6,00,000 for the current batch).

The work is rewarding.

Apart from the three doctors and a couple of technical staff Tribal Health Initiative is run exclusively by people from the local community. Here is one of our health workers the day after the birth of her son. She was delivered by fellow health workers all of whom have grown up in the villages surrounding the hospital.  She had her baby in the sun when I came for morning rounds and we all shared her joy.

You might just get to live in your dream house.

I lived on the hospital campus at the edge of reserved forest land with a small stream a few metres away. My cottage had a small kitchenette, a shower and a high speed internet connection. (thanks to BSNL WLL technology). More than I could have asked for. Meals were in a common mess for all staff who stayed on campus.

You get chances to do surgery.

I learnt more in the two years I spent working with Dr. Regi and Dr. Lalitha than in all six years at college. One of the advantages of working in a rural hospital is that senior doctors have the time and patience to teach you unlike the competitive, hierarchical atmosphere of a city hospital.

You get chances to visit patients at home.
Every doctor should try this. If you visit your patients occasionally at home then you immediately understand what is making them sick and you realise that many conventional remedies are quite foolish to say the least. Practicing medicine also becomes a challenge when you realise that most patients can't read time, read labels or even begin to understand the nature of the medicines you prescribe.

You work with a dedicated, highly skilled team.

The health workers at Sittilingi are all drawn from the local villages and are predominantly from the Malavasi tribal community. I have never seen more competence and dedication. Our neonatal unit has a high success rate only because of the energy put in by our health workers in 24x7 one on one care of sick babies.

Things get scary occasionally.

A city boy like me had to get used to the occasionally enormous, allegedly poisonous spiders that used to sit nonchalantly on my cupboard door. My room was closest to the forest and a sort of immigration desk for snakes, scorpions, spiders and suchlike.

You learn about a different culture.
Living in Sittilingi meant I also saw a part of India I missed in the city. Pongal is one such amazing festival with anticipation building up for months before the actual date and the actual festivities being dissected for months thereafter.

You become family.

Being on duty 24x7 for a month at a stretch means you really get to bond with your staff. We worked, lived, ate and joked together and there was never a time when my inexperience and bad Tamil got them visibly  impatient. Here they pose with the newborn of another fellow health worker they helped deliver. Their pride in their work is obvious.


Ashwani K Gupta said...

A Road less travelled...kudos to you DS.

Mridula said...

Hats off to you Lalit.

amreekandesi said...

Wow! Where most doctors curse this rural posting curse, your post comes as a whiff of fresh air.

We need more doctors like you! Keep up the good work :)

Nisha said...

Way to go, Lalit ! Thanks for reviving the enthusiasm.

Khalil Sawant said...

Nice Spider :D

harini calamur said...

great post and great snaps - thank you :)

clash said...

wow, the blog has an interesting name. no, i am not stopping there, it has an interesting perspective and i thoroughly enjoyed this post.

Lalit Narayan said...

Wow! This is the most comments I've ever got. Thanks everybody. And thank you for the link.

GCP Training said...

Nice. Keep up the good work. Great Snapshots btw...

Cass said...

this is awesome!!!!! you truly enjoyed your time there & boy-oh-boy does it show...

if i was a doctor, i'd definitely be inspired to drop eveything & head to the neares village.

Anonymous said...

thats a great work lalit newer pride to be a doctor..keep up the good work doc...

Kalleda05 said...

This is great work! So glad to see someone actually living the dream and not giving in to so called 'conventional wisdom' and paths that we are all pressured to take. Keep it up!

Parvathy said...


Stumbled upon your blog while doing a research on rural health care workers. If its not oo much trouble, could I have you e-mail/Skype Id. With the kind of experience that you have chronicled in your blog (w-ow!), you would be of great help!

My mail id-



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