Blog Hiatus

As I get deeper into my life as a PhD student I've realized that updating this blog is a lost cause. Not because I am writing less nowadays but rather because my current life revolves predominantly around writing and reading. This blog was started to help me work through my thoughts and passions and experiment with different writing styles as I went through medical college and worked as a clinician in rural Tamil Nadu. Such experimentation contributed greatly to my foray into anthropology. In this sense the blog has served its purpose and it now time to move on to another writing venues. I am however keeping all the posts that I have made so far. I continue to be active on Twitter and run the communityhealth.in and tribalhealth.org websites.

I am still passionate about clinical medicine, anthropology, community health, poetry and photography and would love to hear from you if anything in this blog strikes a chord. Do leave a comment and I will get back to you.

An Emerging Voice tours Europe

Graduate life at Syracuse does not really give one much time to breathe or blog so the last month was a welcome change. I was selected to be an 'Emerging Voices' through an essay competition organized by the Institute of Tropical Medicine (ITM) and got to spend two weeks with them in Antwerp, Belgium attending a workshop on building our research publication and presentation capacities and presenting my essay at the ITM Colloquium. My topic was on language barriers in healthcare settings in India, something I had started writing about on this blog quite a while ago. ITM also organised for us to go to the First Global Symposium on Health Systems Research in Montreux, Switzerland. I was selected to be one of the three Emerging Voices to present our views of the symposium at the closing plenary. We spent hours trying to collate feedback, develop a critique and fit it all into a six minute Pecha Kucha style presentation. The effort paid off when we received the only standing ovation of the symposium the next day, a moment now immortalized on YouTube.

As usual my camera travelled with me although I did not use it much during the actual workshop and symposium days. Most of the shots are from our walks around Antwerp and Sunday trips to Amsterdam and Rochers de Naye.

More Health For All blogs

It is heartening to see that there are now a few more blogs written by people from the Health For All movement in India. Their blogs are slowly beginning to collectively represent the different issues and arenas that health activists work in, from the challenging ground reality of providing health care in rural India to the often esoteric world of health policy.

fieldnotes by Dr. Ramani Atkuri talks about the realities of practicing medicine and doing community health work at Jan Swasthya Sahyog, a unique hospital and community health project in Chhattisgarh.

Stories on Poverty and Rural Health in India documents an attempt by Dr. Johnathan Fine, an American physician and human rights activist to probe into the structural issues that surround poverty and ill-health during his visit to Jan Swasthya Sahyog, Chhattisgarh.

dip tinking is a personal blog by Dr. Dhruv Mankad, a doctor and health activist who has done a lot of work on training community health workers.

Right To Health Care is a blog by Dr. Ravi Duggal, who has worked extensively in the area of health financing in India.

However, conspicuous by their absence are blogs by younger Indian health activists, a group who you would assume would be more comfortable with online media.  It is difficult to hypothesize why this is so. Is it that the younger generation has nothing to say or is it that they are still struggling to find the language and context within which they can express themselves?

The New Anthropologist and Johnny Lever's Hospital

On February 1st, I joined a UCL-BALM research unit in Chennai as a research assistant studying stigma and mental health. This transition is an exciting one for me, since it marks the beginning of my work as an anthropologist. In the introduction of his book Global Health, Mark Nichter, a public health anthropologist who has worked extensively in Tamil Nadu writes about the problems of translating his profession into Tamil and solves this difficultly by calling his discipline 'anubhav shashtra', the 'science of experience'. This is very close to my own idea of what an anthropologist does. I aim to transition from a clinician who is an expert at experiencing patients to a hospital ethnographer who is an expert in experiencing clinicians and clinical care. I hope to look critically at how knowledge and understanding is created in the clinic by different members who inhabit it. I especially hope to explore how non-English speaking patients construct an understanding of 'English Medicine'. All this will involve me look at intimately familiar environments with a fresh eye and I start this endeavor with a reference to someone else who seems to have wonderfully fresh take on the Indian hospital. Presenting the comic genius of Johnny Lever.

MFC meet at Sevagram

Thanks to my recently accquired Canon EOS DIGITAL REBEL XSi I have been a happy shutterbug this month. Check out my debut photos from the annual meet of the Medico Friend Circle in Sevagram.

The Medico Friend Circle (MFC) is a group started in the 1970s that has functioned as a sort of 'intellectual critique central' of the health movement in India. Meetings are held twice a year with all members sitting on the floor in a community circle. The content can be frustratingly impractical to the new comer at times, with hardly any actionable points coming out of two days of deliberations. However old-timers will point out that this is exactly what gives MFC its appeal. It is a place where activists and health professionals who spend the rest of the year working with the practical realities of health in India can indulge in two days of networking and free for all intellectual debate on their projects and ideas. Everyone goes home the richer.

My poems on Ultra Violet

Two of my poems have been featured on Ultra Violet, an Indian feminist blog. Do check them out. And do leave an nice interesting comment. I'm at the point when I need someone to be objective about my writing.

Huddled together

When it rains we the kind

Get wet. Our umbrella is not

Big enough for two.

When it stops we the kind

Get sick. Our dampness is what

Causes us pneumonia.

During sickness we the kind

Get poor. The local hospital

Is not a charity.

Faced with hunger we the kind

Get mean. Our bodies curse

Our moral self.

When it rains we the mean

Remain dry.

http://www.flickr.com/photos/freemind/ / CC BY-NC-SA 2.0

Exploring health with the wind in your face

My friend Varun Kumar recently got bitten by the community health bug and decided that he needs to  get a better understanding about what working for health really means. Being of the adventurous sort, he has decided to go on a bike ride across the country, visiting community health organisations along the way. One of his interests is in how mobile phones, which now seem present in even the most remote hamlets, can be used for health work. His corporate background is evident in his well presented maps of the proposed journey route. You can follow him on his blog  http://journeyofvarun.blogspot.com.

AlJazeera on health care in rural India

I just chanced upon this video on the state of health care in rural India by Al Jazeera English. For a network which is new to covering India they have produced a remarkably balanced report. In a span of a few minutes they give us a glimpse of India's huge burden of common yet potentially deadly infectious diseases such as diarrhoea, the worry and hardships faced by poor rural patients, the ailing government health care system, the frustrations of a doctor working for low pay in a remote area, the corruption within the system, the health movement with its activists and the private medical industry which is far away from all this reality.

Kudos Al Jazeera.

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.