CHAD

It's been quite a while since my last post and so I will have to enter a couple entries together. Last week I worked at CHAD (community health and development). CHAD is a part of CMC. The goal was to have a community hospital to offer basic care to those who couldn't afford to come to the main hospital. In addition, they provide service to people living in the surrounding villages who cannot make it into the center of town. In total they cover 63 of the surrounding villages. CHAD has many different programs. There are many different aspects of CHAD; it is a hospital, an outpatient clinic (actually many different outpatient clinics), it holds doctors and nurses rounds in the local villages, there are patient educations sessions, and it also has community development projects (like skills training, daycare centers).
CHAD's website if you want more info: http://www.cmch-vellore.edu/departments/services.asp?did=6

This past week I took part in the outreach activities for CHAD which included doctor and nurses rounds. I can't remember the exact break down but I'll try to make it made sense. So for each village there is a part time health community health workers (PTCHW) who is a local village women. The PTCHW is then under the supervision of a health aide who is also from the village and I think covers 1-2 villages. They then under supervision of a community health nurse who covers multiple villages and monthly a mobile doctor led clinic will go out to visit these areas. During nurse rounds the community health nurse goes out to visit 3-4 villages. She meets with the health aide and PTCHW in the village and they let her know the patients that she needs to see. Each patient is seen at their own home. Most of the the care is antenatal/postnatal visits and chronic medical problems treatment The nurse also visits the Balvadis (I have no idea if this is how you spell it but it means daycare). Patient education is also a very big part of nurse rounds.

Doctors rounds are a mobile clinic that goes to the village and then the patients come to the mobile unit. Inside the bus is an area where the doc sees the patient with a patient table and the other half of the bus is set up for a pharmacy and is also where the nurse gives vaccinations. The last part of the clinic is outside and is a table where the intern sits and sees the patients they only see the doctor if she has any questions about what to do. The doctor also sees the antenatal patients. The cutest part of the clinic though this the scale they hand from a tree to weigh the babies in. It is a little pouch that they lay the babies in with a scale attached. It is the cutest thing (sorry, I didn't get any pictures).

I didn't see anything really crazy to write home about. We saw quite a bit of diabetes which I was surprised about at first and then someone told me it had to to do with the diet of the people here and the it completely made sense (lots of rice and other carbs). We saw your regular hypertension and surprisingly there were quite a few cases of epilepsy. I'm not sure if it is more common here. I think it is just that the people who come to these clinics are the people who require long term medications rather than the general population. Rheumatic heart disease is more prevalent in the population and so there where quite a few patient we saw with this condition and we got to hear a few murmurs.

The best part though of doctors rounds was weighing the babies and playing with super-cute kids.

Nurses rounds have been one of my favorite parts of the trip and so they deserve their own special blog...more to come later.

On a less academic note.... Another cool think we did during last was visit the Golden Temple. It is a pure 24carat gold Hindu temple on the outskirt of Vellore. We were told that the best time to go was right before sunset. So a group of us headed out there in the evening. You cannot bring your camera so I don't have any pictures :( In addition to no camera you cannot wear any shoes. This of course makes sense because it is a temple but you cannot wear shoes any where on the property. This meant no shoes from the time we entered the gate. Once you entered the gate you had to check your bags and then you had to go to wait in line to be let into the temple. Luckily the line was "short". They basically have theses cages with chairs. They fill one cage up, and then shut the gate and then open the next cage and start filling it. They then open the door to one of the cages and let that group out there is a waiting period and then the next group is let out. And since it is India it there is tons of pushing and everyone is all up on you. It reminded me of the movie "Children of Men". The temple gardens were beautiful. There was a path that encircled the temple in the share of a star that you had to follow around. The whole time you could see the temple as the sun was setting and the mountains behind. It was really incredibly beautiful. Although knowing the poverty that surrounds it makes you a little sad although they said they spent all this money on the gold so that it would bring in people and would provide money for the community...hmmm.
Pic 1: the bus for doctors rounds
Pic 2: Nurse Blessing at the pharmacy window with all of the different drugs they hand out.
Pic 3: Colin and Blessing trying to keep a baby from crying before she gets a shot.
Pic 4: Cute kids. The little girls in the white was hilarious. She would imitate everything Colin said down to his facial expressions. It was so cute and we got some great video of it.
Pic 5: A little girl and her mother with black dots on her face to protect her from the "evil eye"
Pic 6: Me (in one of my India tops) and this girl who followed me around the entire time we were there. She didn't really speak English and I speak only a work or two in Tamil.
Pic 7: Random goats eating the flowers off of the jeep that was parked near us. Animals roam everywhere here even in the middle of the city.