Village Life

Vanakam Readers,

As stated in my posting from yesterday, I'm rotating through CHAD this week. The last few days have involved mobile clinics that travel to villages around the outskirts of Vellore. On Wednesday we went on nurses village clinics. During these clinics we travel with a nurse, a health aide and any number of students (we had one nursing student). We were accompanied by a male chaperon who was also our driver. We went to 5 villages during this day and visited a number of people. Most of the cases we saw were either prenatal or postnatal. In the prenatal cases we examined the expectant mothers and in the postnatal cases the cute babies (papu!).

The landscape around the villages was breathtaking. Palm trees and overwhelming greenery with mountains was our backdrop. When we arrived at a home the women would pull out mats that looked like they had been weaved from palm leaves. Most people in these villages don't have furniture, just a few plastic chairs. If they are wealthy they might have a nice wooden table with chairs, but still sit on the floor to eat their meals. The women would lay on one of the mats so we could examine them and then we would sit on the other. The nurse did a quick prenatal exam finding the papu's (baby's) heartbeat with the stethoscope, something accomplished in the States with a sonogram. A main part of the nurse's job is to educate the women. Like in other cultures with poor education they have many beliefs that can actually hurt a baby. For example, some believe that they should put cow dung on the papu's umbilical stump for faster healing or that they can start giving their papus cow's milk soon after they get home from the hospital. Something else I learned about is that during their last trimester the women move from their in-law's house (they live here with their husband after marriage) to their parents' house. However, the husband is not allowed to move with her. This causes a lot of marriage problems for the families.

I was most struck by the hospitality of the people. They invited us into their homes and sometimes it seemed like it was an honor to have us there. Most would offer us cool water, but we were forced to refuse for fear of getting sick. At one home, the husband went and cut a coconut so we could drink "the most sterile water in India"! This society emphasizes sharing even if you don't have much. During lunch all of us health workers ate in a daycare center while the children took their naps. We sat in a circle (on the mat covered floor) and after separating a portion of the lunch each individual brought they then placed the rest in the middle. Needless to say my cold cheese sandwich wasn't a hit and I ate it all.

The Doctor's mobile clinic was different. We went on an old bus that had been converted into a clinic. It had an examining table without padding, a metal desk, three small fans and no A/C! Everything was nailed to the floor. During these clinics we went with two doctors (an attending and an intern), a nurse, a health aide, two nursing students, and two drivers. We saw both prenatal patients and patients with chronic illnesses. The prenatal visits were like most others. At CMC they don't routinely provide ultrasounds for all mothers, but reserve it as something for high-risk patients. The women are required to bring their prenatal care cards to every visit. These cards have standardized the care of the women and make taking care of such a large number of cases a little more simple. The patients with chronic diseases also had cards. Most of the cases of chronic disease we saw were seizure disorders. I'm not really sure why, but there is a large number of these in the area.

Overall, I haven't been able to do much, because of the language barrier. The less well educated people of the villages only speak Tamil. This makes any sort of communication very difficult. It's amazing to see how far a smile will go. Mostly were looked on as sort of a spectacle. People value being light skinned very much and consider us beautiful just because of the color of our skin. They are baffled when we tell them they are beautiful too.

This weekend we will be heading to Mamallapuram a city with beautiful Hindu temples.