District Hospital

Katrina and I enjoying Sugar Cane Juice outside of Big Bazaar.
No-one here has dryers, so the linens used in surgery at the hospital are laundered, and hung out on the lines.
Dr. Howard with the housekeepers in the tuberculosis wing. I'm wondering where their masks are??
These are some samples of positive HIV screening tests.
This man was a greeter at the District Hospital. He asked us to take his photograph. He enjoyed seeing his photo on our cameras.

This afternoon our field trip was to the District Hospital, which is two levels about the PHC in my last entry (we went to the hospital in between them - I will cover that later). We received a very thorough tour, and learned a lot about how the Indian public health system manages HIV/AIDS. We visited a women's AIDS ward, and saw a seclusion facility for people with highly contagious tuberculosis (we didn't get too close).

Primary Health Centre

The Primary Health Centre (PHC).This is a close-up of a much larger poster. The other half of the poster shows a woman standing beside an outhouse. This piece is part of a campaign to encourage village dwellers to defecate in outhouses instead of near their sleeping and food preparation areas.
Leprosy has not yet been eradicated in India. It is treatable. Our lecturer this morning, Dr. Lobo, is an expert in Leprosy. I'll fill in more about our lecture later - I really enjoyed it.
Here we are being shown the integrity indicator (not the right term) on a vaccine. Maintaining the proper refrigerated temperature range for vaccines is a constant challenge in India. There is a little box on this bottle of vaccine - that box will change color if temperature has not been maintained, signaling to the health worker not to use it. Vaccines that have gone bad may contain live versions of the virus being vaccinated against, and can cause death. Often health workers have to travel to villages by bus to administer vaccinations. In that case, the workers carry small coolers full of ice packs to maintain the cool temperature.

This is a sample vaccination record for a child age 0-5.

Our very first field trip was to a Primary Health Centre (PHC). These centres are the front lines in the public health system in India. Here they do some prenatal care, vaccinations and screenings, and provide other very basic level services. Most of the services at these centres, especially in the rural areas, are provided free of charge. Staff at these clinics is minimal; and on top of that there is a shortage of providers willing to take these posts. Nearly 70% of the population of India is rural yet less than 25% of providers are located in rural areas. You do that math.

*Disclaimer on my blogging from India: I want to share my experience here with friends and family, but my free time is limited. I have made the decision that I would rather post rougher entries but on a more frequent basis than agonize over my prose and only post 3 times while I am here. So if you see spelling issues or clauses that could be clearer; ignore it.

My Digs

Street cows.
Street dog 1. This dog was actually snoozing outside the primary health center. A few cows wandered by, too.
This is my dorm - the international house. We have a security guard stationed outside all day, then we are locked in (or out!) at midnight. The security company is called "Doberman." I'm 5K miles from home and people are still breedist. Anyhow - no men at all are allowed in our dorms. The male student here with our program has to wait for us to meet him out on the corner - he cannot even wait in the lobby.
The view from the 5th floor elevator area - primarily the campus.
Courtyard view when I open my door.

It is just after 6AM here in Manipal, and I have already learned an important lesson this morning - I should do all of my internet stuff in the early AM because no-one else in India works this early! Last night I experienced hours of frustration with gmail and UMD's library server (yes, I have to work on my MPH project from here in India) likely because everyone was online at that time checking their email, FaceBook, etc. But this morning - so far so good. I thought that before I do some work I would take advantage by posting some more photos.

More India Picts

This is the building at Manipal University where most of our classes are held.
Flowers at End Point park area. We've walked here a few evenings already. We go as a big group for safety.
Sunset from End Point on our first night in India.
Monday breakfast. These tasted like really eggy pancakes. Pretty tasty. Sorry Jackson - no chicken pantakes here!
We received a tour of some of the medical education facilities here. This mannequin can simulate a number of health conditions, providing practice to medical students.

I HEART India

My swollen feet on Sunday after 36 hours of travel. Now my left foot swells up in the afternoons. Can someone tell me why?
Our bus from the Mangalore airport.
Mangalore Airport.
Ugh . . . delays in Bangalore due to fog! We had delays in Paris due to a mini-strike.
This one is for my honey who loves the mango lassis!

Howdy everyone! Getting wired was a bit of a challenge, but I am happy to be able to be in touch with my friends and family, and to be able to share some of this wonderful adventure with all of you.

Our journey from Dulles airport to Manipal was so long . . . we had flight delays of many hours, slept on benches at Charles de Gaul Airport, and upon our arrival in Mangalore boarded a bus for an hours winding drive to campus here in Manipal. I got really carsick (not shocking). Anyhow, after more than 36 hours of travel I arrived in my room to find that in my absence ants had colonized my bed! The staff here on campus was wonderful and dealt with the situation, but my room reeks of ant spray. I'm thinking of picking up some incense this evening . . . but come to think of it I don't have any mosquito bites yet. Could the ant spray be providing a protective effect? This is the first time in my life that I'm not the one with the most mosquito bites!

Monday morning we started classes first thing, and I can't tell you how excited I am about what we are doing in these three short weeks. We are being hosted by Manipal University, which is in fact a world class university. The faculty here seems quite happy to have us, and have gone to great lengths in designing our program, and arranging amazing field trips. We're also having a good bit of interaction with the MPH students here at Manipal, which is providing both groups (English and Indian students) with great new perspectives on public health.

Monday morning we received a brief overview of the structure of the Indian health care system from a district health commissioner (very high up). Monday afternoon we took our first field trip to a primary care center, which is where citizens can receive many free health care services like pre-natal care, vaccinations, AIDS, malaria, and TB testing.

This morning a faculty member lectured on Global Health and poverty which was fascinating. In the afternoon we had two amazing field trips. We started off at a secondary level health clinic, which is one level up from the primary care level. These clinics serve populations of around 80K people, and generally have a few specialists on staff. We were given a tour by the clinic head and some of the doctors, and they treated us to coconut milk during our q&a session. Because as a developing nation India does not have many patient privacy practices in place (HIPPA laws, etc), we have been able to see patients in the clinics, and learn about their diagnoses. At the secondary clinic we met a little girl who has ataxia. Ataxia is a neurological disease that causes loss of balance and uncontrolled movements. Johns Hopkins University in Baltimore actually has a groundbreaking Ataxia research center which I have visited, but that kind of treatment is far far away for this little girl; there is no treatment available for her here; it was heartbreaking.

From the secondary clinic we headed to an addiction treatment center located in a private hospital. Because our escort is a very important man at Manipal University we were shown tremendous hospitality including samosas and tea for everyone. We were then allowed into a group meeting for those "in camp" (receiving in-patient treatment for alcohol addiction).

This has been such a superficial summary of my experience so far, but I wanted to get everyone caught up lickety split so I can start blogging in real time. Here are some other highlights or things I think you might be interested to know:

- The food is wicked awesome. We eat in the mess hall with the other students here at Manipal.

- I have AC and my own private bathroom.

- There are street dogs and street cows here. It makes me very sad.

- Our group includes 10 students - 9 girls, and one fella who is a very good sport. There is one other graduate student. I believe that since I am turning 31 this month I am the oldest by a few months.

- The driving here is scary. Don't even think of trying it yourselves!

- I am coping with the heat quite well. This is the BEST time of year to visit this part of India climate wise.

- I got to do a little run last night. I'm hoping to get a few of my classmates to run with me every other day or so.

- We are 10.5 hours ahead of EST.

- Facebook is blocked from the university server here - so don't look for any picts or updates there.

Namaste

Hi folks - I leave on my big trip tomorrow. I am told that I will have internet access, so I hope to blog from India. Please check the blog, and check in with CDW who will have more than he can say grace over with the pets here on the homefront.

More to be thankful for . . .

Abbi would also like to send a big thank-you shout-out to her friends Matt and Heather who both made gifts in her honor. Unfortunately it has been a little harder for us to thank folks who made their gifts directly to Recycled Love. If you made a gift to Recycled Love online please let us know so that we can thank you personally!