Vaccination Clinic

(I do not know a few names and dates, so in there place I have put lines. Please excuse this. )

A collaboration of different healthcare providers in Pune, India is making a difference in the lives of individuals who would otherwise not have access to healthcare by providing wellness checks, medications, treatments, and education at little to no cost. In India, the government provides many vaccines free of charge to anyone who makes the effort to get them. Some of the vaccines, such as the Polio vaccine are very important, and so outreach campaigns will often occur in community centers to make sure everyone gets vaccinated. Unfortunately, there are a few vaccines, which the population could benefit from, but that the government finds too expensive to administer free of charge; these include: MMR, Hib, Typhoid, and Pneumococcous vaccine. In an area where 400 families share 8 toilets, diseases run rampant. The importance of preventative versus palliative medicine can be appreciated in such situations, and the inclusion of all the available vaccines to protect a child is very important. In thirteen different slum communities around Pune, ____ has decided to make some of these vaccines available at a largely reduced cost.

The vaccination clinic began on Sunday the 21st of June 2009. The morning was still cool due to the monsoon rains, which had arrived the day before. Never the less, the temperature was expected to rise to a warm 90 degrees Fahrenheit by the afternoon, making the absence of a fan due to power cuts that much more miserable. Soon around 20 people gathered to help with the tasks of the vaccine clinic. Mothers and their children began filtering to each of the tables where the different vaccines were being administered. Three vaccines, MMR, Typhoid, and Hib each had their own table with multiple healthcare workers as well as volunteers. The patients checked in outside where their health records would be checked and they would be instructed on which vaccines they needed to get for each of their children. The cost for the vaccinations was 50 Rupees per child. One of the vaccines being given costs over 500 Rupees alone so the reduction in cost is significant.

Soon the room begins to warm up as more and more people fill the floor. Looking around volunteers can be seen preparing vacc

inations, restocking supplies, and restraining screaming children whose anxiety has overcomes them. Tea and coffee are distributed to the workers as they scurry around. Each patient’s health record must be checked and the date of the given vaccine must be recorded. Some of the children get all three vaccines while others get only one. There is a wide range of emotion; some of the children seem un-phased by the screams of near by injection recipients, while others are only further convinced that what’s about to happen to them is going to be a painful, and potentially deadly experience. Over two hours pass and one can barley cross from one side of the room to the other. The noise level has maximized as infants and children both scream out of fear. There seems to be very little order or control over the situation, but each vaccine is given, decreasing the worry of a sick child in each parents mind.

The chaos subsides as quickly as it arrived. Somewhere around 300 children are vaccinated and the group begins to clean up a room which hours before was empty, quiet, and clean. The team sits down for a moment of relaxation. Everyone is given a sandwich, which is quickly devoured as talk of the next days work begins.

There are 4million people living in Pune, 70 percent of them live in slums. Public funding for healthcare is far below the countries boasting top healthcare systems. Without the work of groups such as ____, healthcare would be in a much poorer state of desperation.

Since starting work at the hospital it has become fairly difficult to find time to blog and then make it to the internet café to post. The café is about 10 min from my flat, they don’t open until 9:30 (we go to work about that time), and the power goes off everyday at 5pm for 15 min to an hour; hence the lack of posts since last Saturday.

This  week my group has been observing at Deenanath Hospital which is a very nice hospital here in Pune. They are funded through donations/trusts, and serve both wealthy and less well to do  families. The standard of care between Deenanat and Kamale Nehru definitely is different, but a single night stay in the pediatric ICU at Deenanath is ~700 Rs. while it is 5 Rs. at Kamale Nehru. This does make for a difference in the care given, but Kamale Nehur does a great job with the available resources. 

At Deenanath Hospital I spent some time in the Pediatric out patient clinic where I shadowed two amazing doctors. There were some interesting cases of ischemic hypoxia during child birth. The doctor demonstrated how the children were not meeting their neurological developmental milestones to us. Then I also went to the Emergency Department where I saw a few motor vehical accidents as well as a man who had HIV, but did not know because the family had decided not to tell him. I will address this more in depth in my next blog because it is something that sharply contrasts the US. 

We spent a lot of time working in slums this week, and today I finally took some water samples in two different slum areas. I have learned so much about what is really relevant for these people and interestingly enough it is not what you think it would be. 4million people live in Pune and 60% of them live in slums. There are around 600 slums in Pune, and around 570 of those have been recognized by Pune Cooperation, meaning that those people now own the land that they live on because they have been living there since before 2001. All of the recognized slums have water provided to them by Pune Cooperation, which means that the water for every house in Pune including 95% of the slums is all the same water. This makes my study a little less important, but I feel it is still relevant and here is why. Although the water is provided by the cooperation, people still store there water in jugs for at least one days duration sometimes more. Also the social workers expressed concern that the biggest issue facing the slum dwellers is not healthcare, or food, or water or even housing, but rather personal hygiene. There for the water has plenty of opportunity to become contaminated.

I took lots of pictures today of the people I surveyed and took samples from and then had them printed so that I can given the pictures to them. I will post the pictures tomorrow once I upload them onto my computer.

Yesterday I was extreamly ill and could barley get out of bed. I slept until 7am then again from 8-10:30 then again from 11:30-2pm then again from 4pm-7pm then again from midnight to 7am. Today I feel 99% better! Thank god for Norflox because I would still have ‘loose motions’ as they say here without it.

Be safe everyone in Colorado, I have heard about all of the tornados threatening our state these past few weeks. Scarry. Today here it rained, finally!! The monsoon was supposed to start the 7th of June and it has only rained two times this month....Crazy. SO send your rain our way because its stinkin hot here.

Talk to you later. Oh and comment! I like to hear you thoughts and thus far my dad is the sole participant.

Bye

The elders on my street hanging out around dinner time. They do this every night.

This is the post natal ward at Kamala Nehru Hospital.

What a crazy fun day! Michael’s friend Rasul picked me up at 9:30 am, and after breakfast we spent the entire day giving people pictures of themselves, most of which Michael and I took last year in January.

I started off at the hospital. There had been a c-section a few days before, and the woman had a very rare placental condition, which required an operation. Because it was such a rare surgery and they wanted to document it, I became the photographer for the surgery. I was pushed into the front row of the 20+ people in the room and began shooting the events. Today I gave two pictures to the mother of her baby right after it was born, pictures to the surgical department of the surgery as well as a group photo we had taken the day before. The nurses in the pediatric department also got pictures of my group holding a baby in the department. There were also a few patients in the pediatric department that I had taken pictures of and so I gave those images to the mothers. Everyone was all smiles and excited to have the pictures. 

When we were done at the hospital we drove around for quite some time looking for a bridge where some of the other pictures were taken. We did not find the bridge and soon went to meet the other girls for lunch. After lunch we were driving back to Rasul’s house when I saw the art gallery, which was near the market where the other images were shot. After eliciting the help of six or seven rickshaw drivers we finally found it, the dried fish and goat market! I was so happy I could barley contain myself. The people were so happy and welcoming. They recognized the people in the pictures and directed me to the woman who is sorting fish in the picture. Her reaction was priceless, I have never seen someone more excited/confused/befuddled/happy in my life (see images below). When we were leaving the man in the goat market appeared. No one had been in the market when we arrived, but when I looked in I immediately recognized him. What a great experience! I have the card of the fish market so I can easily return again sometime which would be fun. The people there all love me now, guess I am an official punite…

 

We finally made it to Rasul’s house. We had dinner and watched a bit of Spiderman III. Then Rasul and I met up with the other girls in my group to see Angels and Demons. Interesting experience to say the least. The Indian national anthem began playing, and everyone stood up and froze what they were doing. Then half way through the movie there was an intermission…. Weird.

Rasul then drove me back to the flat, and by the way, riding a motorcycle in India is perhaps the best thing in the world! So much fun.

Type at ya later,

Kymberlee

P.s. some of these pictures are from Sunday and not Saturday. I will post sundays blog tomorrow. Thanks!

My apartment bld.

She sells veggies in the market.

Sells bangles in the market.

Sells kumkum in the market near Laxmi Road

Chai wallah.

Security guard.

Man that works in the goat market.

I am really tall in India. 

Woman in the dry fish market. Muchlie in Hindi.

One of the best photos ever!!

The staff in the surgical ward at Kamla Neruh Hospital

Patient in the Pediatric Ward

Patient and mom in the Pediatric Ward

Patient in the Pediatric Ward

Baby born by Cesarian 

Rasul and his sister and her daughter

Thought you all might want a map of where I am. The first image shows the Hospital (B) that I have been going to for Monday Tuesday and Wednesday. My flat is in the bottom left under Parvati Hill.
The second image shows a closer map of the area where I am staying (Tulshibagwale Colony which is in the south west corner of Pune below Parvati Hill.) Then there is a terrain map, my street is the street below Dasbhuja Ganpati Marg all of the way to the west at the end of the street.  

More posts tomorrow!

Day 7

Tuesday June 9, 2009

Today we arrived at the hospital and were able to observe the beginning of an inguinal hernia repair, the end of a breach cesarean section, and three DNC’s. After lunch we rounded with the doctors on the cases in the Obstetrics and gynecology ward. Before leaving for the day we stumbled upon three little girls playing in a large open area of the hospital. We asked them their names in Marathi and then took our pictures with them.