India: Health Perspectives Study Abroad Course

Post by Alex Carter

For my STEP project, I participated in the India Public Health May Session course. The goal of this course was to study India’s public healthcare systems firsthand, including public and private hospitals, clinics, women’s shelters, and preschools. With an emphasis on comparisons, we learned different public health strategies and solutions to similar problems based on a country’s culture and attitudes. Using this perspective, we also were immersed into Indian culture and learned how this culture affected India’s public health system.

This course has truly changed my perspective of the world and different cultures. I have learned that there is no “correct way” to do things. While cultures may have different social norms, one culture’s norms are not inherently better than another society’s cultural practices. To understand a culture other than my own, I have to examine a society in context. Often times these exercises reveal novel ways of thinking and a unique perspective on life that explains the differences between societies. Practicing this in India has made me more open to different ways of thinking and has helped me cross cultural boundaries.

Traveling to India has also made me more confident as a person. Interacting with a culture so vastly different than my own was sometimes overwhelming. However, through perseverance, observation, and patience I was able to adapt to this new culture. By the end of the course, I could successfully communicate with other students at Manipal University, navigate rickshaw price negotiations, and blend in with the people around me on campus. My success in adapting to and understanding Indian culture has shown me how resilient I am and has helped me be more confident and assertive in other areas of my life.

A middle class neighborhood in Manipal, India where our class surveyed people’s knowledge on the spread of communicable diseases, such as HIV and tuberculosis.

Several moments of my study abroad course have influenced these changes in my perspective. The most notable challenge I faced was the language barrier – while most Indians speak English, it is significantly different than American English, and I had difficulty carrying a conversation with many of the professors and students at the beginning of the course. The most striking example I experienced is when I had to visit the hospital after I had gotten sick. I was attempting to describe my symptoms and medications I was taking to my physician, but we both kept having to repeat ourselves to understand one another. After nearly ten minutes of this, the doctor said, “You have a very thick accent that makes it difficult for me to understand you.” This moment has stuck with me because, while I thought he had an accent, from my physician’s perspective I had an accent. My interactions with Indians have shown me that there isn’t a correct form of English, but merely a different cultures adaptation of vocabulary, grammar rules, and diction.

In addition to gaps in language understanding, I also had to adapt to a vastly different transportation system and social structure. My first experience with transportation in India left me rattled – not only were we driving on the left side of the road, but cars kept passing one another at 60 miles per hour on single-lane winding dirt roads around blind turns while honking profusely. There are no crosswalks to cross the road, so we had to quickly adapt to this transportation system so that we could cross the 6 lanes of traffic to go anywhere off of campus. In addition to the traffic, India’s social structure is based on the caste system. Unlike the US, minority groups are not based on appearances, but rather on gender, social class, and occupation. This subtle system of social structured is nuanced and complex, so adapting to this new set of societal standards was also a significant challenges. By immersing myself in Indian culture, I was able to learn and adapt to these different cultural norms, and the self-reliance I gained from these experiences has made me a more confident individual. 

Finally, observing the differences between healthcare in the US and India has forever altered my opinion on the role healthcare should play in a country. Healthcare faces different problems in the US and India – while the US primarily treats noncommunicable diseases, such as type 2 diabetes and cancer, India’s primary challenges include infectious diseases and traffic accidents. As such, each country’s healthcare system is geared towards their respective causes of disease. As an emerging second world country, India faces a struggling economy, uneducated and illiterate patients, and overpopulation that places a strain on its public health system. In response to these factors, the government provides free healthcare and sends members of the community out to low income areas to provide free vaccinations and education about infectious diseases and their spread. The reason these efforts have not eliminated infectious disease is due to the sheer number of people who require health services – there are not enough resources to treat everyone. However, because health care is free, health is treated as a fundamental right as opposed to a personal good. In the US, we have a private healthcare system which treats our health as a good – something to be purchased out-of-pocket. And despite America’s booming economy, when our public healthcare system is compared to other first world countries we are spending more money on healthcare but have higher rates of disease. So, while America’s public health system is outdoing India in many respects, we have several lessons we could learn from India on the importance of affordable and accessible healthcare for all.

Slums in Manipal India where we further surveyed the public’s knowledge of disease and sanitation.

My experiences in India have changed my outlook on life, which will make me a better scientist, a better physician, and a better global citizen. Collaboration across cultural boundaries is becoming more important as globalization continues to bring the scientific community closer together. I have developed the skills I need to communicate clearly across cultural divides, and this will help me interact with the scientific community across the globe and contribute to the collective knowledge of scientists through collaboration. As a future physician, seeing the differences between Indian and American healthcare has inspired me to advocate for better healthcare policies – both in the US and abroad. Perhaps most importantly, I have become a global citizen. I can relate to people who live on the opposite side of the planet and I care for their wellbeing as much as I care about my own. My experiences in India will continue to shape my world perspective as I strive to help the world not only as a physician scientist, but as a human being.

Check out my blog at https://u.osu.edu/carter.1327