CFHI – 2-week Public Health Internship in New Delhi

 

My STEP Signature Project entailed a two week volunteering trip to New Delhi, India. We visited non-profit organizations that catered to various issues in the society like cancer support for the low-income class, TB prevention programs, needle exchange program, HIV/AIDS prevention, etc. We also shadowed the local rural clinics to gain perspective about the Indian health care system.

 

Visiting the field and observing the environments that the healthcare professionals and patients dealt with was eye-opening. It is unbelievable to see the barriers that patients have to encounter to receive proper healthcare. This changed my view because it was difficult to understand that the healthcare system had totally different problems than the issues that we face here in America. For example, the physicians in India rarely asked for the patient’s consent as we observed them, in fact, the doctors openly talked about the patient’s medical records to us. This was shocking because in the US we have the strict policy HIPAA but this did not exist in India. Although this made me realize that India had its own separate set of problems in medical care. For example, lack of education, lack of funding and sustainable treatment are just a few to name. Therefore, this trip made me more culturally competent and I became more aware of the problems that the population of India faces every day. I also realized that just one solution is not enough to solve the healthcare problem in India, there needs to be a culmination of resources to provide proper healthcare like funding, a safe environment, a fair government, and sustainable living.

 

There were multiple events and shocking and humbling experiences that led to a life altering STEP experience. I went into this program with an open mind and ready to help anywhere and any way the population that we would be serving. When I arrived in India, I was dropped off at my accommodation and I had to figure out my own way of getting familiar to the environment. This taught me early on to build relationships with the people that I met through the program. I learned to adapt and find comfort in my new environment.

We began our volunteering trip by visiting a Cancer Support Center in rural Delhi. This place provided free support or a minimal fee to patients suffering with cancer. There were five volunteers on this trip and we were all cramped in the tiny clinic room with the doctor as patients entered and left every five minutes. One of the patients that walked in had a great impact on me. She walked in with her head draped with a sari and head ducked down as she entered. As she sat down she looked around and began to explain her husband’s worsening cancer to the doctor. As the doctor took notes, her voice broke and she looked at me. I could see tears in her eyes as she spoke to me in Hindi, “I have so many problems, my husband is sick all the time…there are just so many problems”. At this point I froze for a second and put myself in her shoes. Her husband must have been her main source of income and now he was suffering through a debilitating mouth cancer. She had to pay for her husband’s medications, take care of her kids, and handle her own job as a home caretaker. Keeping this in mind, I reached out to her shoulders and looked her in the eyes and said, “Sab theek ho jayega” which translated into “Everything will be okay”. The truth was I didn’t know if her husband would get better or if her money problems would finally resolve but I did know that she needed hope and positivity at a time like this.

This experience opened my eyes to the real population of India and the struggles that they went through to gain healthcare. I realized that even in the face of so much hardship it was important for them to keep a positive mindset because there was no other option. I also realized that every healthcare system is different and it also depends on the political, economic, and social issues of the nation.

For example, I noticed that just having the right medication for a disorder was not enough. In medicine, I have been taught to think that the basics of healthcare is that medication is the key to any kind of sickness or disease. But my mindset changed when I visited Sharan, a needle-exchange program in Delhi. Here, they also offered buprenorphine as treatment for opioid addiction. We also walked around the park where most of the population consuming opioids resided. The park was strewn with bottles of a certain over the counter drug called Avil, which they used to get high. As we walked further into the park we saw men laying on the grass, sleeping, some seemed to be in their own high as they rested their head in their hands. This was a terrifying sight because seeing this problem in person, I wanted to help each and everyone one of them. I felt helpless at this moment as I passed through the park. When we spoke to the doctor at the Sharan clinic, we asked her how well buprenorphine was working for the population. We were shocked by her answer as she candidly said, “It’s not working. It is not looking good for this population and this is all that we can do.” I was stumped at her response. How could they just not know what to do? In the healthcare field, it is our aim to find the solution to a problem. That is the reason I want to become a doctor and knowing that there was no solution this problem bothered me. This was a learning experience because I learnt that every issue did not have a solution, in fact, even though there was buprenorphine available it was not working. This was due to the multiple factors that came into play like low government funds, no halfway homes,  and no proper education. This was a transforming experience because I was forced to face not just the harsh reality of the opioid crisis but the struggles of the Indian healthcare system in general.

This is a picture of the other volunteers and I at a non-profit that helped outcast women with vocational training. They dressed us up in saris and that they had designed and made at the center.

This experience was transformational because I got to apply everything that I have learned in the classroom in real life. This helped shape my view of the healthcare system in India and I got to learn a lot about the medical field. As a future physician, this trip was key in understanding all the other factors that affect the quality of healthcare, most importantly, I realized that even having the cure in the form of medication is not enough to resolve diseases. Therefore, I learned that it is important to take account a patient’s lifestyle and their social and economic issues while treating patients.

I also learned that in the face of adversity and even when it seems like there is no solution to a problem it is never okay to give up. Through the doctor at Sharan, I realized that it is still important to have hope and wake up and show up to your job despite knowing that it may not resolve the issue or cure someone.

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