Ashwini Week One: 4 carb meals and Chapattifying Wildlife


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April 6th 2013
Published: April 6th 2013
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We are spending our first placement with an organisation called Ashwini, an organisation developed over 20 years ago essentially to provide healthcare and community development for the 25000+ members of the 5 local tribes. The hospital is now almost entirely managed and run by tribal workers, as are their 8 area centres. In short it is everything an NGO should be-there is a huge focus on ownership by the local population which makes it as sustainable as possible. The hospital is small but well equipped (and being expanded as we speak by the most efficient group of builders I have ever seen in my life. A large majority of which are women. Though their wooden scaffolding held together with rope does look slightly death-inducing). Extension will be much appreciated by the staff as currently the operating department is in X-ray and the labour ward is in medical records! <br style="color:� font-family: arial, helvetica, clean, sans-serif; font-size: 13px; line-height: 15px;" /><br style="color:� font-family: arial, helvetica, clean, sans-serif; font-size: 13px; line-height: 15px;" />It is brilliantly run though very different from the UK. Confidentiality is not really a concept-people just wander in and out of consultations as they feel like it. They are also far more free and easy with their sedating drugs and the hand hygiene nurses would have a field day. The 6 of us sit in a line in clinic and take it in turns to variously prod patients-not at all intimidating! However the positives far outweigh the negatives-the patients clearly love the staff, the services they offer are incredibly efficient and I like how the family are always around to care for their ill relatives-they care for them, change the sheets, keep them company. It is a lovely atmosphere.<br style="color:� font-family: arial, helvetica, clean, sans-serif; font-size: 13px; line-height: 15px;" /><br style="color:� font-family: arial, helvetica, clean, sans-serif; font-size: 13px; line-height: 15px;" />In our first outpatient week (sorry non-medics!) I saw more than I have in months at a UK hospital including acute Gullain-Barre, sickle cell crises, hookworm, previously undiagnosed Grave's disease, lots of TB and more signs than you could shake a DOSCE list at. That plus 99% of the patients have diabetes. Which is not a surprise as they put sugar in EVERYTHING. Cat literally could chew the sugar lumps in her banana shake earlier this week. Everyone seems outraged when we ask for all of our drinks without. Very bizarre.<br style="color:� font-family: arial, helvetica, clean, sans-serif; font-size: 13px; line-height: 15px;" /><br style="color:� font-family: arial, helvetica, clean, sans-serif; font-size: 13px; line-height: 15px;" />The hospital is in the most stunning location in the Nilgiri hills-a sort of Indian lake district without the lakes-surrounded by tea plantations and farms growing all sorts of exotic crops we are gradually learning the names of. And probably eating. Hard to tell. We can watch the sun set over the mountains from our porch. It is just beautiful. There is also a small town called Gudalur about a ten minute walk away which is not so similar to the Lakes-very much India!-but has everything we need including fruit to balance out our 90% carbtastic diet!<br style="color:� font-family: arial, helvetica, clean, sans-serif; font-size: 13px; line-height: 15px;" /><br style="color:� font-family: arial, helvetica, clean, sans-serif; font-size: 13px; line-height: 15px;" />The hospital was largely set up by possibly the most inspirational couple I have ever met-surgeon Nandekumar and his gynaecologist wife Shyla. They trained the nurses 'as mini doctors’ as that is what they knew-when other nurses first visited they were outraged that they could prescribe but not make the beds! They did their specialist training in the US, living in the same neighbourhood as the Rockefellers (as in of the Centre fame) with the full intention of moving back to India to work somewhere where they would be able to give back to the community. They chose Ashwini and have made their life here because they believe so completely in the project and also because they have so much input into the system-as Nandekumar says better to be the head of a fox than they tail of a lion. They have built the most beautiful house about 2 minutes from the hospital. I want to live in it. Shyla is teaching us to cook so expect lots of delights on my return! <br style="color:� font-family: arial, helvetica, clean, sans-serif; font-size: 13px; line-height: 15px;" /><br style="color:� font-family: arial, helvetica, clean, sans-serif; font-size: 13px; line-height: 15px;" />We are staying in a lovely little guesthouse about 50 metres from the hospital which is rather handy. We have a cook called Mala who I genuinely think is fattening us up for the eating. Though have just found the fridge’s resident cockroaches so perhaps that will stem my obesity! Getting pretty nifty with the bucket shower again too. There are 5 of us from Bristol, a medic from Leicester called Ali who fits in brilliantly as she is also crackers and a couple of other people who work nearby, including a doctor called Viveck (spelling debateable) who we have tasked with teaching us Tamil. This so far consists of watching a non-subtitled Tamil film about a killer elephant. Not so convinced about the effectiveness of this strategy. <br style="color:� font-family: arial, helvetica, clean, sans-serif; font-size: 13px; line-height: 15px;" /><br style="color:� font-family: arial, helvetica, clean, sans-serif; font-size: 13px; line-height: 15px;" />On the subject of elephants had no idea how much of a menace they are. We visited one of the tribal villages where they have had to move houses and people seem to get trampled (or ‘chapattified’ as Nandekumar would say) on a semi-regular basis. We walked out to one of the families deeper in the forest who have only a thatched roof but no walls and are (understandably) worried as an elephant comes close to their house every night. At one point we walked past a group of pretty excitable dogs (becoming increasingly grateful I took the rabies jab hit!) and were told to walk quicker as ‘the barking irritates the elephants and they come and chase them away’ at which point I asked, mildly concerned, if we were going to be trampled by an elephant at some point that day to which our Ashwini accompanier, the wonderful Mahantu, comfortingly replied after some consideration ‘probably not’. Found out earlier in the trip I can buy a baby elephant for 1 million rupees (about £12,500). Swiftly going off that idea!!<br style="color:� font-family: arial, helvetica, clean, sans-serif; font-size: 13px; line-height: 15px;" /><br style="color:� font-family: arial, helvetica, clean, sans-serif; font-size: 13px; line-height: 15px;" />We really did not appreciate the extent of the wildlife here. Which is pretty thick as we are on the edge of a national park. So far-and the list is growing by the day-we have been told about the leopards (which ate Shyla’s dog), Cobras (for which there is no venom antidote), tigers (they will gnaw your head), wild boars (who will gore you with their huge teeth and are known to chase the odd medical student) and, last but not least, giant wild squirrels (which as far as I know have no massive risk though chances are they have some kind of sword in their tails). Makes the cockroaches look like kittens! Shyla ans Nadekumar also own the biggest turkey I have ever seen in my life. It is about the size of a shed. Might take it round with me on a lead to fight off the leopards etc.<br style="color:� font-family: arial, helvetica, clean, sans-serif; font-size: 13px; line-height: 15px;" /><br style="color:� font-family: arial, helvetica, clean, sans-serif; font-size: 13px; line-height: 15px;" />Life outside the hospital is all very tranquil-lots of chatting (more often than not about bowels), book reading and mango shakes. We went to a wedding of one of the nurses in the hospital today. Well, I say we went to the wedding. We turned up, were served enough rice and curry to feed a small country followed by coconut milk rice pudding (epic), had many photos taken of us-seriously starting to feel like a celebrity, have perfected my royal wave-and then left. No messing. The lack of alcohol results in a pretty civilised day!<br style="color:� font-family: arial, helvetica, clean, sans-serif; font-size: 13px; line-height: 15px;" /><br style="color:� font-family: arial, helvetica, clean, sans-serif; font-size: 13px; line-height: 15px;" />We are having a party in our house tonight (obviously entirely civilised) as Ali gets her Finals results. So far there is the 6 of us and 2 other guests. Think we need to make some more friends pretty quickly…

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8th April 2013

yay!
great to hear all about it Jen, great descriptions, absolutely spot on. Oh and classic NK quote! Ask Mala for coconut pancakes- I issued her with a genuine marriage proposal subsequently (I like to think it is only the language barrier which meant I didn't get a yes). Sending you lots and lots of love, have a brilliant time xxx

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