Visit to the Villages

Today, we visited a small nearby village. Our goal in visiting this village was to see some of the low birthweight infants that have been born at our hospital over the last 2 years. Low birthweight is any infant that weighs less than 5 lbs at birth. There were 4 children from this village. We were only able to find 1 of them. But, when people found out we were there, many wanted their children to be seen. We saw about 15 children and the same number of infants. We set up clinic outside under a tree. We did measurements and vital signs. We assessed for malnutrition. Most looked healthy. There were a handful that were malnourished, but none severely malnourished. We did refer several to the hospital for respiratory problems, diarrhea, malnutrition, and a child that had yellow eyes and a fever. Since it was 113 degrees outside, I thought for sure we would find more fevers! Loved the village visit. Planning to do an another one next week!

Day 1 accomplishments

Held two in-services on using the Open Warmer in the ICU. Had great attendance. Hands on and Return Demonstration.

 

Held 2 in-services on hand-washing. Had great attendance. Demonstration and Return Demonstration. There are no sinks in the old part of the hospital. I spoke to the hospital administrator about putting hand sanitizer in each room. He said the nurses can just bring it with them. Will have to audit.

 

Made 2 bulletin boards on hand washing.

 

Set up an emergency cart for the ICU.

 

 

The Caste System

In India, there are 4 Caste's. The highest Caste (Brahma) are the elite Caste - wealthy and well educated. The lowest Caste is know as the "Untouchables". The Untouchables are very poor, not usually educated, and considered "dirty". They are the ones that live in the blue tarp slums you see on TV. The government as made an effort to equalize the huge societal divide. They have mandated that a certain number of "untouchables" be accepted to colleges and in to programs that, in the past, only Brahma's have been accepted in to.

Our new OBGYN is an  "untouchable". He looked and looked for a job in the City where he was from, but no one would hire an untouchable. I applaud our hospital for being willing to help these people be successful! The problem is, people don't trust untouchables and don't want them to be their doctor.

How do you break this cycle that India has created?

Conflict of Interest

We have a newborn baby (actually, lots!). But, when we rounded on one of them yesterday afternoon, the mother complained that the baby was not eating well, and had not had wet diapers. The nurse said the baby had a fever. I asked what the temp was, and of course, she hadn't taken  it. Tactile fever! :) So, we took the temperature, and it was 102.4. I asked her to notify the doctor and he said to give Tylenol. I rounded again last night, and the temperature was 103.2. I told the nurse to call the doctor. This time, the doctor said to give the baby a cold bath. That's all fine and dandy, but it does nothing about why the baby has a fever. Being from the western world, I was very concerned and felt the baby should be treated for an infection. That can be serious in a newborn. This morning, I explained it to our doc when he arrived. He agreed with me. We weighed the baby and the baby has lost weight. Normal within the first few days of life But not when you only weigh 4 lbs to begin with, you're not eating, have no urine output, are irritable and still have a fever of 101. Unfortunately, not our hospital. Dr. Jha feels like the baby has a fever because it's 115 outside. Healthy infants can still maintain their temp. I don't like it, but the baby was sent home. One more down.

Being a Tourist

I have been to India 3 times in the last 7 months, and have only seen the Hospital. I decided, on this trip, I should venture beyond the borders of Mota Fofalia, and see what other people come here to see, The Taj Mahal!

The Taj Mahal is the resting place of the 3rd wife of Shah Jahan and is known as a "temple of love" because of that. Shah Jahan was married to 2 other women, but the 3rd wife is the only one that provided him with children. I feel sort of bad for the first 2 wives, that are buried outside the walls of the Taj Mahal. Plus, Shah Jahan's son imprisoned him.

Regardless of those facts, the Taj Mahal is incredible! It is one of the most beautiful buildings in the world  and truly a world wonder! Even seeing it in person, it looks absolutely unreal!

On this journey, we also saw the Agra Fort (where Shah Jahan was imprisoned by his son for spending too much money), the monkey temple, The City Palace in Jaipur, the Wind Palace and took elephants to the Amber Palace. All incredible sites.

I also had one other interesting experience in Jaipur. I got a full body massage. And when I say full body, I mean full body! No part of you is untouched! The human body is sure seen differently in different parts of the world! :)