Medicine in India - Emma's Experiences

So, believe it or not we are actually doing some medicine while we are here as well as shopping, eating and sightseeing! Quite a few people have asked us questions about what the medicine is like here, what the differences are and how we are finding it, so we thought it was about time we wrote something about that! Here are some of Emma’s experiences so far.

 

Us outside the hospital.

 I am working in the Paediatric department, which has so far mainly been in the Paediatric Intensive Care Unit, where the very sickest children (usually babies) are cared for.

In India the healthcare system has two divisions - the Government hospitals which are free (or a very low fee) and the private hospitals which you have to pay for. With the population of India being so huge (over a billion) and particularly concentrated in Delhi, Government hospitals are over-run. In the Paediatric Intensive Care Unit, the babies have beds the size of two tea trays side by side, which is perfect for one little baby, but one doctor told me that in the Government hospitals there can be three babies in one bed like that. Not only does that not give them any space, or the doctors any space to work, but if one gets an infection, they all get it. He had also seen things in the Government hospitals like the ventilator stop working - the machine that breathes for the baby until they are well enough to do it themselves - and the only thing they have been able to do is give the parents an oxygen bag to squeeze every few seconds to give the baby the vital oxygen it needs. It's not because of lack of care or expertise, but simply nowhere near enough resources to match the huge need. 

 The hospital we are working in is one of the cheapest private hospitals around.  As parents will do anything they can to try and get treatment in a private hospital before having to resort to a government one, it means that a lot of the patients we are treating actually come from very poor backgrounds in spite of it being a private hospital. 

Just to give you an idea of the money we are talking in this very specialised ward where I am based - a bed for a very sick baby in the Intensive Care Unit costs the parents 15,000 rupees (roughly £150) a day. That is before the cost of any treatment, investigations or operations they might need. When you think that a doctor in their second year of practicing here has a salary of 40,000 rupees a month, you can begin to see what an immense cost this is. Can you imagine the absolute hell the parents are going through, desperately trying to find money they don't have to try and keep their very sick baby alive?

Because of this, it can be at times very distressing and frustrating working within this system. The problem is I don't know where you'd even begin with trying to improve it. With the population being so vast, and poverty, malnutrition and lack of education so rife, it is a very daunting task. 

In terms of the conditions I have seen here, a lot of things are similar to those I have seen in the UK, but the presentation is often a lot more severe by the time they come to a hospital. This leads to rarer complications that I haven't really seen much before. The biggest burden of disease here is infectious disease - the quantity and range of infections I have seen is much larger than in the UK. 

Doing things like taking histories from the parents is difficult because of the language barrier. Those from poorer backgrounds tend not to speak any English. However, a lot of the doctors I am working with are very keen to teach me things and I can examine the patients and help with procedures. The Paediatric department also has teaching for everyone working there every morning, so all in all I am learning a lot. Whilst in the department, I have been really impressed at the constant encouragement to learn and update your knowledge, no matter how junior or senior you are.

There is a lot of work going on in India to try and get healthcare to the poorest and most needy members of society. This hospital is involved in a lot of it, some of which we were lucky enough to experience this week. An update on this will be coming soon, along with Michaela's experiences :)