Week 2 in Gudalur

WEEK 2

Wednesday 17^th August 11

So I really am not doing well at keeping this blog up to date! Its half way through week 3 and I am only just uploading my blog entries from week 2! Sorry!

MONDAY

Our second week was great. Monday was relatively uneventful but in the evening we had a cooking class with Dr Shyla at her and Dr Nandukumar’s house. It was lovely, and the food was delicious! We made a chickpea curry with this bread called puri – which you have to deep fry in lots of oil- but is just so good! It is quite an art to get them to puff up just right, you have to keep pushing down the little air bubbles that develop in them and then let them go and the whole thing puffs up. It is hard to explain, but Julie was really talented at it!

For dessert we made something called Bison(?), which is vermicelli in milk and cardamom…heavenly! I will definitely make it again back in England! It was also really nice to be invited to the doctors’ house and to hang out with them- I have never really had that sort of relationship with any doctors I have worked with before. We have also got to know a lot of the staff at the hospital as its quite small, which is really nice. A lot of the nursing students come to yoga and we are now friends with them…well as friendly as we can be in that they don’t speak much English and we don’t speak much Tamil! It was hard to break the ice as they are all quite shy but at Tuesday’s yoga class there was an incident of confusion over a yoga mat between one of the nursing students and myself, which left her feeling very embarrassed! She looked so sweet I gave her a hug and since then we have been friends and smile at each other in the corridors. I think her name is Shoba or Shober…I need to check with her again tonight at yoga class!

TUESDAY

So Tuesday we had yoga but we didn’t do very well as we were so tired from our day of trekking from village to village! Basically, the hospital serves many different tribal villages and the Karnatakan tribe live deep in the jungle. In order to reach these people the hospital runs an outreach mobile clinic each month as near as possible to serve the maximum number of tribal people. In addition to this, one of the Karnatakan people has been trained by Dr Nandukumar and Dr Shyla to act as a health animator. It is his job to visit the various villages once a month to see if there are any problems, check on the nutritional status of the children, the health of the sickle cell patients and to ensure patients are taking their medicines. His name is Sree…something. It’s quite hard to pronounce so he gets every one to call him Parsu. Everyone calls him Parsu the Great. And he is! He is a very small, very funny man and we spent the day with him on Tuesday while he did his village visits.

He is the man on the right.

It was really interesting to see how the Karnatakan tribals live. They were very welcoming and let us see inside their houses. Although their homes are in such a lovely setting- amongst the natural beauty of the jungle, they are quite small, usually just one room, with no windows.

About 10 people, usually 2 families, live in each house and they cook indoors on an open fire. Because there isn’t much ventilation – it can get very smoky. Most of the women and children were at home and some of the men, but many of the men were at work. Many of them work as tea pickers on nearby plantations. The women and children seemed quite bored and many of the women chew beetle nut to pass the time. We did a lot of walking and so were pretty tired by the end of the day, but a real highlight was eating lunch on the grass high up in the hills looking over the spectacular view.

WEDNESDAY

Wednesday was a very exciting day medicine-wise. We had a day of surgery at the hospital. This doesn’t happen often, only once or twice a month depending on the number of patients, as the hospital doesn’t have an anaesthetist, so an anaesthetist has to come from another hospital. We had a visiting anaesthetist from Bangalore on Wednesday and there was a theatre list of 5 patients, 2 female sterilisations, a breast biopsy, haemorrhoids surgery and a skin graft. The skin graft surgery was the most fascinating, as I have never seen one before. The patient was a young lady in her twenties who had been cooking on an open fire and had backed into it. She had very severe burns to both her legs. This is quite a common problem here as most of the tribal women cook using an open fire and tend to wear synthetic nylon saris, especially in the monsoon season as they are quicker to dry than cotton…cotton NEVER dries here! You may remember I told you about the other lady last week whose sari had caught fire whilst cooking and who had burnt her entire chest and neck. She was also due to have a skin graft on Wednesday but she was too scared and decided not to have surgery. However the lady who did have the skin graft is recovering well and the grafts have taken. They are worried she has developed an infection and we took swabs for culture yesterday, she has been started on antibiotics and hopefully she will overcome any infection quickly so that the grafts aren’t affected. Mona took photos of all the stages of the surgery and is photographing the recovery process and plans to do a photo diary, when she does I will post the link.

I got to be first assistant in the second female sterilisation surgery, and I really enjoyed it. I even got to close at the end, which I have never done before. I have only ever practiced sutures on foam models and tablecloths, so I was very nervous, but I think I did a good job!

Thursday we had outpatients and we managed to recruit lots of pregnant women to our study, which was good. At lunchtime a performance group that work for the government promoting HIV awareness came to the hospital. They set up their van and speakers outside and there was a band playing music and singing about HIV whilst others danced. One of the dances was very strange and involved them dancing with pots holding plastic parrots on their heads, but I later found out that this was a traditional dance of the region! It was really entertaining and drew a large crowd of tribal and non-tribal people. It was a really effective way of educating people about HIV and reducing the stigma. They also handed out colourful leaflets to all those watching with more information. I was really impressed. 

 
Thursday was also the day of our last yoga class with Mahesh. He is the Ayurvedic doctor who I told you about who is also great at yoga and has been teaching us every other day. He only spends half the month here in Gudalur, the remainder of the time he spends in Bangalore. But I think that he has taught us well and enough to keep going with our practice. We have arranged with the nurses to continue to meet every day at 5pm to practice together.

Mahesh reluctantly agreed to let us have a photo with him as it was our last class!

FRIDAY

I managed to write quickly about last Friday, we spent the morning at a newly developed school for tribal children who have been made to leave their previous schools for a number of reasons. We did health checks on all the children and it was really fun to spend some time with them. The main problems were bad dental hygiene, mild ear infections and scabies. There was a lot of scabies! Scabies is a mite that spreads easily and causes lots of skin itching. If one person has it you treat all their close contacts as they probably have it too. So we treated them all for scabies. They were really sweet and they loved having their pictures taken by us on our digital cameras and then looking at them. Dr Mrdula also gave them a talk about good dental and general hygiene and then they sang us some songs, which was lovely! They then wanted us to sing, so we taught them wheels on the bus and heads, shoulders, knees and toes. It was a really good morning. We came back to the doctors’ mess for lunch and set off mid-afternoon for our long Independence Day weekend in Cochin, Kerala. It was a LONG drive. But well worth it! Next entry will be about that! Bye for now :)