Wednesday 5 April 2017

More memories

The mobile unit team 




"You'll never know unless you try"- Terese Jose 


Sweet Sumithra ma'am 


9th and 11th March ~ Jeeping into the forest

Finally we were set to go to the "podus" (which are tribal settlements) in the mobile health unit, a jeep that I've mentioned in my previous post. This travels 3 days a week to 3 podus. The idea is, there are totally 9 podus around the region among which 6 of them are pretty close to the VGKK hospital and hence tribal people from these settlements access the hospital themselves. But the remaining 3 are quite interior in the forest and hence the mobile unit travels to these places to treat the simple ailments of the people there. No other public vehicles are allowed to travel into these settlements and hence we felt lucky to see the interior of the forest, hoping we'd come across some elephants too.
We'd stop the jeep in an area where the people would come with their problems. We checked the BP of all the adults who came and found some of the readings high. They weren't known cases of hypertension, which made me think, if some kind of screening would help them to be diagnosed early and treatment started.
In one of the podus, a small boy and his sister were asked to take us to their temple "dodda sampige". The tiny boy kept running down and up the contours of the hill to take us there, forgetting to see if we could keep up to his pace. Luckily his sister, who was a little older than him was keeping a watch on us :)
They led us deep in the forest to a big tree which was their worshiping place. It was a treat to the eyes. This was a very peaceful place where all one could hear was the leaves we stepped on and the happy stream running. There were bells hanging high and low considering both adult and kids who would want to ring them, rocks which were covered in vermilion.



These were our cute little guides 
In another podu, a 2 month old baby was brought for cough and cold by it's mother and grandmother. The baby had tachypnea and chest indrawing due to difficulty in breathing and looked like it needed immediate care for pneumonia. Hence we scared them to make sure they ran to catch the bus to the hospital and were happy to see them waiting in the bus stop while we left that place.
On our way back, right when we were discussing that all we got to see of the elephant was it's turd, we found one elephant near some water, a tusker! That completed our feeling of a ride in a forest. 

That evening we went to the hills by steps because Dr. Akhil took us there. Puffing and panting, we some how made it to the top and then realised why he took us there. The sunset was amazing. It was like an orange ball falling into a green carpet. None of the photos could capture it well enough to do justice. We bet on the time the sun would take to set and it sank twice as fast to the smallest time we mentioned and thus the day ended. 

7th March ~ Tele-medicine

This day kicked off early with some exercise thanks to the little pact we made where one had to sit up from sleep as soon as the other called their name .We took the road instead of the steps up the hill to reach the temple on top. The temple was a usual one but the view on the way was a refreshing one. On the way back we got some yummy dosas that we were told about earlier.

It was my friend's turn to go to the PHC downhill, so I went to the OPD at the hospital as usual. A man was brought that day who was too weak to even walk with a history of severe headache and vomiting. Since his BP was on the lower side, we started some fluids and took a detailed history. He was operated a year or 2 ago at JSS for a tumour in his brain. Don't know the exact details of the tumour or the surgery as they had not carried any documents about the same. They said they were asked to follow up for a repeat MRI at the same hospital after 6 months but failed to do so due to financial reasons. So we thought that the current symptoms were probably due to raised ICT maybe due to a recurrence. Then we started figuring out where and how to refer them. For every option that we suggested they would have their reasons. Even when government hospitals were suggested they humbly said they'd need money to travel and stay in the hospital plus they would be prescribed medicines to be bought from outside which would again not be affordable.
That's when the medical officer there, Dr. Akhil, pointed out the potential of tele-medicine in such circumstances where the patient can't afford the travel charges and hospitalisation in a different city. What if we could have gotten the MRI done and took a neurosurgeon's opinion regarding the management through a phone call? Maybe in this particular case it would be tough to manage as the facilities were limited. But if he'd come earlier, probably the follow up could have been arranged in this way. Also there are plenty of simpler illnesses that can be taken care of at the PHC level or at a hospital like VGKK's with an extra help from an expert staying elsewhere. It's an era where all reports are just an email or what's app away.  Infact the computer there even had an ECG app which could be used to send the ECGs taken to Narayana Hrudayala for opinion.
Basically the lesson learnt that day was that there are different ways of delivering health care. When a patient finds it difficult to approach health care facilities, there are plenty of ways health care can approach him/her. One being tele-medicine. The Hospital is already using another way through "mobile health unit" about which I'll be writing in a future post.