8th March ~ International Women's day celebration

We were asked by the high school teacher 2 days earlier if we could talk to the kids for a few minutes in kannada on the occasion of International Women's day. Not because we've achieved something great that can inspire them but because it would be from someone new for them :D 
Terese agreed to help me with the content while I agreed to talk in kannada. So we said yes and that's the last we saw of him. I don't know where he disappeared. So on 7th we spoke to that sweet teacher Sumithra who helped us schedule the event on 8th. She also suggested that we highlight a few points regarding personal hygiene, menstruation, teenage pregnancy etc.  


After a lot of web search and thinking till 8th noon, we had a small talk ready where I narrated the story of Malala Yousafzia to tell them how she had to fight for the basic right to education. And to let them know that this is just one of the rights that the women in some of the countries including ours are denied or deprived of.

We asked them to involve both the girls and the boys in the event because I remember what Emma Watson said in her inspiring UN speech campaigning for #HeforShe, "How can we affect change in the world when only half of it is invited or feel welcome to participate in the conversation?" 

We ended the talk by taking an oath I made in kannada, along with all the kids who participated. 

The translation being, 

"I'm my own master from today. I can achieve any goal I wish. I won't let anyone tell me that I can't do something. I will never discriminate people with respect to gender. If and when I come across gender discrimination, I will try my best to take action against it instead of just witnessing it". 

After which Sumithra ma'am gave an inspiring talk about the other rights that the girls have to be aware of, about female foeticide etc.  

I learnt a few things from her speech. Speeches are inspiring and effective when they are specific. She had just 3-4 points, but she made sure those points reached their mind clearly by giving them tangible day to day examples .    

The school here has lovely teachers who make the children share responsibilities and provide opportunities equally thus eliminating gender stereotypes. 

6th March ~ Uppit day

We made uppit using the induction stove. The only thing worth mentioning that day :P

Otherwise this is how we were all day!

5th March ~ The Model PHC

As told, we got ready that morning in time thanks to the sweet teacher who rescued our dosa dough by making dosas at her home for us and I went to Gumballi while Terese stayed at the OPD in VGKK.

In the bus to Gumballi, I had this different feeling of happiness. It felt like my first small adventure as a doctor. So, the PHC in Gumballi, to be precise in Uppinamole, is a NABH accredited 24X7 PHC, a model PHC, one of the many such PHCs started by Karuna Trust all over the country in association with VGKK.

I entered into the doctor’s chamber, Dr. Ramprasad, and he graciously let me take a seat and help him see the patients waiting. After a while he took off and let me experience the crowd that he probably treats everyday while hearing the drilling of teeth from the next door. Yes, there is a dental OPD as well! Next to which a new born was lying with her tired mother. She was brought for delivery that morning by an ASHA worker. Time flew as I tried my best to treat the patients and soon was having chapathis at the fine canteen there. 

 What makes this PHC so different and better compared to a regular PHC is that it provides services that are not termed Primary health care in the conventional sense. Every wedneday patients are admitted to the first floor who suffer from cataract and get operated on Thursday and reach their homes with a new sight on Friday! Just like how its done at KR hospital, Mysore which is by the way a tertiary care hospital. Heard that they will be tying up with a similar great initiative Aravind eye hospitals which will only make things better here.  

Chronic illnesses which require regular filling of drugs like epilepsy, mental illnesses, non-communicable diseases like Diabetes and Hypertension are taken care of, too. Different specialists come on various days of the week like a specialist for Diabetes on Wednesdays and ENT surgeon some other day.

 The idea of making and running such a successful PHC and catering to the many once unreached people thrilled me. It’s a Public-private parternship initiaitive which according to me is one of the reasons for its efficiency.       

I was taken back in the jeep by the driver Suresh along with the amazing headmaster who showed us stars previously. He told me stories all along the ride back to VGKK which made me search and read about the work of VGKK and Karuna Trust in 
 Community Planning and Monitoring of Health Services - Karnataka Experience.

4th March ~ Once a hut.

We had goosebumps on climbing the rocks to have a look at a tiny hut measuring around 3X3 mt in which Dr. Sudarshan Hanumappa first put up his clinic which later lead to the establishment of VGKK. 

That day we were also excited to go into the forest to reach the tribal people in the jeep called the mobile unit which works 3 days every week. The jeep had almost all basic medicines we might require in handy lockers. But the trip got cancelled because of the program that was being arranged in the school auditorium. It was arranged for felicitating 2 people in the tribal community who actually worked for their community. One of them was a student of the same school who saved up a lakh and gave it as scholarship to the students who earned it by writing good essays about Swamy Vivekananda. What caught my attention was the talk by the other lady, Mrs. Madamma, simple yet appealing. She just asked the kids to never stop learning and not bother about what the society thinks or says and serve the community. Later we had a satisfying meal proved by how much sleepy we got at the OPD that afternoon.

The hospital pharmacy was a real surprise as they had all the drugs that we thought we might need. And a huge emergency kit hanging in the OPD. The only ones that I thought were missing were injectable anti-epileptic drugs. So that afternoon passed by treating a few people who came to the OPD.

Soon we realised we weren’t getting any physical exercise and so went on a nice evening walk and on returning we were told that one of us would have to go to the PHC in Gumballi the next day. 

3rd march ~ New stars

This was the day we had to leave to Biligirirangan hills in short BR hills as it was the option me and my friend Terese chose in instead of PKTB. I chose this inspite of people trying to talk us out of the idea only because this looked like an opportunity to see what the rest of my life might be like since I always have thought that my interest lies in public health.

So we packed up all that we’d listed including an induction stove based on the funny starving stories we'd already heard from our friends and started on the 3^rd morning. Changed 2 buses via Santhemarali and Yellandur and reached the hills by 2:30pm. The first thing I noticed was how quiet and calm the environment here is. We were welcomed by the staff in VGKK (Vivekananda Girijana Kalyana Kendra) which is a huge campus standing in the middle of the forest. We were told in detail about VGKK, what it does, and what activities we can take part in, by the coordinator Arun. He made sure we had everything we needed through Murthy. Murthy is the guy who solves everyone's problems in the campus we figured out. That night ended with a nutritious meal at the dinning hall with all the school kids and by watching the lovely Ursa major constellation shown by the headmaster Ramachari. 

A Promise by a Future Doctor.

Think for a minute honestly.
Is it you who chose which bank account to open and what to do with it?
Is it you who decide/d what you want to be taught (atleast in college if not school)?
What you want to eat when you're sitting at your favourite restaurant?
Where and how your house should be built?
What mobile offers you want? Or what internet plan you want?
I bet your answer would be a "yes" to most of these questions.

But is it you who decide what treatment is appropriate, what tablets to take, for how many days, what alarming signs you should look for and when should the treatment be changed for your particular illness? (unless you are a doctor yourself, it would be a "no")
Do you now see the problem I do? 

For the efficient delivery of any tertiary sector service, the participation of both the parties, the service provider and the receiver would be important. Then why should health sector be an exception to this? Why should we dump the complete responsibility of treating an illness on a doctor and make it inefficient? (unless the doctor is a superman :P).
I believe it's easy for health sector to become a one sided participation because of the low health literacy among the common people.
The importance of letting the patient know what your treatment plan/regimen can not be overstressed especially when it comes to management of chronic illnesses and while dealing with many co-morbid conditions .
This example might explain it better.  
Suppose I started treating a patient Y for a particular condition and I have the protocol of management clear in my mind."5 days of injection and then I'll switch to oral therapy for a month", I think and prescribe the injections for 5 days forgetting to tell him my complete plan or to document it anywhere. Y comes to me after 5 days with a new symptom of his illness. Now I get involved in the management of the new symptom completely forgetting to put him on oral therapy for the previous problem as thought earlier.
Let me rewind and change the story a bit.
Lets say I prescribe him the injections for 5 days and take an extra minute to tell him my plan of switching to oral therapy after 5 days and document it.
And the story follows: X comes to me after 5 days with a new symptom which I'm concentrating on. But then he also tells me, "doctor what about the oral medication you had told that you'll be starting?" Or I notice his previous record in which I've documented my plan.
Didn't that help me and the patient in turn in the efficient management of his condition?
I've heard people gobbling pills for unnecessarily longer duration. For instance my mother herself was taking tablets for carpel tunnel syndrome for longer than the requirement which we realised only after our visit to the doctor after a long time.

So before I become a doctor, and forget what I'd once decided to do, I wanted to make this promise. To deliver 100% quality service, I'll make sure I spend that extra minute in documenting and explaining to the patients what they need to know so it makes their life and our job easier!
I promise.
       

PK, a Threat to Me

I HATE updating myself.
And someone helping others think and change themselves for their betterment, and for the good of the society is the last thing I would support.
This is what I am, and I can prove it to you.
First, let me tell you more about me.
I basically know how the world works. So, its pretty easy to exploit people.
I love to watch movies which have "masala", with absolutely nil brain stimulation and which maintains my state. 
But once in a while I do enjoy the ones which are trying to change people for good. Which make people rethink and question themselves/their beliefs. Oh! Don't fall into the false notion that I watch them to change MY thoughts. I watch them so I can help people NOT change/ rethink.      

For instance, recently there was a big threat to all religions by a movie called "PK". The movie questioned the beliefs of ALL religions. Just QUESTIONED not CRITICIZED (yes, Hindu practices were portrayed more, but no religion was spared).
The protagonist who was an alien in the movie learnt that a Godman was what he called a "wrong number". He realised people were getting blindly fooled, betrayed, looted. Religion is a form to reach God. But he clearly stated that God doesn't need a body guard, there is no need to kill people to protect religion and God. And he asked the audience to choose to believe in God Himself but not the one made by people.
Audience were made to rethink. Rethink about their beliefs, practices, godmen.
I sensed a threat in all this. Because this meant, some people would CHANGE. Godmen would be questioned. People would open their minds, would stop getting fooled. And you know how I HATE change.
I had to stop this. So I watched the movie enough times to create strategies. I must have mentioned that I know how the world works.      
And so, I know how religion works too. So my task was pretty easy.
I belong to NO religion. By "no religion", I don't mean "not a believer". I do respect all religions. But I used this as a weapon to stop the movie from making changes to the weapons themselves.
I planted in the minds of the people and various religious associations the false belief that the movie is criticizing their respective religions. And that the movie must be banned. The theaters running the movie must be attacked. I was almost successful in the beginning. I could convince all religions that their practices were condemned.
But I don't know where I went wrong. The theaters are still running house full. People supporting the movie are more than those criticizing it. Maybe people are getting smart. I can't fool many unlike before. They are liking change. I might have to eventually die disappointed.
~ Status Quo
#WeSupportPK