Today I headed to Community Health And Development which is a mixture of public health and low income hospital care. For the morning we went to the Labor & Delivery ward and watched some births take place in this setting. Everything done is done cost consciously... which is a rather foreign concept so far in my training with OB. Obviously most of the equipment is well used but the equipment here is designed to be reused. Everything from the glass syringes, to the dull needles, to the latex gloves are autoclaved and reused - at least once. Epidural's are not used here, but general anesthesia is available if they need a c-section. The suture comes seperate from the suture needles and has to be loaded, because it's cheaper. But, despite everything being made cheaper, it get's the job done... and done for a fraction of the cost in the US. Talking to the un-attended intern we watched: He's only 22 and a total year of med school including living expenses is around 60,000 rupees here... which translates to about $1,200.00 per year. Looks can be deceiving here. Although everything looks very much 3rd world including hospital buildings, they do advanced procedures like bone marrow transplants. CMC is the oldest med school in India and is regarded as one of the best in the country. Another oddity that we haven't figured out yet is a peculiar smell from the cleaning agents used here that closely resembles the smell of formaldehyde... which medical students have developed a strong association with from the cadaver labs. It's used everywhere, from the OB ward to the shower's at our hostel. It can be quite unpleasant, especially if the room isn't ventilated well. We've asked several people but no one seems to know what we're talking about. Oh well. We finished up the afternoon at the TB Clinic watching and learning the protocols that the government has instituted nation wide. For US students, we haven't seen many active TB cases and so the mental picture that the common name "consumption" conjurs up was somewhat abstract for me until today. It was interesting to see that no precautions such as masks were used by health care providers with the TB patients... seems to go along with the theme of CMC - treating with a little humanity.
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