Today we went on a mobile clinic to a local village and got to see various dermatological pathology such as tinea corporus. We got a patient with chronic cough for a couple months, so we asked them for a sputum sample to check for TB. One of the most memorable patients was a lady that had a BTK (Below The Knee) amputation because while having a seizure one of her legs flailed into an open fire... we just did a quick check for ulcer's on the stump and managed her seizure meds. All in all a pretty relaxed morning that was mostly consumed by making casual medical conversation with the Dr. for the day.
One of our biggest frustrations at Karigiri has been the very structured schedule that doesn't start on time, but has three to four hr periods of down time between morning clinics and afternoon clinics that hold us hostage. If we could just have a half hour for lunch and knock out the afternoon session right after, we could get a head start on the hour commute back to our hostels and get some other stuff done with the day. As it is now, we get back closer to six in the evening. I know, I know - IST (Indian Standard Time) rules the land ;->
So this afternon when we got back from the mobile clinic we went over to the location for the afternoon session and asked if we could start a little bit early... which i'm glad we did because it turned out to be a really unique experience! Karigiri manufactures it's own microcellular rubber from raw rubber stock produced in Kerala, and then uses it in make custom orthotic shoes as well as prosthetic devices. We got to tour the workshop, rubber mill, and even had the opportunity to purchase a custom fit pair of orthotic chappals (sandals) - for a whopping, wait for it, 450 Rs. ($9)... custom, and they did it in under an hour for four of us! I had read in Dr. Paul Brand's book, The Gift of Pain, about the research that went into finding pressure points of leprosy patients extremities and the long process of creating new ways and devices for combating their ulcers. After wearing my new chappals home from Karigiri, i'm a firm believer that the microcellular rubber disperses the pressure on the bottom of your foot more evenly and thus reduces pressure on the pressure points... you ask how, because the sandals I had been wearing had given me a blister in exactly one of these pressure points that has had me limping for the last couple days. With the new microcellular rubber insole sandals on, I walked without a limp and could barely notice the discomfort. It was amazing to see them work, fast and efficient and doing it for literally pennies on the dollar... yet another example of a low cost efficient system. They could even recycle the scraps of rubber into new batches. The icing on the cake was to see that the hard sole put on the bottom of the sandal was made from used tires! After nearly a month of seeing mountains of trash lining streets and a total disregard for throwing trash into trash cans, these guys are recycling! It was a neat afternoon, and we're glad we started early cause we ended up staying the entire afternoon.
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