Indian Health System

Goodmorning all,

Our observation week came to an end yesterday. We saw a lot of things this week that involve the Indian Health Care system and gained a lot of information about the culture.

Wednesday morning we went to a Government School and sat with some teachers and a couple of sports teachers. Raj introduced us and told them that I have been coaching basketball in the Netherlands for the last few years. Basketball is a popular game in the school so immediately we started discussing options for me to coach a group.

We agreed that we would come back tomorrow and watch the boys play. That way I am able to see the level and decide what will be useful for them during the practices. Because of the exams and the holidays the practices will start the first week in January.

In the afternoon we went to the institute of Medical Sciences, a college that teaches physiotherapy, nursing and post-graduate exercise therapy. We met two of the lecturers and what followed was an interesting and insightful conversation.

We were surprised that it is taught in a similar way. Many of the modules and subjects are the same, as well as the textbooks and the competences learned.During our conversation we asked some questions about physiotherapy and exercise therapy as a manner of employment in India. They told us that the therapy in India is recognized, but in a small way, especially in the rural areas where people are not aware of what the therapy exactly is. This can also be a consequence of the fact that people in the rural areas are very poor and most of the time have not had a quality education and therefore are illiterate. In the cities, it is much more accepted and practiced.

When talking about exercise therapy they told us that in India exercise therapy is a post-graduate studies. For them it was really interesting when I told them that I’ve been studying it for over two years now and it’s just a graduate studies. The modules of exercise therapy here are slightly different. This is also because of the four years of medical studies the students have already had before they take this course.
Aside from electrotherapy and acupuncture the course is a bit similar. The school calls it mostly ‘yoga for .. ‘ followed by, for example, low back pain, arthritis, neck complaints, frozen shoulder, etc. The name might be different but in the Netherlands we partly studied the same subjects.

After our conversation we agreed that we would follow a couple of classes. This is something that we really are looking forward to since we would like a firsthand experience in studying physio- exercise therapy in a country such as India. We will also give a few lectures to the students
on topics or interventions that they might not know much about.

Thursday morning we visited an awareness program for women in Thalakkudi. Before we knew it there were around 60 women and a few men present. The health inspector then started with his story. For us it was a bit difficult to follow what he was saying, since it was all in Tamil.
All kinds of subject were discussed, washing, brushing your teeth, food and drinks, women empowerment, Dengue-fever, pregnancy and alcohol abuse.

When finished the health inspector asked the women whether they had any questions for us. They came up with some interesting questions about physical pain during daily activities. For me as an exercise therapist, this was really my cup of tea. The women told us that they often have low back pain or pain in their knees and they asked us how they could solve it.

Of course, there is no such thing as a straight answer without more information, so I asked them to show me how they move during those activities. They showed us how they picked up a large tub of water, doing it in a way that causes a big burden on their back and knees. I showed them that once you lift while bending your knees and keeping your back straight, the weight on your body and joints decreases a lot and may cause less pain while working in the fields or at home. It was really fun to see that the women tried it themselves. At the beginning they were having some trouble with it but in the end they knew how to pick something up and lift, without putting an physically excessive burden on their bodies.

This may be a small thing but I feel very lucky to be able to help these women even if it is just with telling them how to lift and move during their daily activities.

On Thursday afternoon we went to visit a State University that specializes in Social Work.We had a lecture and discussion about the Indian Health Care system with one of the teachers there.Since I had given a presentation at school about this system I already knew some of the facts, however it was a very interesting discussion, since the lecturer was being brutally honest about the shortcomings of the Indian society and the effects on the Health system.

We delved into topics such as supernatural belief, awareness and stigma of HIV, sex education of the youth, effect of technology (social media/internet) on youth, Indian society in general and the rights and implementation of women’s rights.

Following our talk with the social worker was watching the basketball game at the boys’ High School. Once there other students were taking their exam, and it was really interesting to see how they organized it. The kids were just sitting outside on the ground in large lines, next to each other.

We quickly walked to the basketball court, because I did not want to disturb the children. (Everyone still looks at me wherever I go) The boys were already playing there so I took some time to see the level and the aspects that could use some practice.

After watching a couple of minutes my hands started itching and I decided to play. Since the climate is very different from ours (25-30 degrees) and I had to wear my jeans I had a bit of trouble keeping up, though all in all I had a lot of fun playing the game and so did the boys. There is a lot of room for improvement, but I am looking forward to the challenge.

In the evening we successfully killed a lizzard. Twice. Or maybe three times. (The same lizzard that is) At first we tried to chase him outside but when it did not work we tried to kill it. Put yourself in our shoes, lying on a matras (from 5-10cm) on the ground while there are walking lizzards around - yeah, not much fun. We felt kinda bad afterwards since it was still moving it's limbs once it was dead. But hey, at least we could close our eyes while sleeping.

Friday morning we had an interaction with an HIV/AIDS patient. We had the conversation in our apartment because if we went to the village everyone would start talking if they saw him talking to us. That is the culture. As we already heard yesterday, lots of the stigma attached to HIV and other diseases are due to a lack of education in rural India. The person we talked had never even heard of HIV/AIDS, before being diagnosed with it.

Moving onto his son, suffering from a mental disability, we learned that the society and government does not care about this group of people. They are being neglected at school and do not receive any help at all. He only went to school for a couple of months when he was five, and has not gone ever since. He is 17 now.

He works as a goat herder, because that is the only job he knows. He does not have any friends and he prefers to be alone most of the time. When asked if the family believes that his condition is just tough luck or that it is a punishment from God the answer was: “who knows”.

After our lunch we went to witness an awareness program for people with Leprosy. At school we had not studied leprosy yet so we were really curious for this meeting.

Right away we were able to see the consequences of the leprosy disease. The men we spoke to all had visible deformations in their hands or feet.
Leprosy is a communicable disease, it spreads through breathing, coughing and sneezing. Once you have the virus, it hurts the nerves which causes numbness in the hands and feet. Because of the numbness they often do not notice once they burn their hands, or if they walk into a rock, or when they get a wound. If this wound goes unnoticed then it has a very high chance of getting infected. Infections can have all kinds of consequences, but if it is not treated at all, none of them are good.

The most important thing for these people is to point out the dangers and the problems that might arise. Since they do not know what they are suffering from they do not know how to cope with it the best way.

Last week was a really interesting one. I can already say that I have changed as a person and I am curious to see how that will work out when I get back home. But that will have to wait, since next week we are starting with our project for school: 'creating a prevention plan.'

Enjoy your weekends,

Stephanie & Bhavvik