CHAD is awesome!

So my last two days have made this whole trip worthwhile. Going to the villages and meeting the people is reason enough. They are so friendly and so grateful, it's just amazing.

Yesterday I went on what the Community and Health Development Department calls "Nursing Rounds." Basically, one nurse and a community health aide who usually lives in the village, design a plan to make home visits to particular patients within that same village. The village we visited is called Palavansathukuppam! There are about 5,000 people who live in that village, and the health aide who lives and works there for CHAD named Janasee, coordinates the visits for all these people.

During the day, the main objectives are to do well baby checks, antenatal checks and chronic illness checks for things like blood pressure and blood glucose. This particular village was located fairly close to CHAD hospital, which is a different hospital located near campus. According to the nurse I worked with, even though the hospital is close, home visits are still necessary because the village patients would not go to the hospital otherwise.

We saw a variety of patients from pregnant moms to preterm babies to geriatric patients. At one home we checked a pregnant mother for fundal height and blood pressure and her friend whose house we were in showed us her tongue. Because it was so pale, it was obvious that she was anemic, so because of the home visit we were able to refer her to CHAD and get her some help as well.

In another home we visited a baby who was born at 34 weeks gestation. The baby was still underweight, yet he was growing appropriately. One interesting thing was while we were there the baby got hiccups, so the mom put a leaf on top of his head as a remedy to make the hiccups stop. I don't know if it worked because we left soon after that, but it cool to learn a remedy that the villagers believe in.

Today was a great experience. I went on "Doctor's Rounds," which is similar to nursing rounds except the patients in the village come to a certain location at a designated time and in the van physical exams are performed and outside patients are seen for acute and chronic conditions and get prescriptions which are filled instantly since the medications are taken to the villages.
The day started out with health education by one of the residents. Today's talk was about hypertension and its effects on the body. It was great to see the people so interested in their health. One interesting case in this village was about a family of 5 siblings whose father had a history of progressive spinal cerebellar degeneration. Currently three of the siblings, two females and one male, have different severities of the same disease and a group of researchers from Chennai are studying their family's pedigree and looking to see if there is a relationship between the severity of the degeneration and number of tandem repeats in the gene known to cause this debilitating disease.
We then travelled to a different village and used the same system of seeing patients. In the third village we visited, named Arcottankudisai, we started with a visit to a 17yo female's home with a history of a cobra snake bite about 2 years ago and subsequently her muscles became paralyzed and she became blind. Over the last two years though, with physical therapy and treatment of anti-venom, she can now stand and walk a few steps on her own and she has progressively regained her vision. It was sad knowing that if she had transportation to the hospital that day two years ago, she may have never suffered these losses because the anti-venom could have prevented it if given soon after the bite.

Here the women were very kind and grateful. As I was helping the intern tally the patient population, I felt someone putting something in my hair and realized it was flowers. Whenever I see the older women from the village, I think about how much they possibly endured living in this village their whole lives and what interesting stories they might have for younger women such as myself.

I also saw a 6yo girl with tetralogy of fallot who never had surgery to correct the problem and now lives with heart failure at such a young age. We wrote her prescriptions for Lasix, Digoxin and potassium. I also noticed the clubbing of her thumbs and great toes, which is a sign of chronic heart failure. One other woman was seen for her elephantiasis, which is when there is swelling and thickening of the skin usually in the legs and genitals due to a parasitic nematode worm.

At the end of the day, all the children from the village were returning from school. The tallest girl in the middle of the picture started talking to me and asked me my name and if I was from CMC. Once the other children saw her, they all wanted to gather around. They were all so cute and when I wanted to take pictures of them, literally 40 children surrounded me! It was cool interacting with them and seeing their smiling faces.

At the end of the day as we drove away from the villages back to CHAD, I realized all the positive aspects of this community health program and how many lives were impacted in just one day.