India Study Abroad

This past winter, I traveled to Jamkhed, Maharashtra, India on a Global Health: Ethnography study abroad session. I was humbled by the successful, sustainable health care the Comprehensive Rural Health Project (CRHP), founded by Drs. Arole, provided to the rural villages in Jamkhed and surrounding districts.

Sustainable by Development

Dr. Raj and Mabelle Arole believed in “comprehensive health care,” which means that the living conditions of the villagers were just as important as their health. And this so logical, since we know that how we live directly affects health repercussions. Because of this mindset, Drs. Arole decided to progress the development of villages to improve their health. Some examples of this were providing clean drinking water, covering water pits (to prevent mosquitos from breeding and spreading malaPicture1ria), and improving irrigation (for water supply during dry seasons).


In the doctors’ book,
Jamkhed, one story particularly struck out to me about the importance of development in rural areas. During a demonstration when the villagers went up to thank the Aroles, the majority of villagers were grateful for the water pumps installed in the villages rather than for the medical work the doctors were providing. In impoverished areas, it is vital to provide basic necessities to improve health.

Sustainable by Empowerment

Another aspect of CRHP I was impressed with was that it strove to change the traditional social structure. The caste system is thousands of years old and embedded in the Indian way of life. On top of that, the society is heavily patriarchal. In order to fight these norms, Drs. Arole had to come up with tactics to change the perspectives of both the health workers that worked for them and the villagers. They sat in circles rather than having the highest status person sit at the head of the floor mat. They placed the water pumps in areas where the Untouchables (lowest of the caste system) lived, so that different castes had to interact to get water. One key tactic was to train women to become village health workers. This gave the women more respect and responsibilities in the village. Furthermore, training a villager rather than bringing in someone new to be the village health work allows the village to stand on its own instead of relying on CRHP.

CRHP’s mission and impact in Jamkhed has shown me that sustainable health care in underserved areas is attainable. My experience in Jamkhed has reinforced my desire to serve in an underdeveloped community. And now, when I hope to improve people’s health, I will remember that development and empowerment are just as important factors as medicine to better comprehensive health.

Written by: Sharon Pang

Further Readings:

Jamkhed: A Comprehensive Rural Health Project, by Mabelle and Rajanikant Arole

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Step 1: Teach

I was swept away in the conversation about life choices, movies, and culture. As I walked out of the room, I was shocked to find out that almost an hour had passed by already. I was at New York Methodist Hospital volunteering as a part of the Congestive Heart Failure Volunteer Intervention Program (CHF-VIP).

This program trains volunteers to teach heart failure (CHF) patients about healthier life choices and prevent re-hospitalization. We visited the patients in the hospital to give them “teachbacks.” During the teachbacks, we covered diet changes, reminders to take prescribed medicine, and ways to survey if symptoms were worsening. Then, if given permission, we gave callbacks every two weeks for six weeks after the patient’s discharge. In the callbacks, we answered patient’s questions, and reminded them about what we talked about in the teachback. We also encouraged them to make an appointment with a cardiologist within two weeks after discharge.

Often times, I would finish these teachbacks in 10 to 15 minutes. I would go in and follow the lesson I had practiced many times teaching, wait for any questions and then leave the room. However, during one of my shifts I ended up speaking to the patient for almost an hour regarding his past failures to change his lifestyle for his health. As I continued talking to him, he seemed encouraged, even motivated to learn more and change. He even quoted from a movie, “We all die, but it’s about how we die.” I was inspired by his response to take these teachbacks as opportunities to look into the window of the patient’s life. I took more time to ask the patient questions and empathize his or her situation. I found the time spent much more rewarding, and experiences confirmed my hopes of becoming a doctor someday.

During a lecture I attended as a part of NYM’s Summer College Intensive Program, an E.D. doctor wisely told us, “All doctors are teachers. In order to be a good doctor, you must be able to teach your patients about the disease, symptoms, and possible solutions.” I did not really see the truth behind her words until I saw how my teachbacks and callbacks affected patients. NYM’s CHF-VIP has taught me and helped me develop one of the most important steps in becoming a good physician: to teach.animated-light-bulb-gif-30

 

Written By: Sharon Pang

Volunteering: Who, What, When, Where, Why, How

WHO: YOU! The perfect pre-med student.

WHAT: You must volunteer your time at a hospital to show your commitment to health and helping. This is not easy, especially when you have a hefty course load.

WHEN: You should get this done before Spring Committee, meaning before the spring semester of your Junior year (if you plan on applying to med school straight after college). Also, many hospitals have certain times in which they are accepting volunteers, so always be on the lookout for those deadlines.

WHERE: Any hospital is good! Here is a list of hospitals within New York City. The best way to determine what needs to be done for each hospital is to do research on their volunteer department. Don’t be afraid to call, usually that’s the best way to get an accurate answer fast.

WHY: Once again, you must show your commitment to public health and serving the community. It also gives you the experience you need before making your ultimate career decision.

HOW: The hardest part is getting out there and actually networking. Many hospitals list a general number for their Volunteer department and it is up to the student to make the call. These positions do NOT seek you. You must actively seek out opportunities and utilize your time in a way that would benefit you the most. However, this should be kept in mind. General rule of thumb is 200 hospital volunteer hours for a competitive application!