Lessons from India; International Volunteer Medicine

This summer I got to combine two of my most cherished passions; travel + naturopathic medicine. Here is a little tidbit of my incredible journey…

Finally began in clinic today! We headed to a slum in Delhi and saw 46 patients this morning. Even though we all sweat through our scrubs a good 3 times over, it was a fantastic experience and I can't wait to go back tmrw. Thank you SO MUCH to everyone who donated to this trip. I will update more so that you can see where your generosity is going. I would love to have photos of all the wonderful patients and children I saw this morning, but there are strict rules about taking photos of those who come to you for this service, as there should be. So instead, this photo is of my colleagues, the small clinic room we work out of, and the fantastic doctor who supervises our work and teaches us through experience. Thanks again. Namaste.

Finally began in clinic today! We headed to a slum in Delhi and saw 46 patients this morning. Even though we all sweat through our scrubs a good 3 times over, it was a fantastic experience and I can’t wait to go back tmrw. Thank you SO MUCH to everyone who donated to this trip. I will update more so that you can see where your generosity is going. I would love to have photos of all the wonderful patients and children I saw this morning, but there are strict rules about taking photos of those who come to you for this service, as there should be. So instead, this photo is of my colleagues, the small clinic room we work out of, and the fantastic doctor who supervises our work and teaches us through experience. Thanks again. Namaste.

Sitting here, at the airport in Kangra, I know my journey is coming to an end. I’ve only been away from home for 6 weeks, but having stopped in 8 countries and moved through almost as many time zones makes the time spent abroad feel much longer. The airport is deserted, save for a few guards and a haphazardly confused ticket salesman. Oh and the man sitting on the bench to my right. Having arrived 3 hours early for my flight, paranoid that something would have waylaid my journey here from the Tibetan colony in Bir (i.e. a wayward cow causing a traffic line up), I am both at a loss for how to spend the time I have on my hands, but yet also content that I have it. Having left for India as a Type A stressball basket case, I am sure this newfound contentedness is a direct result of the country I am about to leave.

India, to my western eyes, is full of extremes and paradoxes. People walk slowly, drive fast, and usually always arrive late. The air is hot, but the chai is even hotter. There are rules, but it’s always a judgment call as to how strictly they are enforced. There is such wealth, but such widespread poverty. There is inherent compassion, but also busy cruelty. Foreigners are revered but also taken advantage of. Lush greenery and dry hot dust coexist to create the scenery. There are so many people, and even more stories to tell. India taught me so much about myself, but even more about others. To me, humanity reflects off of every facet of India in a way no other country has shown me, and it was such a fantastic, perplexing sight to behold.

THE MEDICINE.

My adventures in India were brief, and much too limited in scope, but rich in life and experience. It all began in Delhi, hot and dusty Delhi, where 47 degree weather was just a fact of daily life. Serves me right for heading there in June, but truth be told, I loved that heat and soaked up every ounce as my clothes did double duty soaking up my sweat. While the tourist sites were beautiful, I won’t bother listing them all, sightseeing was my least favourite part of the trip, save for arriving at the Taj Mahal, decked out in traditional Indian dress, at 5:30 in the morning. That was a good day.

What I loved most about Delhi was the meat & potatoes of my reason for coming to India, my medical volunteerism in slum clinic health campaigns. Every morning around 9, a driver would ring our doorbell and we’d file out decked in scrubs, stethoscopes round our necks, and tuck into the back of a van or a crowded tuk tuk, headed for a local slum or slum school. The clinic in the slum was a small room, covered by a tin roof, the roof being the newest, shiniest part of the clinic. A few chairs, a table and 2 wooden benches that we would later cover with a tablecloths and use as rickety examining benches, filled the small room. Each day the 10 of us would pair off, one set taking the reception and vitals station, and the rest finding a small spot against a wall to use as our own examining station. This would be a similar set-up in later weeks as we traveled to schools and monasteries up in the Tibetan colonies in northern India. Word had spread through the area that we were there for the week, so patients would dutifully show up between 9 and noon, creating a line around the perimeter of the room. Demographics wise, patients ranged in age, almost equally distributed across all decades, about a third babies to toddlers, a third in their elderly years, and the rest in between. What struck me the most about my time with these patients was the resiliency of the human body. In North America, especially in medical school, it seems like the pursuit of health is a full time job. There are hundreds of thousands of supplements, millions of pharmaceuticals, en masse pilates or yoga classes, gym memberships, running clubs, and what have you. We conduct millions of dollars worth of research so that we can have the best evidence-based medical protocols, but yet we’re still sick and left always wanting more, chasing an elusive game of cat-and-mouse, health-and-cure, disease-and-drugs, the elixir for life. But in the slums of India, all this fanfare fades away. There isn’t the money or need for the expensive empty promises that come in bottles, fresh off store shelves. I look around at the environment these people thrive in; hot temperatures making dehydration a constant threat, dusty, polluted air that leaves eyes, nose and throat membranes irritated and red, daily chores that tear rotator cuffs and leave backs aching, sanitation systems that expose one to diarrhea causing bacteria on a regular basis, access to a smaller variety of food sources leaving some open to vitamin and mineral deficiencies, little to no access to reliably clean water or simple toiletry items like toothpaste. I looked around and saw all of this, and all my training and the privileges I enjoy in my life in Canada, told me that health can’t be found in the situations like I saw in Delhi. But that is where I was wrong, and that is where my assumptions and all my knowledge and all my privilege up until that point failed me. What I saw in Delhi was a resiliency I had never been shown before, in both body and spirit. Of course there are serious medical conditions that plague the population of India, such as malaria, typhus and tuberculosis to name a few, and fast, affordable medical care is a necessity that not all have access to. What I saw in the slums however, were beautiful people with kind spirits and sturdy, mostly healthy, bodies. Many of the cases of shoulder and back pain that I saw were from repetitive overuse, ie years of scrubbing laundry the same way, that could be remedied by rest and simple exercises. Most of the watery eye complaints were attributed to the air quality and dust blown around during the months preceding monsoon season. Most of the rashes were a direct result of the heat and sari’s rubbing against sensitive skin throughout the day. So many of the patients were in infinitely better health than I expected, and the majority were a great deal happier than patients I see in clinics back home. They come in smiling and joke around in Hindi, laughing sweetly with me when I clearly have no idea what is being said. Children come around to cluster outside the clinic, vying for our attention to teach us new handshakes or try on our sunglasses. Babies crack small, shy smiles from the comfort of their mother’s arms, their beautifully large brown eyes following you with curiosity. Grateful patients shake your hand on their way out, stopping in front of you fully and grasping your entire arm, their eyes conveying their appreciation. There is so much heart in the simplest actions, and to be honest, India reminded me of how good it felt to honor the basics.

The simple sincerity of each patient made it easier when a patient with a chronic or debilitating condition came in, and I felt utterly powerless in my ability to exact any change in their lives. As much as a diagnosis like Parkinson’s disease or scoliosis are painful to hear in Canada, there was another sense of despair I felt in that slum clinic, watching the patient walk out the door, knowing that treatment may not be an option for them.

As a naturopathic student, we are brought up in a medical system where creating rapport and establishing a trusting, mutual therapeutic relationship is not only important, but vital to our patient’s success. In India, seeing patients only for the duration of the physical exam, not speaking the same language, and knowing that we each come from vastly different cultures and that my time in their country will be short-lived, put a much-felt distance between each patient I saw and myself. The tools I usually had to create rapport were suddenly gone, and I was left with just a few raw materials. It was in this space that I began to witness the ability that simple human touch holds and how powerful it can be in the doctor-patient relationship, or more broadly put, the human – human relationship. Each exam I began by assessing the patient’s lymph nodes, laying my hands directly on their skin to palpate after only exchanging a few words. It was in this first touch that I had the opportunity to convey my intention for the rest of the exam. I channeled confidence, empathy and concern through my fingertips, and sometimes I could feel the patient ease under my hands, their energy relaxing and opening up. Understanding their reaction to my initial exams set the tone for the rest of my assessment, and it was like an unspoken language. Through facial expressions I could get children to laugh while I tested their muscle strength, or babies to giggle while I palpated their abdomen. Even the simple act of checking a patient’s blood pressure could put a smile on their face. At a loss for the words that I would usually ask during an exam, I resorted to repeating the word for pain in Hindi, “Dard?” while I pressed and palpated their head, neck, arms, abdomen and legs. So many osteoarthritis patients leaned their heads back in relief if I massaged the tight muscles around their sores knees. The momentary healing capacity of just an ounce of touch was astounding, and it is a lesson I will not forget.

We talk about something in naturopathic medicine called The Vis; which in my own way of explaining it, is the unique energetic life force that exists in each of us that reacts to outside influences, determining our resiliency and our ultimate state of health. Traveling to India and being fortunate to work with a few wonderful doctors and so many amazing patients gave me a new appreciation for the vis and the capacity for the human body to heal itself. I didn’t know that stepping into the medical system in a new country would expand what I have learned in school so fully, but the expansion came anyways, and I am incredibly grateful.

I have so much more to write about India, for what that country has taught me so far is immeasurable, so I hope you might look forward to more 😉