Week 1: Patti Village

Hello everyone! Greetings from North India and the Himalayas! I apologize for inviting you to my blog and then not writing anything for over a week :-)

I arrived safely in Delhi last Saturday evening and caught a few hours of sleep that night before getting a 5am train to Dehradun. From there I was transported by Jeep to the village of Patti, roughly 25km north of Dehradun. I was pretty bushed after the 2.5 day transit but life in Patti has been calm and relaxing since.

There is so much to write about already and I have loads of photos to share with you but I'll list some of the highlights of my first week here:

1. Dr. Paul and Patti Clinic:
The man. The myth. The legend. He is the physician in Patti. Dr. Paul lives in Dehradun but spends his weeks in Patti doing clinic and medical camps. His clinic is a 6' x 8' room with a desk, an exam table, and a medicine cabinet.

 Dr. Paul in his clinic along with Shanti, the health worker 

The photo here is Dr. Paul in his clinic/office, which you can see here, also dubs as a two bed hospital. The patient here is getting IV fluids and antibiotics for UTI/pyelonephritis. There is also a small pharmacy in the clinic that is stocked with a pretty impressive array of standard medicines as well as herbal remedies. The pharmacy is on par with what you might find stocked at, say, Grace Clinic. The medical care and any medications are completely free and funded for by CFHI, the organization that I am working with during this rotation. There is no on-site laboratory or imaging (patients need to go to Dehradun for these) so Dr. Paul must rely on 20 years of experience and dynamite history and physical exam skills to make diagnoses.

The most common complaints in the Patti clinic are cough/cold, acid reflux, muscle strain and back pain, headache, abdominal pain, and pelvic pain. Common diagnoses include URI, GERD, strains/sprains, HTN, and PID. So, very similar to American medicine in terms of pathology but we did also see a few patients follow-up for Typhoid and TB. The highlight physical exam finding was a terrifying burn:

And two days later... 

I'm almost certain this hand would be cause for hospitalization in the US. This goes to show you how Dr. Paul works with the resources he is given. It's truly remarkable.

Dr. Paul has been a rural physician in Patti and the surrounding villages for over 20 years and for the past 10 years he has worked with hundreds of medical students like myself, showing them his trade. His Patti clinic serves some 15 surrounding villages and 5,000 people. His clinic is always open and there were a few times this past week where we opened the doors late at night to see an urgent/emergency patient. Additionally, Dr. Paul and the health team make a trek once weekly to surrounding villages that are not accessible by road. After spending a week with him, I truly feel that Dr. Paul is a hero for his dedication to providing medical care to the under-served village people of Uttaranchal.

2. Health Camp: Village of Batoli
On Tuesday of last week the health team - Dr. Paul, myself, Shanti (health worker), and Viranda (pharmacist) - set out for the village of Batoli to provide the 200-some inhabitants with their monthly healthcare. The hike was roughly 6 miles through a pretty big valley:

Hike to Batoli.

The hike took roughly three hours but it was definitely worth it! The village was gorgeous and the people were so grateful and appreciative. There are no medical facilities in Batoli so our clinic was the village courtyard. We saw 28 patients with no real serious ailments. The greatest part of the day was undoubtedly getting to meet the village elder. When he heard there was visitors (me) in his village he insisted on talking to me. At 85 years old and paralyzed by congenital polio, we had to walk to the top of the village where he lived to meet with him and when we arrived he had two chairs (one for me and one for Viranda who interpreted) set out for us. He spoke to me about the village and asked me what I thought, I told him I thought that his village, people, and lifestyle were precious and that he was very lucky. I then listened to his lungs (CTAB despite a 70 pack/year history) and checked his BP (110/76). I certified him with his monthly bill of health and thanked him once again.

Batoli Village Elder

Batoli Health Clinic

Cookin' it up. 

3. Holi - The Festival of Colors

I had no idea what was in store for me on this day! I knew it was a religious Hindu holiday because a few of the house staff were fasting and - per tradition - there was no electricity in the village the night before. I awoke on March 8th expecting a normal day of Patti clinic but Dr. Paul told me to leave my white coat behind. We went up to the village and everyone was painted (head to toe) in pink, green, and yellow dye! Each villager had a bag of dye and they would go up to one another paint each others faces and then hug one another.

 Patti youth on Holi (probably one of my favorite photos thus far)

As we congregated at the village market there was a group of school kids who - per usual - were looking and snickering at me. Dr. Paul told me that they wanted to play with me and the next thing I know Dr. Paul was chasing the school kids all over the village! I joined in the fun - it was awesome! 

Shy village child painting me up for Holi!

4. Cricket

Despite playing around one hour each day for the past 6 days I still have no idea how this game works. This is me launching one over that mountain yonder. The ball may be somewhere on K2 by now. We'll never know. 

Alright honestly I struck out like 500 times.

Cricketeers (?) batting around at lunch break. 

5.  Medical Camp - Junior Schools

We also hiked around to a few of the schools. The middle-, junior-, and high-school are all in different villages, which means pretty substaintial daily walks for school kids. Approximately once/month Dr. Paul and the healthcare team visit the schools and see ALL the kids. Apparently kids either do not report when they're sick and/or their parents may not seek care. We ended up seeing 58 kids (116 ears, 58 lung and heart exams - uhmm yeahhh - practice makes perfect, right?) and there were actually quite a few ailments, including a number of otitis medias and tonsillitises.

Dr. Paul seeing kids at the Junior School 

Junior school medical camp. 

6. Himalayan Herbal Medicine Hike 

Dr. Paul and I hiked a few hours one evening and he showed me over 30 herbs, plants, trees, fruit, etc that are commonly used in North India. I will write more about this later - I have some good photos as well. 

7. Hike to Mussoorie 

I set out this morning at 6am on the 20km hike to Mussoorie where I currently am now. Dr. Paul helped me hire a guide from the village who showed me the way. It was a pretty intense hike with at least 2,000ft of altitude gain. In fact, it's quite cold here in Mussoorie and I already had to purchase a hat :-) From what I can tell from being here only a few hours, Mussoorie is a touristy town. It's the most popular of the "hill stations" and I can see why because it's gorgeous. I'm excited that I get to spend a full week here and seek it out. Will report more later. 

Getting higher into the Himalayas. Mussoorie is just over the mountain behind me. 

Well thanks for staying tuned guys! It was truly an exciting first week! The countryside has a slow pace but it was welcome - now on to the more hectic lifestyle on inner-city India. Let me know what you think - I hope now that I have more consistent access to internet I can write more and get more into some insights and not just facts. 

Getting excited for match day! Looks like the polling has closed and, despite some disagreement, it seems that Minneapolis is this blog's audience choice. Thanks to the few scramble/flint, mi voters - nice :-)

What's going on in Wisconsin? Still snow? Still skiing?