Mussoorie was such a magnificent place. It is a hill station within the Himalayas, meaning it is a popular tourist attraction. Luckily, March is before tourists typically visit because most kids are still in school. The views and hikes we were able to do experience were truly amazing. They also had many cute coffee shops that offered a great atmosphere to relax after rotation.
I learned so many things this week during my time at Landour Community Hospital. One of the things that stuck out most to me was how big of a problem tuberculosis still is in India. Diagnostic tests and treatments are all provided free of charge by the government. However, there is a stigma of having the diagnosis so some patients refuse to get treatment. Of those who begin treatments, another issue becomes compliance. Although they combine three medications into one tablet, the tablets are very big and the dose is based on the weight of the individual, meaning they may still end up taking multiple tablets/day. Treatment is 6 months in total and missing even one day of medication could lead to prolongation of treatment duration. A public health initiative by the government was to begin doing direct observation therapy (DOT). With DOT, patients must come to a clinic every day and be checked off for taking their medication. While this initiative had some effect, the medication was not individualized. Therefore, if someone was resistance to one of the medications, making it an ineffective treatment, then nobody would know and they would continue on that treatment plan and never see improvement. Now they have created a blood test that will show sensitivity or resistance to one of the key medications. In addition, they have begun using an online app to keep track of the patients records and daily medications, making it easier to seek care from anywhere for the observed therapy. While there this week I was able to observe a patient initially diagnosed and the intake information required before beginning treatment, such as HIV status. After this, our preceptor was kind enough to show us a sputum stain under the microscope of someone with tuberculosis (showing acid fast bacilli).
, Something else I learned is the rate of interstitial lung disease in India is very high. Delhi has a lot of air pollution because it’s neighboring state, Punjab, produces most of the food in India and causes a hazardous amount of emissions. In addition, many people who live in small places heat their house with firewood which can also be damaging to the lungs. DAfter leaving Mussoorie, we packed for a busy weekend trip to Jaipur (city in Rajasthan) and Agra (city in Uttar Predesh). Jaipur is known as the Pink City. While there we rode elephants and toured various historical landmarks, One of my favorite activities was going to something called chowki dawni. It was a huge venue that offered activities such as traditional dancing, performances, camel and elephant rides, and a 16 course meal of Rajasthani food. It was entirely too much food but delicious none the less. Agra is where the Taj Mahal is located, one of the seven wonders of the world! I could’ve spent so much time just appreciating it’s beauty. Before we caught a train back to Dehradun our CFHI coordinator, Hema, in Delhi invited us to her apartment for dinner. Her and her husband made chicken biryani, which was fantastic. We really enjoyed getting to know them better
Before catching our train to Delhi, Meredith and I found out where we matched! The moment we have been anxiously waiting for months to know. We couldn’t be more excited to share that Meredith will be doing pediatrics at Akron Children’s Hospital and I will be doing family medicine at Novant Health in Charlotte, NC!
I am truly enjoying every minute of my time here. I feel so lucky we chose this program and have the opportunity to meet and experience such wonderful people and culture.