Reflecting on the first week….

I have officially completed my first week of rotations in Dehradun! It was so much fun and I felt like I learned so much in such a short time.


My rotations in EM and Pediatrics for the week were very impactful for a multitude of reasons. I got to practice more EKG reading, listen to different heart and lung sounds, and learn more about healthcare and how it works in this part of India. I was fascinated to learn that mitral stenosis is much more commonly seen here than aortic stenosis (which is quite the opposite back in the states) and also that India has the world’s highest incidence of diabetes diagnoses. I also learned that the concept of seeing a licensed medical doctor for patients is a luxury provided only to those who are educated or literate. Those who are not as educated either don’t receive healthcare or receive it from individuals who “claim to be practicing as doctors.” In addition, we learned that doctors in this area frequently open their own hospital or center and provide services to patients that way, rather than working at a hospital or institution. My exposure to pediatric healthcare in India was very insightful and I will be sure to carry that with me on to my future training in Pediatrics. He went over concepts like milestones, upper respiratory infections, vitamin deficiencies, anemia, and many other conditions that he emphasized for us to know very well. 


Every day that me and Lindsey navigated our way to rotation felt more and more natural. We became more comfortable with crossing super busy streets, knowing where to catch a Vikram, and figuring out where shops were. We even went shopping on some of our lunch breaks and bought some cool things. I bought a book called Guru English, so I will be sure to share my thoughts. We also bought tunics at a store called Fab India with clothes that were all made in India, so we are very excited to wear them!
This weekend, we went to Dehradun’s flower festival that is held once a year! Our local coordinator invited us to attend along with him and his family. It was so nice getting to spend the day with them, as well as experience all of the absolutely gorgeous flowers that were on display. I have never seen anything quite like that. Afterwards, we drove up into the hills to a local cafe that served desserts, tea, and smoothies. I had a delicious mango smoothie while watching the beautiful view of the Himalayas. It was surreal, to say the least (the views…not the smoothie 

😉

). While we were there, our coordinator told us how 90% of Dehradun had never even heard of this cafe or would have been able to afford it, so we felt extremely fortunate to be able to experience it.


All in all, I am loving the sunshine, culture, and spicy Masala Lays potato chips that India has to offer, but I do find myself missing my family and my sweet sweet pup, Jack. They are always in my thoughts, and I know they’d love it here. Until my next post!

-Meredith

Blonde hair in a brown-haired culture

This week has gone so quickly! We became much more familiar with the area and it is starting to feel like my second home. With that said, I am still trying to adjust to the number of stares we get every day. It is not uncommon for people to take photos of us or blatantly stare. Yesterday we went to dinner and were waited on by the owner of the restaurant. Today, we were asked if we would take a photo with a group of students from the local university. While none of this seems malicious it is very unusual and has contributed to some culture shock.

Reflecting on this week of rotations: Both the emergency medicine and pediatric rotation sites were private practices. In India, the government allocates very little funding to healthcare so many patients in urban settings go to private practices if they can. While some patients have insurance, many are self-pay. Even with insurance, companies will typically try very hard not to cover anything. Next week we will be living in the town of Mussoorie and our rotation site is in a public hospital. I will be interested to compare the two settings. Another interesting thing I learned is that there are so called “quacks” that practice medicine without a license. I asked how patients can tell the difference and one of the doctors mentioned that many patients do not know, especially if they are illiterate or do not know who to ask.

This morning we woke up early to hike at a place called Forest Research Institute (pictured above). It is one of the most beautiful views I have seen in Dehradun so far. It was very quiet and surrounded by green space. In the afternoon, we went with our coordinator and his entire family (wife, son, and mother and law) to a spring festival of flowers at the governor’s house. We were able to walk around and enjoy all the flowers grown locally and taste some rice pudding made of rice specifically grown in this state. To finish off the afternoon, we went to a small coffee shop that overlooked the mountains. Our coordinator shared that even within the city of Dehradun only about 10% of the population knows about this coffee shop or could ever afford to ever visit. This really put into perspective what a privilege it was to be there and to be able to travel to this beautiful county.

Tomorrow we will travel to a city called Rishikesh. The city is known as a place to study yoga and meditation and a 2000 mile long holy river, the Ganges River, flows through it. Stay tuned for more pictures 🙂

Learning to navigate our first week.

Traveling to rotations has been quite the experience. It has been great for immersing ourselves in the culture! We begin our journey by walking through the neighborhood of our homestay, where we are greeted by dogs, cows and loud horns as cars drive past. Once on the main road, we have to cross lanes of constant traffic to catch a vikram. Vikrams are a form of public transportation that has three wheels and typically fits around 8 people (I posted a few pictures above). At first it felt intimidating knowing when we needed to get off, but we’ve caught on quickly.

Our first rotation of the day is at a place called City Heart Medical Center. There is one physician, Dr Ghandi, who is in charge of the entire facility, which includes regular outpatient visits, an ED, a higher intensity unit (usually for those with an acute heart attack), and a general inpatient ward. No appointments are made so patients are seen in order of medical necessity. Dr Ghandi’s day is not complete until all patients are seen. Being the only physician in the practice, he mentioned that he typically works 18-hour days. In addition, he shares his phone number so people can call him at any time with questions or concerns. Many of the diagnoses we have seen so far are very common in the US, such as diabetes, hypertension, hyperlipidemia, and coronary artery disease. Several interesting things I have noticed so far include taking off your shoes before entering the high acuity ward of the hospital and the amount of drugs reps that come every day. Dr Ghandi refers to them as “the bombardment”. Since there are no patents on drugs in India, they create many versions of the same drug (i.e. 58 brand names for statin drugs used to treat high cholesterol). He allows them to come each day because otherwise there is no way to keep track of all the new names of the drugs.

Our final rotation of the day is at a nursing home, which in India means a medical clinic. Here we see mostly pediatric patients. The structure is similiar to the other clinic where no appointments are made and patients wait their turn to be seen. This clinic also has a small ER and inpatient unit that is used. The diagnoses we’ve seen here are primarily upper respiratory infections and influenza but we’ve also seen some cases of cavities and vitamin D deficiency. The kiddos we see are always so happy and it adds a great atmosphere to finish out the day.

While the language barrier can sometimes make the patient visits difficult to follow, I have already learned so much. The work ethic and care these physicians provide is truly amazing and I am so grateful they have taken time out of their busy schedules to teach us.

-Lindsey

Greetings from Dehradun!

It is officially my fifth day here, and I can honestly say it has been five of the most interesting days of my life. We arrived in Dehradun on Sunday from New Delhi via the train. It was a 6.5 hour train ride, but we were served tea, breakfast, and gorgeous views of the countryside so the long ride wasn’t so bad. When we finally got here our local program coordinator took us to meet our host family that we’ll be staying with for 2 weeks while we’re here in Dehradun. They are so kind and welcoming, we got so unbelievably lucky.

The first thing we did once we got settled in was go to a Buddhist monastery, fittingly called Mindrolling Monastery, that was gorgeous and something I had never seen before. I hope you saw some of Lindsey’s pictures from our trip there…we enjoyed taking those pics!

Monday we started our rotation for the week (as every week is a different rotation schedule). For this week, each day is split up between Emergency Medicine and Pediatrics. Both of our preceptors are so invested in teaching students and providing all sorts of helpful advice in practicing medicine. Specifically, our EM preceptor told us that he lives by a principle with the acronym “ABC: Availability, Behavior, and Competence.” He states that he lives by these principles to help shape his role and impact as a physician. The physician who manages the hospital originally started out with a one room facility that has now grown into highly staffed divisions that treat patients for high acuity, general inpatient, along with 2 rooms serving as an ED. Many of the patients present with conditions similar to what we have seen in the US, such as uncontrolled diabetes and hypertension, acute on chronic COPD, pneumonia, pancreatitis, and myocardial infarctions. At the Pediatric clinic, our preceptor teaches us and the patients on topics regarding each diagnosis and their management. These docs are providing great care and I’m honored to be learning from them

Every morning, me and Lindsey walk to catch a Vikram, or what is otherwise known as one of India’s public transportation systems, to our rotation. Vikrams are tiny cars that can hold 6-8 people that drive a certain route for the day. If your stop is on that route, then you hop on the Vikram and they will take you there along with anyone else who is on that route. It’s so different from anything I’ve ever done, but that’s what makes it so refreshing and exciting. Our walks on the street to the Vikram are shared with quite a few cows, dogs, motorcyclists, and fellow walkers. We never know what we’ll see on our walks to rotation and that’s most certainly the fun of it.

From what I have seen, India is all about sunshine, showing kindness to others, and lots of horn-honking (:
-Meredith

We made it!

After a 14 hour plane ride into Delhi (from New Jersey) and a 6 hour train ride we’ve finally arrived in Dehradun! Apparently neither of us got up enough during our travel because our feet got so swollen they made our shoes almost unbearable. It was also difficult to adjust to the 10.5 hour time difference.

Delhi is a densely populated city and that was definitely apparent while driving. Even after spending a month in Botswana I still experienced some culture shock on arrival. Since increased tensions with Pakistan remain there were many security checkpoints of guards with guns. There are also many things that differ vastly from the US such as their water system, sewage system, how they handle trash, and driving infrastructure. Finally, with Delhi being such a big city the pace is very fast and it feels overwhelming to catch up.

We knew we were close to Dehradun when we began seeing the foothills of the Himalayas, which gave us an instant sense of calm. The pace in Dehradun, even though it has also become more populated, is much slower paced. Our homestay family, Mr and Mrs Mehta, have been amazing. They are an older couple that have been hosting students since 2001. They greeted us with a delicious meal of lentil soup, spicy califlower, basmati rice and paratha. After getting settled in, we took our first autorickshaw ride to a Buddhist monastary, called Mindrolling Monastary. It is one of the largest stupas, a monument housing sacred relics usually associated with Buddha, in the world.

Tomorrow we begin our first day of rotation! We will be working in the emergency department in the morning and pediatrics in the afternoon.

-Lindsey

Meredith saying a prayer as she turns the cylinder

pre-trip thoughts

Welcome to our blog! My name is Lindsey and I am a fourth year medical student at Ohio University Heritage College of Osteopathic Medicine. I am lucky enough to be participating in an international rotation with one of my best friends, Meredith, to Northern India for four weeks. We are traveling with a program called Child and Family Health International. We both plan to update this blog and keep everyone informed on our experience abroad!

We chose this program because it will allow us to explore healthcare in both the rural and urban setting (specifically the cities of Dehradun, Mussoorie, and Pattie). Additionally, I am really looking forward to developing a better understanding of their culture and appreciate some of the great landscape surrounding the Himalayas.

Initial thoughts while planning: “life is better when you’re laughing”. Between applying for a Visa, getting all the required vaccinations, and having heightened tension between India and Pakistan occurring the week of our trip, it has been a constant level of stress making sure we did everything correctly. The only thing we could do was be proactive and laugh along the way. Luckily that was easy to do having Meredith along. I hope you enjoy our journey!

Lindsey

Departing for Dehradun

Hello everyone! 
My name is Meredith DeCoy and I am a fourth year medical student at Ohio University Heritage College of Osteopathic Medicine. I am sharing this blog while me and Lindsey Matthews are abroad on a rural Himalayan rotation in Dehradun, India for medical school through the organization, Child Family Health International. Both me and Lindsey are excited to learn more about global health and experience other cultures as future physicians. We specifically chose to go to Dehradun to better understand the culture and medicine within their vastly diverse population of patients, while enjoying the beautiful scenery of being in the foothills of the Himalayan mountains. In addition to spending 2 weeks in Dehradun, we will also be traveling to Mussoorie for 1 week and the village of Patti for 1 week. We hope to add as many photos and posts throughout our trip. I’m excited to share my experiences and things i learn in the blog. Lindsey will also be posting in the blog, so between both of us we hope to share 2 blog posts a week! 
-Meredith