HMRI part 2 , the saga continues
Posted by sapnasshah on 30 September, 2010
The night before we went on our 104 mobile visit, we had important matters to tend to. Here we were in the city of pearls; we would be remiss if we didn’t do some serious damage. So, Neena Auntie to the rescue, we arrived at an awesome jewelry store where we all had a great time followed by a trip to Neena Auntie’s sailing club (yeah we’re high rollers here). While we were waiting for our pearls to be strung, I naturally was drawn to watching a little girl about 3 years old at the store. She had on a yellow shirt and a floral skirt complimented by two curly pigtails. She was clearly not as interested in pearls as her mother, but was happily entertaining herself. She was watching herself in the mirror, making faces, and playing with the sash from her mom’s salwar-khameez for over an hour. I was in love. She was so well behaved and you could tell this was not her first time out on a long shopping trip with her mother.
I couldn’t help but think about her when we arrived at this remote village and saw a little girl the same age with those same curly pigtails, a black and white dress, and shy smile entertain herself with her 23 year old gravid mother’s sari. I followed them (don’t worry I wasn’t going to steal the child, Amanda) from registration where she and her mother had their photos taken for their EMR, to station 2 where temperature and review of systems was obtained by a nurse and station 3 where they took weights and heights. They bypassed station 4 which was for blood pressure management and patient education about chronic diseases (primarily asthma and diabetes) in favor of station 5 where her mother had her hemoglobin checked via mouth pipetting and a haemometer, and finally on to station 6 for folic acid and multivitamins. Just like the little girl in the pearl shop, this little girl was so well behaved and you could tell this was not her first time through the line. From a young age, she was both receiving basic healthcare monitoring and being exposed to the importance of medical care.
As I fell in love with another indian baby (probably the millionth on this trip), I couldn’t help but think how these two beautiful little girls were from very different families. One had the means to spend an evening buying pearls and the other likely had very little extra comforts at home. However, to a certain extent, 104 mobile is at least able to bridge the gap in healthcare access for them. We have seen a lot in these past three weeks; it’s really been an incredible experience clinically. However, 104 mobile is definitely the program that I think has impressed me most. While they are limited in the services they provide – they only have a staff of 7 per van, their only labs are hemoglobin, accucheck, urine albumin, glucose, and HCG and their dispensary is limited—they have an incredible opportunity for expansion and refinement. Just today, Peter and Luis returned crazy with excitement after a great day with the HIV specialist, Dr. Emmanuel, at Gandhi Hospital. They said he had heard of 104 mobile and they were planning to work with them to expand their ability to diagnose and treat HIV. The program has only been in existence for 15 months and already they are starting to make an impact on both the rural and medical communities. The potential for this endeavor is vast. We have witnessed a lot of discouraging cases, overwhelmed clinics, people unable to afford care, and caring providers often too late to make a difference. I thought visiting this village might be a little depressing. The people there do not have much money. They live in substandard housing. Their school has 110 students in a very small states and only goes up to grade 7. But it turned out, we were welcomed graciously (no surprise here) by some of the happiest people we’ve met so far. If this service can break the poverty-disease cycle, even for a few people, that’s really encouraging.