C.H.A.D.

Community Health and Development is what CHAD stands for. This is the rotation that everyone seems to love. It gives us the opportunity to go around to the surrounding villages and see patients to determine whether they need to go to the hospital or if they can be given meds out of the supply carried in the truck. There are doctors rounds, nurses rounds, and clinic held at or for CHAD which is next to the CMC campus. The doctors rounds are in a large van/bus that goes around to the villages to see patients. I will tell you about nurses rounds because I thought they were more interesting.

On nurses rounds we went out into the villages in a four-wheel drive SUV so we could maneuver over the potholes and dirt roads. Luckily it has been dry and hot so I did not have to push any trucks out of the mud like I did in Kenya! Nurses rounds are done either before or after the doctors rounds to work up a patient or follow-up with a patient. There was one nurse, three medical students, the driver and we picked up a local health aid worker in each village who was supposed to know where all the patients lived and if they were home. All of this works beautifully in theory but when it comes to reality things start to fall apart. Without the modern luxuries of cell phones, landlines to the huts or email it's difficult to communicate with the patients and remind them the health workers are coming. I don't know about you but if I could go to work in the fields to make money and feed my family or sit around and wait for medical care at home I would probably go to work too! We wonder why it takes so long for people to come and seek help for their ailments but when you break it down to a matter of life and death I would pick life and tolerate the pain then deal with the consequences when the time comes.

The truck.

The people we did find and take care of seemed like a social visit more than anything. We would go to the home to seek out the patient, would subsequently hear about the rest of the family then the neighbors would come over and talk for a bit then everyone would leave feeling like something was accomplished, just continues to prove the power behind a good listening ear. We saw mostly foot ulcers secondary to diabetes. The nurses also collected death certificates of the recently deceased, checked on any pregos and newborns, which I was excited about. However, the two pregnant ladies we went to check on had left that morning to go to the hospital and deliver (Both had healthy baby boys, fyi) so we didn't get to see any of them.

Little girl in the school with nutritional supplement in her hand.

I have to say the best part of the day was visiting a little school house that had kiddos from ages 1-5 and they were all busily writing on chalkboards when we first entered. We went to deliver some nutritional supplements which was some sort of peanut butter based block of stuff (highly technical term, I know, but I don't know how else to describe it) with additional glucose and vitamins. We tried some and it was a little too sweet for my liking, needed more peanut butter, but it was definitely filling and the kids liked it. Before leaving the kids all got up and sang a song and jumped around dancing, imagine twenty screaming kids in a small concrete building jumping up and down, it was awesome!

Little girl at one patient's home that was terrifed of me, blue eyes are not very common in India, but she really wanted to eat the peanuts.

All in all it was a lot of fun wandering through these little towns and seeing where people lived and not feel like we were there as tourists but as people providing a service and something they were appreciative of having. It was definitely hot, once again, but we lived through the day and ended at a health clinic and shared a cup of tea and friend plantains with another nurse and her family.


So far everyone seems to be doing okay. Vida's bag finally arrived completely intact and there have been minimal GI issues along the way. This weekend we are going to Kerala to get on a houseboat and relax for a few days. Next week is Ob/Gyn, woohoo!