On the Road: Parting from a Place Apart

Amy Gajaria

26 June 2009

…leaving Than Goan

The idea of leaving this place fills with such sadness.  I cannot
imagine trading the sounds of chirping birds for the honking and dust of Dehra Dun.  Being here has been such an amazing experience, and in many ways what my idealized version of India was before arriving.

A few days ago, we hiked a few hours uphill through the jungle to an even smaller village; this one inaccessible to motorized vehicles.  We went up with a team of medical staff, a doctor two nurses and a porter, who routinely hike to remote locations to provide medical care to people who wouldn’t otherwise have access to it.  Being a part of that experience was amazing.  We sat out in the courtyard of a locked building and spoke to the array of people streaming through: some who just came curious to watch, and some with genuine medical concerns.
I can without a doubt say that it’s the most unique place to ever have checked a blood pressure or looked in some waxy ears; it made primary care provision exciting rather than a little mundane.

Though much of the healthcare that I’ve seen thus far is comparable to what we do in Canada, this experience was quite different.  The doctor we were working with (the unique and lovable Dr. Paul) had to do all his diagnosis and treatment with what the porter was able to carry up the moutains on his admittedly strong back.  Despite this, he was still able to provide so much to people that otherwise would have had to hike for hours in somewhat difficult terrain just to get acetaminophin or to receive solutions to balance their electrolytes after a bout of diarrhea.  Were anyone to need any lab investigation or dental work, or even were they to need to see any kind of specialist, they would have to hike hours to a place where they could hop on a shared jeep into Dehra Dun.

The other day in the primary care clinic in Than Goan, we saw a woman who had been gored by a bull, her arm cut deep to the muscular tissue.  Luckily she living in Than Goan, but we heard stories of people with similar wounds hiking five hours to have it stitched and then, after receiving stitches,  hiking five hours back uphill to their home.  It really helps put into perspective how lucky I am, living in a Canadian urban center, to have such easy access to healthcare.  It’s unbelievable how difficult it is for people to see a doctor, and I couldn’t believe how sick some of them became while waiting to see a doctor.   People even have to hike hours to the clinic to get something as simple as a urine pregnancy test, which is unbelievable to me.

Though so much of what seems to be done here is basic primary care:
taking temperatures and treating the flu and gastrointestinal issues, it’s sobering to remember that people cannot simply buy a thermometer, and even if they could, some of them wouldn’t know how to use it.  The gastrointestinal issues are severe, and yet, people are still walking with such little energy that when they arrive to the clinic, they need to be on a multiple day IV.
It’s particularly eye-opening to see the way that sexual health issues are dealt with here.  The doctor we work with cannot even ask about pre-marital sex, for fear that the whole village will descend on his clinic in anger, and so just prophylactically treats all potential sexual transmitted infections.  It’s such a different way of life that it’s sometimes hard to wrap my head around and accept.  Apparently abortions are legal only for married couples here, which though it seems culturally appropriate, truly worries me.

On top of all the amazing medical things I’ve seen, the physical landscape that I’m surrounded by has been unbelievable.  I wake up to do yoga just after the sunrise and take my evening meal outside under the stars.

The mountains gently rise in the distance before plunging into lush valleys through which clear water gurgles.  After one of our hikes, we plunged into the moutain stream, fully clothed, and scooped the clear water into our mouths.

On either side, steep paths switchbacked through the trees and butterflies flitted past our suddenly cooled heads.

Amy Gajaria has just completed her first year of medical school at the University of Ottawa. She’s set off on a two month journey across Asia, spending one month of that doing a medical elective in traditional medicine in the north of India. Amy has yet to see a deadly animal in India, but will keep her eyes peeled in anticipation.