Emma Gordon - Medicine and Healthcare, Medicine in India

Outside the hospital In July 2008, as a prospective medical student I traveled to Kerala in Southern India for work experience in medicine abroad. My parents are both doctors in General Practice and I already possessed a wealth of experience ‘shadowing’ doctors in both Primary and Secondary care in the UK. I hoped to gain an understanding of medicine in a totally different cultural environment and to be able to compare and contrast the medical problems of an affluent western society with those in the developing world.

Departing Gatwick at 10am I arrived just 12 hours later in Kerala via Dubai to be met by a representative from Projects Abroad and driven the 6 hour trip to the Projects Abroad office.

Within 24hrs of leaving home I had attended an infertility clinic and then was fortunate enough to watch a mother giving birth; an amazing event.

I was then immediately taken on a tour of Kerala to view temples and spice farms; and discovered that all there was to eat was curry-even for breakfast!

I soon learnt that Health Services in India are a complete contrast to those at home, albeit there exist both heath service hospitals which are run by the government and free to the public alongside private health clinics as in the UK.

The Government run institutions are incredibly busy and there are no national standards by which physicians, nurses and hospitals are trained and no clinical governance. Indian medical students Guidelines and protocols for the management of disease, including length of hospital stay, are virtually non-existent and the ability of hospitals to determine the appropriateness of medical and surgery therapy seems years away (there is no evidence based medicine).

Only 5% of patients can afford the 30p it costs on average to see a doctor in a private health clinic and there is no health insurance. Government hospitals in rural areas are called ‘Primary Health Centers’. They focus on preventing epidemics of infection by vaccinating and health education. Major hospitals are multi-specialist, perform major surgery and have the most updated facilities and exist in large cities only.

Traditional medical practices like Ayurvedic systems are still in practice throughout the country and compete with traditional health care.

I was fortunate enough to visit St. Luke’s Leprosarium in Peikulam, situated in a highly endemic area with a 3% prevalence of leprosy; one of the highest in the world. It was founded by Dr R Vedabodakam in 1954. The hospital offers free treatment, food and clothes to the sufferers. Sponsorship provides the in-patient finance of around 15 rupees a day excluding food with more than 600 people being treated as out-patients and about 100 as in-patients. The hospital is extremely supportive of each individual, ensuring that they are able to continue their hobbies and even earn money during their time there e.g. by making wicker baskets.

If you join a program like this you will see a medical and healthcare system that in many ways reflects the West, but is interspersed with local influences. You may find a doctor trained in Europe who will not carry out an operation because of the position of the stars and you will come across tropical diseases rarely encountered in the West and conditions that have not been diagnosed until very advanced stages.

You will be taken to visit the Leprosy Clinic in Manamadurai where you will observe how this disease is treated and how surgery and physical therapy are carried out.

As a contrast, you also have the chance to experience 5000 year-old traditional Ayurvedic medical treatments at the Vasudeva Vilasam Hospital in Trivandrum.

A weekend break to Kerala's famous wildlife reserve in Thekkady offers boating, trekking and watching the wild animals. You can also take an elephant ride or visit a spice plantation.

This was the most amazing 2 weeks ever and I cannot recommend it highly enough to anyone thinking of applying for Medicine. On returning home I was due to attend a conference at the Royal Society of Medicine and submitted a Poster Presentation on my 2 weeks in India for which I received a commendation certificate.

Emma Gordon

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