*Medical Student, ANU
Together with another Australian National University (ANU) medical student, Kate Thornton, we undertook our elective at CSI Holdsworth Memorial Hospital in Mysore and stayed in the onsite staff accommodation provided by the hospital. Commonly known as the Mission hospital, it was one of several in the town of around 800,000 people and generally served quite a poor population. It became apparent very quickly that despite the haphazard infrastructure and crowded wards, the staff had the clinical skill and access to technology to provide remarkably good care but their efforts were often hampered by their patient’s inability to pay for their treatment. That said, the hospital went to every effort to make care affordable to those who requested it, by discounting fees, minimising lengths of stay, and even going as far as washing and reusing disposable gloves. The doctors were very welcoming of students, and since most of the patients couldn’t speak English, the doctors were invaluable in translating consultations so that we could actually tell what was going on.
Our first week was in the medical Intensive Care Unit (ICU). This was fascinating to experience, since a lot of the causes of Indian ICU admissions rarely happen in Australia. There were quite a few snakebites, organophosphate poisonings, tropical diseases and more TB than you would ever want to see. However, there was also lots of asthma, diabetes and diseases which one more commonly associates with more developed nations. The doctors there made reference to the increasing wealth of the Indian middle class, and how it is causing the incidence of diseases like diabetes to rise markedly. Once we became accustomed to taking off our shoes and putting on thongs to enter the ICU, we realised that the paternalistic model of healthcare is still very much alive and well in India, with patients rarely questioning their doctor’s orders.
The second week was surgery. Unfortunately December and January are the quietest months of the year in Mission hospital with fewer patients and many doctors on leave, so the theatre lists were rather sparse. However, we still had the opportunity to witness a castration performed under regional anaesthetic for a man affected by prostate cancer; something which was both cringe-worthy and very unlikely to occur in Australia.
Week three was paediatrics. Here we attended outpatient clinics where children mostly were experiencing typical upper respiratory and gastrointestinal infections. It was on the wards however, where one could see a huge variety of mostly infectious diseases; TB, hepatitis, gastrointestinal infections, typhoid, and dengue.
In the last week, I spent most of the time in the surgical wards. For whatever reason, nearly every patient I saw during this week had either suffered horrific burns or head and facial trauma in motorcycle accidents. It was confronting, and I’ll never forget a 19 year old male patient who had broken every bone in his face after crashing his motorcycle without a helmet and how distressed his family was.
After our elective, we spent two weeks travelling; to Mumbai which was the most hectic, busy and unrelaxing place I have ever been, and to Goa which was laid-back, beautiful and a terrific way to end our trip. All in all, the time in India was sensational. The food was to die for, and with a little common sense you can get through a trip there without getting sick. Everyday tasks in Australia like buying a train ticket or crossing a road can be exceedingly frustrating or downright dangerous in India, but all the social contrasts merely add to the fun of travelling there. I would warn however that Caucasians in India attract an enormous amount of begging and heckling from people and vendors on the street, and the enormous population and poverty can be very striking. But I really enjoyed our elective in India, and would recommend it highly to any medical student considering an elective on the subcontinent.