August 30th- September 2nd: Visiting ICTPH Clinics

Rachael, Marjorie, Alison, Andrea and Sarah at the clinic on Wednesday

The rest of the week we have been visiting the three clinics that are currently open and functioning in three different villages. The clinics are small and the patient flow is sometimes minimal at this point. Most clinics only see about 5-25 patients a day. In one of the villages the clinic is the only access to health care for the entire village. It was nice to have such an amazing introduction to the theory behind the program and then to see the theory in practice at the clinics.

Clinic equipment: scale and blood centrifuge

The clinics are sustainable and small. ICTPH typically buys out a shop and turns it into a clinic, using nice floor tiles and translucent doors that can be used to create privacy when needed (like it can be pulled out to cover the bed, but is tucked away when not in use). The materials are all locally produced. The one we saw had a large room with dividers and two examination rooms. Each clinic has an autoclave (to sterilize instruments) and lab diagnostics. Currently, two clinics send their blood to the third clinic which serves as a diagnostic hub. Samples are sent by way of a motorbike, then the blood is tested at the hub, and information is uploaded on the computer and the original clinic can view the results. The patient waiting area is on the covered terrace. All of the health records are electronic and are audited in real time.  

The vegetable garden behind the clinic

Prices are listed on the walls and payment is made at a separate shop. If patients can not pay the full price, then they can pay any amount that works for them. There are also Community Health Workers (CHW) who are from the village and work 20 hours a week, going into houses to tell community members about heath promotion (they do not say to just come to the clinic, but to seek care in general). Villagers can go to the CHW's house for questions or to ask for their blood pressure to be taken.

The nurse's work area in the PHC

On Wednesday we went to a clinic. It was very modern and clean. Unfortunately, there were only a few patients- it was Eid (a Muslim holiday to celebrate the end of Ramadan) and there was a big wedding in the village, so that might have affected the attendance. We went to a primary health center (PHC) afterwards which was further away from the center of village it served. The clinics were different in a number of aspects, including types of services offered (for example, the PHC also cares for pregnant women including labor and delivery).

                                             

An example of one of the delivery beds at the PHC

In the afternoon on Wednesday, we drove by a rice field and decided to stop and watch the women as they work and take pictures with their permission. They were chatting a lot as they worked and there was a lot of laughter, which was nice to see.

Women working in the rice fields

Peruvudaiyaar Temple

Wednesday evening we went to the huge Peruvudaiyaar Temple (also known as Brihadeeswarar temple) and wandered around. It was a large holiday that day, Ganesh's birthday, and there were many at the temple to celebrate. We went inside the holy of holies and were all blessed by the priest and then he asked us where we were from. At the next altar, the priest welcomed us again and gave our blessing in English and told us about the gods. It was very nice and welcoming. A lot of people approached us- to practice English, to learn about us, to see if we liked India, and to take pictures with us. It was very nice to be a part of the ceremonies and feel like we could observe and not be a complete outsider.

The ICTPH clinic from Thursday

On Thursday we went to a community health worker's house to hear her story. With her new education, she helps meet some of the health care needs of her community. She feels that her status in the village has risen with the training she has been given.  She said she wanted to be a CHW to learn more about health and at first her husband resisted but she persisted and now he is glad she is a CHW. Other villagers come to her house to get their blood pressure taken and many are on medication now because of that awareness. She refers villagers to seek care when needed.

One of the children in the village showing off his reading skills
in english and tamil

The village we visited on Thursday while
spending time with the CHW

Over a cup of chai, we learned more about her family and played with the many children running in and out of the house. All of the children (4+) speak English (as do the mothers) and they receive workbooks in English and Tamil at school. We played outside with the children, one boy was very energetic and running around then when we went inside, he wanted to show us his school work and he sat right down and practiced his letters and numbers. He was almost four years old and writing in both English and Tamil. It's amazing how most people are bilingual! One four year old girl sang a song in English for us. We had so much fun spending time with the CHW and her family. The women had all married into the same family, three brothers, and were very close-knit. We have noticed that in India the family is very important, if not the most important part of life.

The large and welcoming family we enjoyed spending time with at the village on Thursday

An example of the equipment used during
 eye exams at the vision clinic on Friday

On Friday, in the village of Alakuddi, we visited the last clinic and then walked through town. We were being shown the village by one of the ICTPH health workers who lives in the village. She showed us her house which was next door to a house where a feast was taking place for a woman who was 32 weeks pregnant. It is village tradition to hold such a feast at 32 weeks for the woman's first child, in the father-in-law's home. There were many people from the village and we were asked to join. The pregnant woman was wearing gold jewelry around her head, neck and even tied into her braid. Her clothing was a beautiful sari of maroon and gold. She looked so proud! We took pictures with her and then sat on the floor where banana leaves were placed and seven different types of rice were set out. We felt so honored to be a part of such a special day.

The ICTPH vision clinic we visited on Friday

We then had dinner at our hotel restaurant and as we have been enjoying most of our meals here, the waiters knew us and our music tastes. Sarah enjoyed a particular song and asked our waiter friend about it. He was kind enough to go to the market and gave the CD/DVD of the singer to her as a gift.

Our favorite waiter from Temple Tower in Thanjavur!

Friday night we all piled into an overnight train back to Chennai for our last weekend.Once there, Sarah decided she wanted a new hairstyle and cut off around 6 inches from her hair! We can not believe the three weeks are already finished. Time has flown by and we've enjoyed ourselves immensely.

Alison, Rachael, Sarah, and Andrea enjoying
a game of Quiddler on the train

Getting ready to board the Thanjavur train

Thank you to all who have followed our adventures. We look forward to sharing more pictures and stories when we return with our family and friends. Our biggest thank you is to all of the Indian villages/ communities, CMC, and ICTPH for hosting us and making us feel welcome!
Sincerely,
Sarah Chipps, Alison Ercole, Andrea Leverkus, and Rachael Starnes

Sarah getting 6 inches chopped off