We finish our time in Hyderabad with an excellent final visit to Snehakiran Hospital, a site run by Catholic Health Alliance of India. Our discussion with the two providers there was assisted by cultural connections (the primary physician trained in the US, and his wife is American) and the strong sense of mission that this couple possesses – thanks in part to this, we were given a very frank view of the Indian health care industry. In honesty, there were too many fruitful comments in our long chat with Dr Ravi to review them all here, ranging from kickbacks and corruption on the part of physicians to discrimination against HIV positive patients to how Indian patients bring malpractice suits (answer: by their relatives savagely beating the doctor who appears to have made an error). Perhaps one aspect to bring out was the amazing example that he provides of one of the most strenuous approaches to a global health career, where one lives with your family in a low-resource setting (and, in his case, makes a salary by doing 2-4 week stretches of nocturnist work in the USA periodically), as well as a very frank discussion of the fears he lives with about contracting TB (as one of his nurses very recently did).
(I should note that his wife is also amazing, and also has made those same decisions – I single him out just since we spent a much longer time talking about the above aspects with him than with her)
Too, he provides a great example of moral motivation and calling. Among his many pithy lines in our hour long discussion, the one that summed it up best for me was the elegant truth of closing a paragraph on the hardships of HIV patients, “sooner or later, somebody’s got to do something. And that will not change things for everyone, but improvement for all starts with improvement for some.” (slight paraphrase)
I leave Hyderabad with ample new knowledge on global health, both experiential and factual; less ample and less welcome new weight (great food and not biking each day takes a toll, even over two weeks!); and most of all a series of developing relationships, ranging from deepened connections to my (amazing) colleagues on this trip, novel connections to many impressive healthcare providers throughout Hyderabad, and a vastly expanded connection to my role as a global health educator.
Obligatory shout-outs: Ania, Kari, and Lauren have provided impressive discussion in person and online – I look forward to our continuing dialogue, especially with Kari and Ania as my inaugural residents in the BMC IM global health pathway. And, of course, this trip could not have occurred without the connections that Gopal has nurtured throughout the years – I’m appreciative of his generosity in organizing the venture, in providing support for it (not the least by leading it!), and I’m eager to help grow the BMC-Hyderabad links in the months and years ahead.
I believe we’ll continue to use this blog both for incidental posts about global health affairs as well as a method of inducing (perhaps forcing) some amount of reflection from other residents who go on international rotations in the coming year. Thereafter, BMCIM-HYD 2014 looms large in my mind…something I will be looking forward to for next year!
(a final picture of the three blondes looking with appropriate concern at the sole item of street food we purchased on the trip, haleem, a local delicacy consumed during Ramadan [or Ramzan as they term it here] – it was very tasty, but the jury will be out for 12-36 hours as to whether it was very wise!)