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Last thoughts

So, we’re back from India. The traveling portion of the trip has settled into the longer, tapered-out phase of letting what we experienced sink in. If I had been asked before leaving to predict what topics I had learned the most about, the list would have looked something like this:

  1. India, itself
  2. health systems, in general
  3. tropical disease

And the After list looks more like this*:

  1. economics
  2. money
  3. how things get paid for

*numbers 4-10 are Ivan Illich

In retrospect it’s not particularly surprising that all the finance-related stuff would be so important, and it’s not surprising that I failed to guess how front-and-center it would be. As I imagine to be the case for most people at my phase of training, I’ve had to move from a concept that global health was a matter of adapting to being a doctor in settings with different resources and systems; it’s more about learning to adapt resources and systems. Nothing captures that quite like learning about money. A lot of that learning happened for us via readings and discussions, and India was a wonderful backdrop against which to see that demonstrated. What I’ll remember most about our experience on the ground was the stratification of care that we saw – different resources and systems a few blocks apart.

I want to end with a word of appreciation for all the support that made the trip possible:

– James Hudspeth, our intellectual guide

– Gopal Yadavalli, for making these trips an important part of our residency program

– Yuvaram Reddy, for so much effort behind the scenes

– and finally, Ashley, Sukhie, and Karen for being such great trip-mates

This entry was posted in BMC.
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