Village Medical Camp

Quite a many public health experts think of a one time medical camp as a waste of resources. However, we get invited many a time by organizations to conduct medical camps in villages. 

I usually oblige. The prime reason being that I need to have a very good relationship with the organisations who call us for these camps. The other reason being that many patients who need surgeries are identified and referred. However, experience says that very few of them turn up. 

But, the major reason for going for a camp is that we doctors get a hang of what is happening in the communities only if we go for such camps. 

Last week we had a medical camp was in a remote village in Chinia block of Garhwa district.

My quick notes about the place – 

- The impoverishment of the area strikes you. There were only about a dozen people who had an average physique. Almost all the women were poorly built and nourished. 

- There is a high incidence of hypertension. We calculated about 40 newly detected patients with high blood pressure in the crowd of about 400.

- There is a high incidence of cataracts. The fact that the elderly are quite disabled by cataract is comfortably ignored. Very few families were bothered about it. The attitude was that they are old anyway and therefore there is hardly a need to worry about their sight. They only want some medicine to be put and we found it difficult to convince the families that these elderly would benefit from a simple surgery. And we were doing it free. Of the 40 odd patients whom we referred, only one turned up for free surgery.

- Another striking aspect which was also seen in camps we did earlier was the high incidence of corneal opacities in the young. Most of them were secondary to trivial injuries to the eye.

Of the above, the most worrying . . . the relatively high incidence of hypertension in rural communities. With the amount of follow up that non-communicable diseases such as hypertension warrant, they could spell the death knell for quite a lot of our agrarian populations.

The quite a few number of strokes we get in NJH is good enough proof.

 
I wonder how serious we are about the morbidity and mortality that non-communicable diseases can do to agriculture economies . . .

Geriatric Care . . . cont'd

The elderly lady sitting in front of me in the medical camp couple of days back in a village near Panki was the epitome of all what stood for geriatric care in rural India.

The rugged creases on her face and forehead would have been the delight of any professional photographer. She had such an artistic expression of the ruggedness of the countryside.

Then I looked carefully into her face. Both her eyes were glazed, caused by hypermature cataracts. I wondered how long she has been blind. I looked more carefully. In addition to the cataracts, she had pterygium in both her eyes.

Then I noticed that she was feeling her surroundings with her hands. I was having the glass of 

Sprite which was on table while she was helped to the patient’s chair by one of the volunteers.

As I helped her hands on to the table, I was horrified to see that both her hands were stiff from the shoulder down. The elbows were bent and fixed at an obtuse angle. The muscles had obviously wasted away. I asked her about her hands. Small pox . . . that was the answer.

The best thing I could do was to help her out with her cataract. However, the volunteers told me that she had come alone. They could not trace anybody who knew her. Tracing her home could take some time as people from more than 50 villages had come for this medical camp.

I wrote on her case sheet. - Bilateral cataract. However, no relatives to help with decision.

I gave her some multivitamins. And, a dosage of deworming medicine.

She got up to take leave. She wanted to know if she got some medicine. I told her I have written some. She was happy. She gave me a toothless smile . . . very similar to the one that a baby gives you when you give her a cuddle.

And as she stood up, I was horrified to find out that she was bent over. She had  a very bad spinal gibbus. It needed quite an effort from her to change her position. 

I once again asked the volunteer to ask her about her relatives. She had overheard me. She waved her hand and told me that nobody bothers about her. So, there was no point in asking that.

A very simple condition like a cataract was a major challenge for her. We were ready to treat her, provided she had someone to take care of her during the peri-operative period.

The sad state of our society where the elderly find themselves at the margins with nobody to turn to for help says quite a lot. 

(The snap used in the post is not that of the lady mentioned in this post. This has been googled.)