Tuesday, January 8, 2013

Healthcare in Jamkhed, India: A Winter Intersession Experience

Elizabeth Krawczun, a CUNY BA student with a concentration in Epidemiology and a member of the Verrazano Class of 2014, is spending the winter intersession in rural India.  Elizabeth received a Verrazano Study Abroad Scholarship to help support her study abroad experience.  Read below for her first blog post.

Seven months ago, I certainly did not expect to be starting 2013 in rural India. The Brooklyn College program in “Global Health” is very applicable to my major in Epidemiology. I was surprised and excited to see this study abroad course offered. The majority of the study abroad courses I researched sounded lovely and promised to be educational and an unforgettable experience. What struck me about this study abroad, in particular, was that its purpose was to immerse students into the lives of villagers in rural India.  

India, while a growing global power, possesses an extreme discrepancy in distribution of wealth, power, and standard of living among its citizens. The rural villages within Jamkhed, where I will be studying, are undeveloped and the people there live in severe poverty and lack the basic services that we, as Americans, take for granted. Diseases that have been eradicated for decades in the United States continue to inflict India’s impoverished areas.

I will be housed and study at the Comprehensive Rural Health Project in Jamkhed. This facility was first established in 1970 and is now recognized by the World Health Organization as the “Jamkhed Model”. This model is quickly being adopted by many health care facilities in the southeast and has gained international attention. The two founders of the project created this model with the idea that doctors should not have a monopoly of knowledge; that knowledge of disease treatment and preventative health care measures should and must be brought to the people. 

To begin the transition towards this new design, a young woman was chosen and trained by the staff at the hospital in identifying common diseases, like leprosy, administering some treatments and educating the villagers. These “Village Health Care Workers” faced a huge amount of discrimination and mistreatment. There was and still is a huge amount of gender inequality in India and the founders of the program believed that this inequality was one of the major factors contributing to the high death rates and low standard of life.

In this study abroad course, I will learn and study the Jamkhed Model and be able to discuss why or this outline could or could not be applied, with success, to other countries and other methods of, as the doctors in Jamkhed call it, “biomedicine.” Relating this design to others, based on numbers and statistics, is not enough. The international and intranational politics, including non-governmental organizations’ intervention and foreign aid, must be factored in.
During my time there, my group will visit some of the surrounding villages and have the opportunity to observe the Jamkhed Model in its application. It will be difficult to see the state of some of these areas, and I have been warned of some of the dangers associated with being a Westerner there. We will meet the Village Health Workers and be able to see the good that they do. The course syllabus is flexible because there are likely going to be times when we will be called away to see a surgery or medical procedure, either in the Program’s compound, or in a nearby village. 

In the past, students have been present for medical procedures, for example, cataract surgeries and child births performed by a midwife. I have always been interested in medicine and have seriously considered medical school, but chose the major in Epidemiology because I feel as though medicine can sometimes be too distant and that a patient can easily be considered only as far as what symptoms he or she presents. What most attracted me to this course, and why it corresponds with my major, is that the focus is on the people. Training the people to care for and educate the people comes before the medicine. One of the goals of the founders was to prioritize preventative measures over curative medicine.

I am grateful for the opportunity to travel abroad to observe such an amazing mission. However, there are many safety precautions that have to be taken. Along with routine vaccinations, I have had to take malaria prophylaxis, along with typhoid, Japanese Encephalitis and several other vaccinations. In addition, there are fairly strict codes of dress, particularly for women. In Jamkhed, all the women wear saris. The females in my group and I have been told that we will only need to wear a sari when traveling to the larger villages and the two holy sites that we will visit. At all times, we must have our legs covered to around mid-calf and shirts that are loose and cover our backside. Scarves should always be worn, as one never knows when a head-scarf will be needed to cover long hair, which is considered to be suggestive and inappropriate in some areas.

The weather varies greatly during this time of year. The days generally reach 85 degrees, while the nights are around 40 degrees. The housing areas do not have heat, air conditioning, hot water, and flooring. Bottled water is provided by the Project and visitors are counseled against using any other water. Luckily, all meals are provided by the facility and, again, foreigners are advised not to eat anything from street vendors.

The first hurdle I have to get over will be the daunting task of sitting on a non-stop flight for fifteen hours, immediately followed by a nine hour bus ride. 

I know that this experience will be life-changing and am very much looking forward to this once in a lifetime opportunity. I cannot wait for my journey to begin.

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