Volunteering in India

MY VOLUNTEERING

INDIA: JAMES HOSPITAL

I have always wanted to go to India. For me, it is the ultimate exotic location. The culture is so diverse, and there is something about India that, having been there now, I can only describe as intoxicating and rather addictive. My gap year from university took place back in 2001. 

India’s 25 states covers an area of 3,287,263 sq km and I went to Tamil Nadu, which is about as south as you can get in India, to do a placement at James Hospital (JH) in Colachel.  This small town is in the middle of nowhere, and by that I mean that there is no toilet paper to be bought or begged for. 78% of India’s health care system is privately run, financed from private resources and charges patient’s hospital fees. Only a small 22% is government funded, providing free treatment to patients. The private sector dominates, which means that a significant portion of the population have difficulty accessing hospital treatment. 

FREE MEDICAL CAMP

Community action in India plays a vital role in helping to provide better access to healthcare for the underprivileged sectors unable to reach a health care facility. An example of a village health service scheme in action was the Free Medical Camp run by James Hospital in association with the Lakshimipurum College of Arts and Science. I went along with volunteer doctors from JH and student nurses from the nearby nursing school also run by Dr Premkumar James. 

The idea of the Free Medical Camp was to provide free medical care and medication to the poor. The nurses came with little boxes containing a few bottles or red cough syrup, some tubs of standard pain killers like Paracetamol, and Ibuprofen, and a limited amount of tablet bronchodilators, Laxatives, Vitamin B complexes, and some antacids.  It was hard to watch them try to treat all the people with the limited supplies they had. The air became tense when the cough syrup ran out before the end of the free clinic session had ended, and the mothers in the queue argued with each other. It was dark when we started to pack up, the supplies exhausted, and over a hundred people had been seen.

With the nurses, dressed in blue and white saris, I also went on out-reach visits to several villages, part of a community action programme. Diarrhoeal diseases are still the leading cause of infant mortality in India, and I watched as much needed health education was provided to the villagers, teaching them good breast feeding techniques, basic food hygiene, and the importance of seeking out oral rehydration therapy (ORT) early on in an episode of diarrhoea. Other topics covered included the importance of getting their children immunized, as the number of children who had completed their immunization programme by their first birthday was too low. The main problem that these community action programmes face, is the communities attitude to health in general, they give less priority to health issues compared to programmes where they get financial benefit.

I learnt that the community action programmes have helped to control vaccine preventable diseases, by making the public more aware of national immunization days, and out-reach immunization sessions. As a result, there has been a decline in new cases of poliomyelitis for instance. Community action programmes have also been successful in providing drinking water and sanitation schemes, and I saw one such drinking water scheme at work in one of the villages I visited called Simon Colony.

CHURCH OF SOUTH INDIA (CSI)

There are about 18 million Christians in India, and 3/4 of them are located in South India, with the Church of South India (CSI) being the biggest influence. Tamil Nadu contains a large number of highly educated Christian Tamil’s, who are very wealthy. There are various CSI run facilities, which are funded by donations from such people, and from visiting Christian missionaries, and other foreign Christian charities and individuals. 

CSI Polio Home & Primary School

CSI: POLIO HOME & SCHOOL

I visited the CSI Polio Home and Primary School in Allencode, which concentrated on rehabilitating victims of poliomyelitis, a viral infection that attacks the spinal cord, and causes fever, malaise, and in severe forms, paralysis, particularly of the limbs. The school provided free food, shelter, and schooling to children that needed a home. The children would be fitted with free leg braces and given crutches. With the help of physiotherapy and a good education that with their disability, they would normally be unable to acquire, the programme that the home has is designed with the aim in mind of eventually reintegrating the child back into the community that had ostracized them. To the children who are fortunate enough to have a loving home, the emphasis is on community based rehabilitation or CBR where there are home visits made. The number of new polio cases have been falling due to improved immunization efforts through the pulse polio immunization (PPI) campaign, which was initiated in 1995.  They now also deal with cases of cerebral palsy. 

CSI: SCHOOL FOR HEARING IMPAIRED

In Kottaram, I visited a CSI School for the Hearing Impaired, although they called it the Deaf and Dumb School. The higher secondary school was attached to an infant school, and it was great to get a look around and sit in on a few classes.Teaching methods in India often involve learning by rote or ‘parroting’ fashion. I saw this in effect at the nursing school, where a textbook would be learnt by heart word for word, and the exam questions based on that alone.

At the CSI School for the Hearing Impaired, the learning method was very different, and it was great fun to watch the little children compete with each other for the chalk when the teacher mouthed a word out for them to lip-read. When they wrote out the word correctly, they had to try to say the word out loud. When they had difficulty, the teacher would take one of their hands and place it on her own chest, while placing the child’s other hand on their own chest. This helped the child to get a feel of how the word actually sounded. Some words had the same spelling, and almost the same pronunciation, but had different meanings, and were distinguished by the way, for instance, the first letter ‘p’ was said, hard or soft. To help with this, the teacher would have to say a hard ‘Puh’ sound on the child’s cheek, letting the child feel the whoosh of air associated with making the harder version of the sound.  

CHARLES PEASE MEMORIAL LEPROSY HOSPITAL

I also got the chance to visit the Charles Pease Memorial Leprosy Hospital (CPMLH) in Udayarvilai. It was opened in 1890 by Charles Pease, a Christian missionary, in association with the Kanyakumari Medical Mission, a division of the CSI. It is now attached to a sparkling clean private out-patient clinic where rich patients pay for medical treatment, which, coupled with donations from other wealthy Indians Christians, allows the clinic to maintain the leprosy home, and give asylum to leprosy sufferer’s outcast from their own families. 

Most of the patients stay at the CPMLH as in-patients until they die, and are buried out back in a little garden in a secluded spot marked by a stone cross. I met a man who had stayed there for 50 years, and came when he was just a little boy.

The stench and squalor of the leprosy wards was in stark contrast to that of the outpatient clinic. Meals took the form of donations from the local’s. The patients also made their own clay pots to sell, and tended to the land, on which vegetables were grown, and lots of coconut palms. 

I talked to Dr Hyma Ravi, the medical superintendent and second to the chief medical officer Dr Blessed Singh, who ran the CPMLH. She said that although the WHO had issued a statement that said leprosy should be eradicated by 2008, it is far from gone. 

In an attempt to upgrade the health system, many projects have been initiated, amongst them, the National Leprosy Eradication Programme. A management information system and computer database have been gradually introduced, and while the attempts to make it a nation wide system have not yet been successful, some states are participating, and with the help of the WHO, data is compiled weekly and epidemiological reports made to the WHO on a regular basis. Recent figures from a WHO website state that the “prevalence of leprosy has declined from 39 per 10,000 population to 7 per 10,000 by 1995…due to the use of multi-drug regimen” But that the “number of new cases detected annually has remained the same at 0.5 million.” This confirms Dr Hyma Ravi’s matter of fact view. She further stated that the major constraint against progress is the high level of illiteracy, and the failure to seek medical attention early on, mixed with a stubborn belief in quack-doctors, traditional herbal and religious medicines. She said that it was common for people to hide an illness for fear of being ostracized, leading to progression of the illness beyond much help. In addition, there is the problem of low-income levels, and the different social classes to contend with.

I talked to a man who said that although he had requested a prosthetic leg a year ago, it still had not come, and I found out that it would cost about £74. I was allowed to take a few pictures in selected areas, due to my connection with Dr Premkumar James, as photography was actually prohibited. During previous visits from foreigners, lots of graphic pictures had been taken and used for fund-raising purposes without the CPMLH’s knowledge. They did not receive any of the money raised, and were understandably very wary of me. 

TB SANATORIUM

I also got the chance to visit the Kanya Milk Factory in Nagercoil, just prior to visiting a TB Sanatorium in Aasaripallam. Since the introduction of milk pasteurisation a lot of people have avoided needlessly getting TB, but it still continues to be a huge problem in India, despite the BCG vaccine, evident by the size of the TB Sanatorium and the fact that it was full. The wards were individual huts laid out in a uniform formation, rather like the German POW camps that you see in movies like The Great Escape, and set over acres of desert land.  There are currently 14 million people suffering from active tuberculosis in India, and about 0.5 million die of it each year, according to a WHO website. 

SHISHU BHAVAN, KOLKATA

With a population of about 12 million people, Calcutta the capital of British India, or rather Kolkata as the city dwellers now prefer to call their city, may at first glance appear to be just a very dirty and overcrowded place to live in. However, having lived and worked there, the enigmatic magic that is Kolkata has been imprinted into my mind, and I’m already working out a way to get back there.

Mother Teresa once said “We can do no great things; only small things with great love.” And it’s true.  I simply turned up in Kolkata at 1am, found a bed, and the next day turned up at the Motherhouse and registered as a volunteer. What followed was one of the most fulfilling and fun filled times I have ever had in my life, even though it was physically gruelling. 

The Missionaries of Charity was started by Mother Teresa in 1950, and has many homes in West Bengal. There is Nirmal Hriday, the home for the dying, Prem Dan, the home for the sick and mentally ill, Nirmala Shishu Bhavan (Shishu Bhavan), the children’s home, and Shanti Nagar, the home for the lepers, and 6 hours from Kolkata.  I chose to volunteer at Shishu Bhavan. It is essentially an orphanage, divided into two halves, one half being for disabled and malnourished children.  Protein-energy malnutrition and micronutrient deficiency disorder are still common problems in India, and as said earlier, death from diarrhoeal disorders is frequent among the very young. Some of the children given into the home are given in temporarily as the mother is unable to take care of the child, while most have been abandoned in the streets.

These children showed symptoms of developmental delay, due to themselves being malnourished during the early months of their life, and due to the mother being malnourished during pregnancy. A pamphlet by Myron Winick, entitled Early Nutrition and Brain Development, found that malnutrition during the first year of life led to a reduced head circumference, a reduced number of neurons in the brain, and a reduced rate of myelination.

Many of the older toddlers did not know how to walk, as they had been kept inside their cots for most of the day, everyday. Part of the job of a volunteer at Shishu Bhavan was to provide some stimulus to the children, who would be unusually docile, so used to staring into space from their cots. We helped the toddlers walk by holding their hands and making a round, and by playing games with them. Among the practical jobs to be done, there was changing nappies, clothes, and feeding. Some children were unresponsive, which made feeding them very difficult. Nappies were simply bits of clothes, similar to a tea towel or dishcloth, and it took a while to figure out how to tie them on.   The main thing was to give the children a lot of much needed attention; cuddles and piggybacks were always popular! And for the smaller babies, just holding them near you and talking or singing to them was enough.

I am holding baby Clarissa, one of my favourites, in the photo above. She had no arms, but was perfect. I met her mother once, she had come in to visit, and had been watching Clarissa from across the room for sometime before coming up to me. I asked her whether her baby had a name, and she said no. So I called her Clarissa because she just looked like one. I also asked her whether she wanted to hold Clarissa, but she refused, and I never saw her again after that.