Health post: Medical Camps in Rural Villages

Last week I traveled to Bhopal, the tier-two capital city of Madhya Pradesh, a state in central India. I was there to participate in a health camp called Medical Yatra, which is an annual event to bring healthcare services to rural villages across the country. Each year, the Medical Yatra team convenes in a new city and spends ten days traveling out to neighboring villages. It’s a joint effort by an association of India physicians based in the states, local hospitals, the non-profit foundation Aarogya Seva, and the Rotary International club (http://www.aarogyaseva.org/medical-yatra-2017/).

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Aarogya Seva’s slogan is “Promoting Healthcare Volunteerism.” While I wasn’t planning on doing any volunteering on the Watson, I felt humbled to be included in the group and able to contribute in some way.

I heard about the camp because a company I interviewed for the project, MyCliniCare, was going to attend for a few days to bring their technology along with the medical supplies. MyCliniCare provides a telemedicine solution in the form of a suitcase for on-the-go healthcare. The suitcase, which can be brought to any rural area, has many small medical devices and monitors along with a laptop that synthesizes the collected data and connects to a trained doctor over a video call.

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The MyCliniCare team and me in our volunteer t-shirts! The MyCliniCare suitcase is in the shot as well.
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Dr. Dayaprasad, founder and director of the Aarogya Seva foundation, giving a presentation to medical students in Bhopal about the various medical diagnostic devices included in the MyCliniCare telemedicine kit.
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Here, Gururaja of MyCliniCare is demonstrating the telemedicine setup by pointing the multipurpose otoscope into his mouth. The resulting image of his throat is displayed on the projection screen, which is what a doctor would see remotely.

One new addition to MyCliniCare’s set is the iBreastExam device, a handheld sensor for breast tumor screening. Using piezoelectric sensors, the device checks for lumps in a patient’s breasts and delivers a result in 5-10 minutes; if it finds anything, a mammogram follow-up is required. In each village that we visited, the MyCliniCare team set up a private place for their technician to screen women with iBreastExam.

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The iBreastExam handheld device is pink and white, and it delivers real-time results to the connected app.
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In the same room as the breast tumor screening, we performed ECGs with this portable device (which also sends its results to a smartphone app, connected via WiFi).

Though I initially intended to tag along with the MyCliniCare team and simply observe, I ended up becoming a full volunteer for a few days since the health camp needed the help. For the first two days, I teamed up with a doctor to run the blood-test station. The doctor spoke to the patients in Hindi and pricked their fingers to get blood, and I took the samples and ran the tests with the devices we had brought. We had a small hemoglobin device to test for anemia and a small glucometer to test for high blood sugar.

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The HemoCue hemoglobin meter that we used. Incidentally, it is made by a Swedish company!
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Medicines set up by the pediatricians in the same room as the blood testing.

After months of interviewing people about attitudes towards health and medical technology in rural India, it was invaluable to see those very attitudes in front of me. It felt like all of a sudden I had gone from using secondary sources for my information to primary sources. Most of the villagers were comfortable getting their blood drawn and tested, as it was a simple and quick procedure that was explained to them in Hindi. However, they rarely reacted to the results due to a general lack of awareness of how much blood sugar was too much and what that meant, as well as what the purpose of hemoglobin testing was.

A few of the villagers, especially the children, were scared to get their fingers pricked and found it quite painful (making very familiar cringing faces!). One woman in the village of Tumda sat down for a blood test, had her finger swabbed with alcohol, took one look at the little lancet that was about to pierce her fingertip, and started cursing in Hindi and nearly ran out the door. I was stunned that she hadn’t realized what a blood test entailed. Her reaction reminded me of a few interviews I’ve had here in which people have told me that many Indian patients, especially in rural areas, are resistant to invasive procedure from finger-pricking to surgery.

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Tumda Village.
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As things quiet down in Tumda, the volunteers show each other how to read a classic blood pressure monitor.

As part of the camp, I traveled to the villages of Seoni, Tumda, and Berasia. I was happy that my fellow volunteers were mostly Indian; I wonder if the villagers were a bit put off by my presence (being an obvious foreigner), and it was challenging not knowing Hindi. So it was good to stay useful, and it was fascinating for me to be around so many doctors volunteering their services. Of course, the question of sustainability is always important: how do these one-off health camps help the villagers if we can’t come back to the village? The doctors I asked told me that some care is always better than no care, and the big problem is awareness – many villagers are not aware of their medical issues or how to address them. At least with a visit from specialists via this type of health camp, patients can get the right information and seek the appropriate care at a more accessible (and permanent) health center or hospital. The Medical Yatra team keeps track of all the patients that need to be referred to specific hospital departments, and they send those lists to the nearby hospitals, who then send vans to the villages to pick up the patients for free treatment at their facilities. Also, most patients do have a mobile number, so we can at least call to follow up.

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The school in Seoni where we set up camp.
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Medical Yatra volunteers registering patients for treatment.
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In Bhopal, we visited this government center making prosthetic limbs and offering rehabilitation techniques. Professor Schull, on the left, was interested in comparing their design to his 3D-printed prosthetic designs.
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One of Professor Schull’s 3D-printed prosthetic prototypes.
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The internal medicine room that we set up at Berasia village. The hallway just outside the room was packed wall-to-wall with patients all day.
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Dr. Ramesh Shah, a volunteer from Ohio.

I’m very grateful to MyCliniCare and the Aarogya Seva foundation for letting me join their effort for a few days. It was inspiring to meet so many hard-working doctors and actually operate the type of medical devices I’ve been thinking about throughout my project.

 

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