CHAD OPD

India is incredibly polluted; thus, my allergies are driving me crazy out here. In the US, the further south I moved in Texas the worse my allergies got. I seriously thought that when I came on this trip, allergies wouldn't be a problem for me. I almost did not bring my meds b/c of this. Turns out I was sadly mistaken. India is super polluted with all the cars, ricksaws, & motorcycles all over the place. Plus it doesn't help that people throw their trash everywhere like it is nobody's business. I refuse to contribute to the pollution of India so I carry all my trash in my bag all day long until I can find a trashcan, eventhough I know the trash will end up in someone's backyard pretty soon. Plus, one of the other foreigners told me he doesn't feel too bad when he litters since some goat, cow, or stray dog will probably end up eating it anyway. I guess it is just for my own piece of mind.

My first week here I was fine, but since monday of this weekend my allergies have been ridiculous. Right now I am taking a bunch of meds just so I can breathe properly and get some decent sleep: I am 25mg of benadryl at night, 10mg of xyzal in the morning, one drop per eye of azelastine twice a day, and 2 sprays of nasonex in each nostril every morning. I was hesistant about adding benadryl to the mix, but sleeping monday night was incredibly hard. I felt like someone was smothering me as I tried to sleep. But with benadryl on board, I sleep like a baby.

On monday, I started my CHAD rotation. CHAD stands for Community Health and Development. It is like an outpatient facility for the indiginent population of Vellore. The services they offer here are even cheaper than those offered at the CMC. My CHAD rotation started in the outpatient pediatric department. I was amazed by the amount of kids we saw that wore no shoes. They would be running about the clinic, but with no shoes on. It really bothered me. I wasn't sure if it was a cultural thing or just a I don't have enough money to even buy my kids some shoes thing. Of course all the kids we saw were super cute. Their parents put jingling ankle bracelets on their daugthers along with a bunch of black bracelets. The bracelets are believed to ward of evil spirits. They also put black dots on the cheeks, mid- forehead, or on the soles of their kids. This was to ward off the evil eye. Hindus believe that when someone gets in the face of their child and praises them and says how cute they look this brings bad things upon their child. So they put these marks on them to ward such things away. Some of them also used an eye pencil to draw in their kids eyebrows but I have no clue what this marking was for.

Most of the kids that came in were similiar to the typical things I see in the US. The doctor spent a lot of time consoling parents about colds or viral syndromes. I got a bit bored after a while since the doctor was mostly speaking Tamil and not talking to me much so I moved on to another doctor. I looked around and found a fellow American doctor with a translator so I went over to his table to shadow him. He was great to work with, but spent a lot more time talking to me than his patients. He was also a fellow Texan and recieved his family practice training in Forth Worth. He stated that he has lived in India for the past two years after being called by God to come do missions here. He has been very appreciative of his time here and enjoys the fact that his patients are so grateful for whatever help he can offer them, which he never really felt he recieved in the states. He stated that he gives each of his Hindu patients (not the Muslim ones) a booklet on the Gospel of John after he takes care of their complaints. He feels Hindus like religious people and are very open to learning about other peoples' religious beliefs. His translator was a convert to Christianity 10 years ago and recently married a Christian woman but was disowned by his family after he did this.

Most of the patients I saw with the American doctor were your standard diabetes and hytertension patients. He kept on telling me that I wouldn't have to deal with such issues as a pediatrician, but I had to remind him that I was coming from the obesity capital of Texas. He also told me about how he had read a recent article about an increase prevalence of diabetes in low birth weight babies and he felt this may be one of the contributing factors to the high rates of diabetes in India. He stated that by the time his patients are diagnosed with DM, they already have signs of neuropathy and ridiculous difficult sugar levels to control.

I was so proud of myself when I noticed before the American doctor did that one of his patients had pityriasis versicolor, but the patient wasn't interested in treatment of this rash since it wasn't bothering him. Another interesting patient was a hypertensive patient whose BP was out of control. The first time his BP was taken it was at 211/110 and at this current visit it was at 180/110. They can't get his BP under control b/c he doesn't take his meds on a consistent basis since he can't always afford to purchase them. He works as a security guard on the CMC college campus and only recieves 2500 rupees a month. This is nothing when I am living on about 500 rupees a day for food and transport which doesn't include my accommodation expenses.

After clinic monday, Kathryn, Collin, Nicollete, Erica, and I decided to visit the Golden Temple. This the temple I spoke about in my 2nd or 3rd blog posting that is a big tourist attraction here in Vellore. It is only a couple of years old and is a multi-million dollar project. Sidenote: Spending so much monery on a temple didn't make much sense to me since so much poverty surrounds India. Developing countries never have have their priorities straight. Anyway, this gold plated temple was built to honor a 31-year-old godman who calls himself Narayani Amma. He is believed to be a incarnation and embodiment of the spiritual Divine Mother, the Goddess Narayani. It was amazing to me b/c tons of people worship this man like he is a saint. They journey from all parts of India just to pray to this man. They believe him to be a healer as well. Some western doctors have moved to Vellore just to practice in the presence of Amma. Some people shave off all their hair in sacrifice to him when they make the pilgramage to see this man.

I will say that this temple is a site to see and is hard to describe on paper. They would not allow us to bring cameras, cellphones, or anything with us when we went to see it. We also had to take off our shoes and walk through an intricate star-shapped maze just to get to the middle to see it. Messages by 'Amma' were laid out along the path to the temple with writings from the Gita, the Bible and the Quran. It was a very calming and unusual experience.

Pictures above:

1) A picture showing the dots parents put on their kids' faces.

2) This is a pic of Kathryn and Collin in the ricksaw next to me as we were off to see the Golden Temple.

3) This is a pic of us on the roof top of Hotel Darling after our trip to the Golden Temple. If you look closely we all have red dots mid-forehead which means you visited a temple. They put it on your forehead as you leave the temple.