Mobile Clinic and Julie's Birthday

Tuesday December 13^th 

^{Mobile Clinic} 

This was the day for Beth and I to go out with the mobile clinic, Julie and Jeremy had gone the day before. It was certainly an exhausting experience! We climb up in the van with the Medical Officer, 2 nurses, 1 nursing student, one assistant and the driver and began our journey to a village… somewhere… On these mobile clinic visits the CMO functions like a PA or physician, but they are provided only a few months of informal training. The CMO has the capability to assess and treat or refer the patients he/she sees during clinic. While in the hospital they work with the doctors and there is one in the ICU or wards at all times. 

After only 20 minutes in the van we made a stop. I was excited and thought we were there, “yay, no bumpy windy ride today!” But no such luck. This was just a brief stop for supplies. The village we were going to was a new location for the mobile team, so Beth and I were not the only ones who didn’t know what to expect. After stopping and asking random individuals on the side of the road for directions (who needs Mapquest?!) we finally reach our destination. A pretty little village that sat on the bank of a river lined with small fishing boats and surrounded by the mountains. 

We arrive at the village and are informed that we will be loading our things into a boat and taking a ride up and across the river to get to where the clinic was to be set up. We could get there by car but we would have to go incredibly too far out of our way. Not gonna lie, Beth and I got pretty excited over a little boat ride. So we took a little stroll into the village and along the river with the sisters (nurses) and the CMO while the car was to be unloaded. We get to the river and see one of the boats we are about to take. Not sure how I feel about this boat ride any more… the rim of the boat was about 6” from the water surface! Right about now I was regretting that second chapatti I had with dinner last night and the sweets they brought us for dessert. Oh well, good thing I know how to swim! We returned to the vehicle about 15 min later only to find out that plans were changed, we were to set up shop on the front porch of a home and there was no boat ride L. That was to be the highlight of our day! Then again, not sure I really wanted to swim in THAT river. Not the clearest I’ve seen!

Clinic is simple, not much to set up. A desk with one chair on 3 sides (one for Beth, myself and the CMO), an area for the lab assistant to collect blood, a place for the nurses to hand out the few medications we had available, and a station to do height and weight. Clinic started with a few children lining up for height and weight and then sitting on a mat waiting to see us. So Beth and I were doing this in a tag team fashion where one of us would work on the physical exam while the other spoke with the parent (CMO as translator) to get the history and make visit notes. 

This approached worked out for a VERY short period of time, until we became completely bombarded. People started coming and it wasn’t long before the front porch was FULL. Then it became so full that people were no longer taking their turn in line and began crowding tightly around the table. As soon the chair where the previous child had been seen was empty there was a parent throwing their child into it. So we reconsidered our approach and Beth and I each took on our own patients with the CMO acting as a translator to us both. This continued on for nearly 4 hours and in those 4 hours we saw nearly 85 patients between the 2 of us. Most were children, a few ante partum and post partum women, and a few elderly individuals at the end. 

Throughout this entire process there was absolutely no privacy what-so-ever. These were focused physical exams, so no undressing was involved and if the ante or post partum women required examination, they were brought into the home and examined there. But all the while we are interviewing patients and hearing about their weight loss, loose motions, loss of appetite, vomiting… you name it… 10 other people were crowded around, listening in and waiting for that chair to clear so they could throw their own child in it. It was just so unreal to us since we were so strictly taught to follow HIPPA. Certainly no HIPPA here!

Finally once all the commotion subsided and all the patients were seen, we were able to breathe! We thought this was a busy day for them, but this CMO said that 60 patients is about the average. This day was a bit busier since it was a new clinic, but otherwise the CMO will see all these patients on their own. Before we left the women of the village organizing the clinic brought us a lunch of potatoe patties with soft homemade buns and a Pepsi. The patties were delicious! After our little lunch, at 3:30pm, we packed up and headed back to the hospital, exhausted!
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Birthday PARTY!
Upon returning from the mobile clinic visit we take our showers and get ready to head out on the town for Julie’s birthday!! Ok… not really. But the previous day Beth and I made plans for the 4 of us to have dinner at a nice restaurant in Chiplun (30 min away). We thought we’d splurge a bit and go to the Riverside Hotel. The following is an adaptation of Beth’s rendition of our dining experience.

Julie’s birthday celebration, Let’s just say we had a grand ole time – minus the fact that our ride never showed up because of a miscommunication, nothing new there. Finally though, we were on our way to Chiplun, to eat at this restaurant I found on the internet. Well the hotel this restaurant was at was a little ways out of town (which I did not know) so we ended up driving through the entire city of Chiplun and out the other side into the darkness… Uh… hmm… hope we’re still headed for this restaurant… We are pretty much clueless and sitting ducks, just hoping that our little vehicle miscommunication was truly straightened out. 

Finally, we see a sign for the hotel. Phew! The website for the hotel seemed pretty nice, so I wasn’t sure what exactly to expect (the whole way there, again, I was just praying it wasn’t a shabby grass hut with chickens running around waiting to be eaten. The internet can be deceiving you know!) We pull up… and this place is AWESOME!! Walking in, we’re just hoping that they let us stay and eat (we’ve had experiences before where we’ve flat out been told we can’t eat in places… not sure why??). We get to the front desk and explain that we would just like to eat dinner… “Oh, yes, absolutely, right this way!”… This is a little too good to be true! We are shown to a table out on the veranda of the restaurant. Light music is playing in the background. The garden before us is immaculate. The seats even have cushions! We are in heaven. This is the nicest place we’ve been to since our arrival. We open the menu and low and behold, they even have adult beverages!! (The first we’ve seen of that as well since being here) Could this get any better!?... but just wait… it does! We open the menu… and all we’re really hoping for is non-vegetarian food… but out of some stroke of luck they even have non-Indian food!! (Yes, I know I’ve raved about the food here, and it is AMAZING, but after 3 and ½ weeks of nothing but rice and curries, our palates have been craving a little something different.) So we engorge ourselves in cheese sticks, mini pizzas, chicken pasta and prawns with potatoes. Honestly, some of the best food I’ve had in a LONG time – in America AND India! 

But of course, we must remember, it IS Julie’s birthday we’re out celebrating… So I do my friendly duty and tell the waiter. He responds with a toothy smirk, “Oh, don’t worry… I take care of it”. Oh great… can’t wait for this! A few minutes later different music starts to play over the loudspeakers and out he walks with an ENTIRE cheesecake in his hands with a candle on the top. The music then bursts into some Indian form of the “Happy birthday” that talks about how she “looks as young as she is”. So we laugh to our hearts content and enjoy our entire lemon cheesecake (which doesn’t taste like cheesecake at all, more like whipped lemony fluff on a crust, but still tasty). 

So we relish in our delightful meal and relax for awhile. After a bit the waiter comes over and brings us our bill. He quietly tells us he’s only charged us 200 Rupees (4 dollars) for the cheesecake. But what would be a night of ours if something weird didn’t happen right?? So after we thank him for our cheap dessert he turns to us and says… “But I do have one request from you… you’re all doctors right??... So I have these bumps on my arms and back…” We all look at each other and can’t help but to burst out laughing! Can’t get anything for free these days can we!?!? So we take a look at his bumps, which turn out to be many little lipomas (benign and nothing to worry about). We tell him this and he thanks us over and over again… Apparently his doctor told him that they were from him eating fatty foods. Which actually has NOTHING to do with it. It is merely a genetic variant that causes fat cells to build up under the skin. So enough of the medical talk, the waiter was pleased with his diagnosis, we paid the bill (which was still incredibly cheap for us) and made our way home… Laughing the whole way back of the crazy encounters we always tend to find ourselves in…

Getting there... only 6 days behind at this point! Don't worry there's more to tell, but it's 10:00 now and time for bed!

~Becky