Greetings from India!
This past week, we were lucky enough to accompany the fourth year BSc nursing students (equivalent to our BSN) to their community “posting” (placement) in a small village outside of Manipal. The Manipal College of Nursing (MCON) has three “adopted” villages that both second and fourth year BSc nursing students rotate through for their 7 week postings. In these villages, they assess and care for a variety of patients and diagnoses.
We accompanied the students for three days and were able to meet and assess many of the members of the community. Their diagnoses ranged from acute issues, like a common cold, to chronic conditions like hypertension and diabetes. We were even able to assist in an antenatal assessment – this was an amazing experience as we did it on a mat on the floor of this young woman’s home and used the bell of the stethoscope to hear the fetal heart tones! Truly unforgettable, especially for us women’s health folks
On Thursday, we took part in the monthly Morbidity Clinic that was set up in a nearby office building. This clinic has been running since 1994 and happens on the 2nd Thursday of every month (in addition to another clinic for a different area on the 3rd Thursday of every month). The clinic averages about 30-35 patients in each session, with the main focus on chronic conditions like hypertension and diabetes. The same students who accompanied us in the village were the ones staffing the clinic, along with 2 doctors and some of the university staff.
These students “campaign” in the beginning of the week to ensure that the individuals in the surrounding areas know that the clinic will be offered, which is regarded as the most crucial aspect of the clinic by some of the MCON faculty members. At the clinic, the patients are assessed by the MD who then determines if they are in need of medications or lab testing. The lab testing available is pretty basic but appropriate for the needs of the clinic (including GRBS for blood glucose and anemia screening), and individuals who are in need of more advanced testing (like a HbA1c) can be seen at the nearby hospital after their clinic visit. Those in need of medication are given a month supply, which they can then refill at their next clinic visit. All of the medications are sorted by the nursing students the day before the clinic and are provided free-of-charge to the patients. They stock a variety of medications necessary for the treatment of the most common conditions seem in the clinic, like ACE inhibitors, diuretics, statins and oral diabetic meds. Additionally, the Friday after clinic is used as a follow-up day, where patients who were seen in the clinic are visited in their homes for further education and reinforcement, and medications, if needed.
Friday may have been one of the best days we’ve had in India so far – we got to spend the morning at an Anganwadi with children under 5 and had so much fun! As mentioned in Jen’s earlier post, an Anganwadi is a child and mother care center that combats malnutrition by providing nutrient rich meals to children and monitors their growth and development. The children are led by a teacher, and although there is no structured education component, they were being taught quite a bit by her. They recited information about their town, state, and country, as well as Hindi and English ABCs and days of the week! Our favorite part was their singing and dancing, which was completely adorable. We even got the chance to teach them Head, Shoulders, Knees and Toes which they seemed to really get a kick out of it. We had a really incredible day with them!