Monday, June 30, 2014

Rural Village Program

Rural Village Home
Today, I went to the rural area outside of Mumbai.  There, I witnessed the interconnected network needed for Leprosy treatment and prevention.  The villages were all separated from each other and each village had one or two Leprosy patients.  All the patients completed Multi-drug therapy (MDT) treatment, but all of them needed supplies for disability prevention and treatment. 

BLP goes out once a month to provide these supplies to the Leprosy patients in the rural areas.  I went with members of the BLP satellite clinic, and we saw approximately twenty patients over the course of nine hours, showing how difficult it is for patients who don’t have access to transportation or clinics to receive health care. 
Rural Village Home

This experience has also shown me how extensive BLP’s network is.  Not only does BLP work with people in Mumbai, but it also reaches out to the rural areas, something that is extremely difficult to do.  In order to achieve this, BLP has a volunteer in each village who visits the village members afflicted with Leprosy and contacts the organization if there is a new case of Leprosy.  This is a form of community-based prevention, as the volunteers are all members of the community who know everyone in the villages, and know the cardinal signs of Leprosy.  Not only is this more effective, as volunteers will be able to detect incident cases faster than the BLP workers, but there will be less of a stigma towards Leprosy. 

Rural Primary Care Center
Throughout my experience here, I have realized the need to learn more than one language.  Everyone in India knows at least two or three languages.  Finding that out has humbled me because they can communicate to such a big range of people.  I've realized that I need to learn another language if I want to communicate to a greater range of people.    

Tuesday, June 24, 2014

Internship Week 1

16/6 Busy clinic. Observed.
17/6 Slow clinic day.  Looked through a leprosy presentation, observed, and read leprosy textbook.
18/6 Observations, slow clinic, finished textbook.
19/6 Observed diagnosis, treatment, and disability prevention/rehabilitation, went to Bandra clinic (satellite clinic)

This week's experience at the Bombay Leprosy Project has been extremely eye opening.  I did not realize how complicated leprosy was, and the amount of care that it required.  When I was corresponding with Dr. Pai, before the internship, I specifically told him that I studied leprosy as part of GPP 105, and that I did not need to spend the first couple days learning about the disease, the treatment, or the disability prevention/rehabilitation program.  I, however, was wrong.  There are so many different types of Leprosy, and each type has its different signs and treatment regime.  Although I've already spent the week learning about the disease, and observing the physicians, there are so many questions I have, such as why are there still reactions after treatment, and what causes relapses.

However, even with all that I'm learning, spending my time observing is stressful, especially when I hear about all the other projects that the other students in the Global Internship program have started.  Work culture here is also extremely different.  The US work culture is more monochronic, where people are always focused on one task and work at a fast pace.  Nevertheless, India has a polychronic work culture in which the employees will work on multiple activities at a slower pace.  People in India also value building relationships a lot more than getting work done as quick as possible.  As a result, there are several tea breaks throughout the day, and the employees will pause to talk amongst themselves.  The laidback feel that the physicians and employees have is extremely different from the hustle and bustle of a doctor's office.

It is amazing how many people are affected by Leprosy, each person extremely different from the other.  One thing that stood out to me was two 18 year old females.  One had no lesions, but had a clawed (disfigured) hand to the point that there was almost no muscle in her palm.  She waited 5 years to come to BLP, and even with reconstructive surgery, her hand would probably only return to 20% function.  Another girl presented with several lesions, hinting at a type II reaction.  To me, nothing looked wrong with her apart from her lesions on her arm, showing me how difficult it is to diagnose and treat for Leprosy.  Both cases showed me how the same disease can affect two people so differently.

The highlight of my week was the Bandra Clinic, most likely because it was something that was different from the main BLP center.  Because it was part of a government hospital, the doctors from BLP would rarely go to the clinic.  As a result, the patients were already waiting for the us when we arrived.  At the clinic, I witnessed various cases of Leprosy, and the severity of the disease when left untreated.  

Sunday, June 22, 2014

Week 1

Week 1 of India consisted of orientation, or learning how to get around India.  First of all, the traffic rules here are crazy.  There are no lanes and pedestrians don't have the right of way.  I've learned to always be aware and walk as fast as possible when crossing the street.  The minor has always stressed the importance about integrating yourself with the culture you will be serving in, and I feel that the Global Internships Program did an amazing job with helping the students and I learn about Indian culture from Hindi lessons to shopping for clothing and restaurant excursions. 


My name is Janine Myint and I'm an incoming senior majoring in both Public Health and Integrative Biology.  For my practice experience, I will be working with the Bombay Leprosy Project in Mumbai, India.  Along with this internship, I am taking a class at St. Xavier's college and an online course (ISF W187) as part of the Berkeley Global Internship Program in Mumbai.  
The Bombay Leprosy Project is a non-profit organization with the goal of "A World Without Leprosy."  Currently, Leprosy affects approximately a quarter of a million people in the world, with the majority of the cases in India.  Leprosy is a disease that affects the nerves, resulting in disability and disfigurement.  In India, Leprosy is an extremely stigmatized, with many of the infected being dropped off in Leprosy colonies and isolated from the families and friends.  Leprosy is an extremely complicated disease which requires specialized diagnosis, treatment, and disability prevention/rehabilitation.  As a result, NGOs such as BLP work with the government to provide specialized care to those inflicted with the disease.
My project during the program is to create and administer a form that BLP will use to measure the effectiveness of their treatment and disability programs.  These answers will be entered into a database, and be used for impact measurement.