Doctor's Appointment in South India

Dr Joanna Williams, now a Junior Doctor at Lincoln County Hospital, worshipped regularly at St Peter’s while a medical student in Nottingham. Here she reports on the final part of her training at a hospital in India, April - June 1998.

Having safely passed my final exams (phew!) I flew out to South India for my "elective" - the final part of our medical course, giving us the chance to travel anywhere in the world to gain experience of medical practice outside the UK. Myself and two of my colleagues flew to Madras and took a train to Oddanchatram. The Christian Fellowship Hospital was founded in 1955 by an Indian Christian doctor, Dr Tharien (still working there despite being in his 70s!), and is situated in a small rural town Oddanchatram in the state of Tamil Nadu, having started off as one or two small buildings with rudimentary equipment. Over the years it has grown into a well-known and respected hospital of around 260 beds, with departments of Medicine, Surgery, Paediatrics, Obstetrics & Gynaecology, Orthopaedics, Dermatology, ENT, Ophthalmology and Dentistry. The hospital also runs a local orphanage, holds clinics in the local villages, and has involvement in the promotion of literacy and employment in the area.

Around fifty doctors work there, all of whom are resident on the hospital campus. Most are committed Christians who have sacrificed the potential to earn a far higher salary elsewhere to work amongst the poor in this rural area of South India. Patients come from locally and further afield. The biggest health problems arise from poverty, limited education and lack of a good water supply. TB is a massive problem, as is HIV - Tamil Nadu has probably the highest incidence of HIV in India. Patients have to pay (with the extremely destitute receiving free treatment), but charges are much lower than in government or private hospitals, where bribery and corruption are the order of the day. Additional donations to the hospital are accepted only from Indian nationals, with no aid coming from abroad. One of the saddest things I saw, all too often, was patients who were simply unable to afford the treatment they needed. This was especially tragic in the case of patients who needed major life-saving treatment only provided by larger medical centres, e.g. kidney dialysis.

The majority of the doctors’ time is spent in the out-patient clinics; patients have no appointments, and it is common for around a hundred of them to be seen in some of the departments every day. The wards are simple, but clean and well-staffed. The "Operation Theatre" remains busy for most of the week with scheduled and emergency surgery being performed - with very basic anaesthetic techniques! Neither the special care baby unit nor the twenty-bed intensive care unit has any monitoring equipment.

I spent a little time in all departments. Only being able to speak a few words of the local language, Tamil, I was limited in how much of the consultations I could understand, although I learnt a good deal through examining patients and talking with the medical and nursing staff, who had excellent English. However the sheer number of patients to be seen meant that I remained an observer for most of the time. During my stay I was able to visit two of the rural villages, and went to the homes of several patients whom I had seen treated at the hospital. I also visited a recently opened hospice for AIDS patients, run by an English missionary.

The atmosphere in the hospital of dedication, love and humility, and the strong Christian fellowship amongst all who worked there was a real inspiration - and humbling too. We felt very welcome, and the friendliness and hospitality of everyone was tremendous. I was exposed to a wide range of clinical material and gained an invaluable insight into the challenges and realities of practising medicine in the Third World. I thoroughly enjoyed my stay there - the medical experience, meeting and living in a community of so many wonderful people, the strongest sense of Christian fellowship I have experienced, and being immersed in a totally different culture. The memories will last me a life-time and I enjoy corresponding with many new friends.

Joanna Williams

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