Restoring health in the slums
Dr Miriam Dolan describes her rewarding experience volunteering for Slumdctor in northern India
Last year I volunteered for the first time with the Slumdoctor (UK) project which set up an annual three day medical camp in a Northern Indian village. This set a contrasting scene from my rural Northern Irish practice in county Fermanagh.
As a generalist it is sometimes difficult to fore see your precise role in such an different environment as you will be dealing with new disease presentations, late presentations, unfamiliar health beliefs and an under resourced health care service. Before leaving I was aware that India struggles with inequalities between rich and poor especially in rural areas. It has problems not only with communicable diseases, but the non-communicable such as diabetes, hypertension and heart disease are often undiagnosed and untreated and lead to high mortality and disability rates.
The 2012 team consisted of more than a hundred volunteers including doctors (GPs and hospital consultants), nurses, audiologists and optometrists from across the UK, Ireland and mainland European countries and many local volunteers. We spent three days working in a village in the state of Punjab working up to 12 hours a day. Together we provided treatment to more than 8,000 people. Patients were triaged and further investigations were organized locally. Patients were referred to the local hospital if needed for treatment funded by the charity and we provided necessary medication.
During the three days many patients were diagnosed and started on treatment for diabetes, cardiovascular risk disease or risk factors, COPD, severe menorrhagia or third degree uterine prolapse etc. Hundreds of people were fitted with hearing aids or glasses and many people regained sight due to cataract surgery.
Slumdoctor is a charity based in Halifax which was set up by a diabetiologist Dr Vijay Bangar. The medical camp is now in its eight year having grown from two volunteers to 30 oversees and 120 local volunteers. As the camp is growing Slum Doctor is looking for volunteers for next years camp which will be running from the 8 to the 11 th of March 2013. GPs, practice nurses, specialist nurses, nurse practitioners etc. can all make a difference. As for my own experience, it was s very worthwhile trip both on a personal and professional level. It was rewarding to work with such an inspiring team in challenging circumstances. My GP skills proved a huge benefit. The patients were so grateful that you took the time to listen (through a translator), to discuss their condition and offer treatment. The health services in this region are under resourced and without integrated care patients get lost and are treated inadequately. If you are interested take a look at the webpage of slumdoctor.co.uk or visit the Facebook page and apply. This project ticks all those boxes we had as idealistic medical students.
Dr Miriam Dolan is a GP in Co Fermanagh, Northern Ireland
I am currently a salaried GP working in Maida Vale, West London. Having completed my GP training in the east Midlands in summer of 2010, I embarked on a six month maternity locum job in Nottingham. Towards the end of this, a colleague introduced me to the Slumdoctor charity. I met Vijay Banger, a consultant diabetologist who for the last 10 years has run a free medical camp in the northern Punjab village of Phillaur in India. For me it was a unique opportunity to practice medicine in a different country with different restraints and boundaries, treating patients with diseases that have never had medical intervention.
By March 2011, I was part of a 30-strong team that left for India made up of GPs, audiologists, nurses and consultants in ophthalmology and rheumatology. 40 teachers from the school, and 40 local volunteers, helped administer the camp.
Over a three day period 8,000 patients were seen. Each morning we travelled to the Baba Braham Dass High school which was home to the medical campwhere patients were seen from 9am to 6pm. We would be met by the daunting task of a waiting room of thousands of patients. Some had travelled from all around many for days often by foot and would wait patiently all day to be seen. Patients were triagedon arrival and they were streamed into ophthalmology, audiology and general medicine specialities. My consultation room was one of the school classrooms with a few desks pushed together making up my examination couch.
Fortunately I had the invaluable resource of a translator with me. In the three days I encountered a complete spectrum of diseases. For some the treatment was advice or the provision of a pair of glasses or an invaluable hearing aid. The presentation of common UK diseases was a recurring theme with asthma, diabetes and osteoarthritis presenting in similar ways but the challenge was to manage these patients efficiently with limited resources and without the safety net of being able to follow them up a few weeks later. Most would go a whole year until they would see a doctor again. The charity would buy in supplies of medications so that patients could leave the camp often with a years worth of treatment. Other more extreme pathology such as a massive thyroid goitre, hydrocephalus, splenomegaly and hepatology were also encountered in patients who needed more urgent medical attention. The nearby Sant Sarwan Dass 200 bed charitable hospitalwas available for urgent scans and blood tests which the Slumdoctor charity funded. The work was relentless with the aim of the camp to see every patient who wanted to be seen; in the final afternoon of the camp I saw over 100 patients.
Of the 8000 patients seen,300 eye operations were arranged, 300 hearing aids were fitted and 50 more serious surgical operations were organised. The medical camp has grown year on year and many of the GPs who returned with unique experiences from the patients they encountered, have returned to participate in the project since.
Dr Wesley Jospeh is a GP in Maida Vale, West London.
For more information on the Slumdoctor project visit www.slumdoctor.co.uk