Jana and baby patient

Scrubs, check. Stethoscope, check. Anti-malaria medication, check. Headlamp, check. I packed my bag for India with the same ingredients as I had for my last international nursing trip. I didn’t have a crystal clear idea of what my volunteer role would be, but I was pretty sure I would be doing some direct-patient bedside care. 37 hours of traveling later, I found myself working as part public health nurse, part nurse consultant, and part tribal field nurse.  As for what I had packed, malaria season was over, locals stared oddly at my shapeless clothing and my headlamp was used mainly to help discern the contents of my dinner plate in my mostly electricity-less living quarters. My stethoscope was pretty useful, but what I really could’ve packed was some chill-pills and some go-with-the-flow elixir.

My first week was an intensive orientation to Indian tribal language and culture, the details of RMF’s malnutrition and HIV programs, an insanely spicy and vegetarian diet, living quarters with very intermittent water and electricity, and learning to deal with the very inefficient roads, government, and hospital management. Appointment scheduling and linear modes of problem solving were thrown out the window. Tracking a power drill to put up mosquito nets in the NRC took 28 days, patients would suddenly migrate or run away, or the Catholic Church just happened to get involved.

We examined HIV patients who lived everyday with chronic uncomfortable opportunistic infections and learned that almost no doctors in Jhabua were trained sufficiently in HIV care. We observed that there were abundant crops growing around but the lack of education perpetuated the cycle of malnutrition. As we were doing field visits for our HIV and malnutrition patients, sitting in the patient’s home, taking a look around, it was hard to pull back and see the big picture.

Thank goodness I wasn’t alone. It’s hard to feel down for long when you have the amazing RMF staff pushing hard for the change that needs to happen. We visited the pediatric HIV patients in the home and performed health and psychosocial assessments. We then took our notes and brainstormed for solutions. We evaluated the hospitals and reported our findings and suggestions to the RMF staff and to the hospital manager. We audited all of the HIV patient’s charts tracking CD4 counts and identifying those who may be failing first-line therapy or needed more counseling. We wrote out a proposal to sponsor nurses to attend a one-year HIV specialty program in Chennai. There was so much to do!

Jana, another Volunteer American Nurse, and two Bilhi public health workers

At times it felt like little could be done in the month that we were there, but it’s the stuff down the line that gives me the gratification I need. I can imagine nurses graduating with an HIV specialty and advocating for HIV patients for the right to excellent medical care, a young man feeling better because we finally reduced the viral load in his body with the right drug by changing medical policy, or helping one of our local staff finish her degree in social work so that she may continue to educate villages of mothers to prevent malnutrition. In the end, it’s always about the bigger picture.

For more information about RMF’s Malnutrition Eradication Program in India, click here and our HIV/AIDS program here.

We can use any financial help you are able to provide on this project to continue our Education, Treatment and Outreach and help towards our goal of Malnutrition Eradication in this region of India.

To contribute to this initiative, please visit our website at realmedicinefoundation.org.

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