2/25 At the Clinic

2/25
Today Tana traveled with Dr. Bruce to the AHM trust clinic. The clinic is in a compound composed of training and community development as well as health services. Bruce pointed out the training site for young unemployed men. They are training in carpenters, masons, and woodworkers. We parked and go to the clinic were I met the nursing assistants, laboratory technicians, and nurse practitioners. We enter a room with several stools and a desk. Bruce takes out basic equipment for vitals signs, peak flow and assessment. He has reference books for medications in herbal, homeopathic and western medications. The health care system in India has standardized a medication formulary and protocols for all common health problems. Patients are given basic health care at no cost and treatment at low cost. The prices look small by western standards until you realize that a mason makes $4 a day. This clinic refers to Madurai people who need CT scan or other state of the art interventions.
We start to see patients. They are called by a queue system of first come first served. We see a man with resistive TB. TB is serious and medication is dispersed daily by a paid overseer often a shop keeper in the patient’s town. A woman who needs open heart surgery is monitored for chronic congestive heart failure. She can not afford the surgery and her life will be shortened as a result. Next a woman with headaches presents a chart history of receiving thyroid medication. Bruce questions the medication indicators. He states there are numerous ways that medical practitioners fleece the public-over treatment is just one. After seeing an uncontrolled arthritic, an anemic asthmatic, various dermatological problems, chronic status ulcers, hypertension and others, Bruce tells me he is seeing less hookworm. He thinks this is due to public education and cheap worm medication not sanitation or clean water. A 23 year old man comes in complaining about nighttime emissions. Bruce uses this time to discussion normal sexual development and AIDS education. The patient goes away smiling. A 68 year old with congestive heart failure is given a statin which will cost him 49cents a pill. Bruce tells him the Kris Kringle quote,” How old are you?” “Old as my tongue and older than my teeth.”
The German female MD comes and states she will take me on a tour while Bruce debrides the feet of a young man with corns. The MD has been here since 1992. There has been an 8 year drought she indicates a site where they tried to grow silk worms until they ran out of water. There are public posters about AIDS prevention. She describes how AIDS is transferred by “national carriers” the truck drivers, prostitutes, and migrant workers. She indicates it is difficult to get these people to use condoms and advocates for the a universal legalized prostitution.
We pass the microeconomics office. A young woman describes the work of assisting the women to start, control and develop small businesses. She has programs in political awareness, child worker and women’s rights. Her name means “showers of luck”. There is a school at the end of the complex for children from child labor and other exploitation histories.
Bruce and I return at 1130 the electricity has not been turned on so the millet has not been ground. After a lunch of baked peppers we go to an afternoon session. One woman has returned and says she wants to know how same sex couples have children. Amanda explains her situation. We discuss homosexuality, widow status, divorce, dowry, disabled concerns and the need for shelters. It is a time of thoughtful conservation and clear separation of the cultures--our privilege. It supports the “freedom is not free” slogan. I think again of the early suffragettes. After group we go to pick up our purchases and pay. Most women are excited about the gifts and treasures and low prices. We swim and relax with wine coolers. It is good. Supper is light and lovely. Later Bruce takes us to the roof where we recline on mats and pillows. We listen to his works of short stories and poems--compassionate tales of care,
-assisting with birth and missing a much desired concert,
-treating a conflicted hidden homosexual young man who commits suicide by fire,
-a preteen girl who forms a temporary relationship with a sea captain over olives and leaving home.
Poems of love and distant places.
We sink into our beds to dreams of India and Home.
Tana Durnbaugh, Elgin,IL