Khojawara Hospital

Three times a week Lindsay and I climb into a jeep and drive two hours to a remote rural hospital in Khojawara, which is in the Kherwala district. The road becomes more and more rural until we are surrounded by arid hills dotted with cacti. 

Dr. Salvi is the pediatrician, and Dr. Mahalakshmi is the Ob/Gyn at the clinic.  Sometimes they each see up to sixty patients a day, so the clinic is a very busy place.  After working her whole life as a military physician stationed as far north as Ladakh and as far south as Tamil Nadu, Dr. Mahalakshmi retired and works three days a week in this rural Seva Mandir clinic.  They are both extremely brave for being rural physicians, as there is literally no other help for hours and they are on their own.  

Dr. Mahalakshmi, Nurse (Sister), and me

Dr. Salvi and me

 The patients mostly speak Wagri, which the physicians do not speak.  It can be very challenging to treat patients with a communication barrier, limited resources, and an overwhelming amount of patients.  Even so the physicians are very patient with Lindsay and me, explaining diagnoses and translating for us occasionally. On one of the first days Dr. Mahalakshmi asked me what I came here to learn, and I said rural medicine in a developing country poses completely different problems.  Physicians have to rely more on their physical exam skills and use fewer diagnostic resources.  She replied "You came all the way here to learn that?" I think she feels a large responsibility to help us learn because we traveled so far just to learn from her.

We see completely different pathologies here in rural India than we do in Chicago.  Malnutrition is a huge problem, and may children have shrunken bodies and the characteristic large head and bulging eyes.  Dehydration and sanitation is a huge problem, so much so that even men frequently have UTIs here, which is uncommon in Chicago.  Malaria and typhoid are also common diseases, whereas in Chicago if I saw one of these diseases I would be surprised.

Pharmacy at the clinic