On the road again

I find myself living in a hotel again (although this one is noticeable cleaner and insect free than my previous home away from homes), this time in the lovely city of Indore, in the state of Madhya Pradesh. I am training another round of surveyors, which consists of alternating days between classroom training and going out to rural areas to practice with doctors. At least this time the training is in Hindi, so I have more hope of figuring out what is going on since I’ve managed to learn key phrases for our project such as I have a fever, diarrhea, nausea, high blood pressure, a cough, and I am seven months pregnant and have swollen ankles. Let’s hope the Hindi I’ve learned never comes in handy.

I’ve noticed that I can be cruising along over here and almost forget that I’m in India and then something happens and it becomes oh so clear that I’m not in Kansas anymore. Yesterday, I walked into the lobby of my hotel with Rajan, a coworker of mine who is running the training. We were heading up to my room to work on my laptop when the woman at the front desk stopped us. She kindly explained to us that it was hotel policy not to allow a man in a single woman’s room. I felt like I was in boarding school or something, I wanted to ask if it was alright if we kept the door open and had housekeeping chaperone us. Then I thought of asking “well then how am I supposed to have an illicit affair with him?” I settled for offering to bring the laptop down to the lobby.
One of the doctors we observed yesterday managed to see 30 patients in the 30 minutes we were there. Sadly this isn’t really out of the ordinary over here. Actually, doctors here operate with an efficiency that I wish would catch on in other sectors. Patient comes in, tells the doc what’s wrong, doctor asks 0 to 3 questions, hands out some drugs, takes some money, and calls up the next guy. What was amazing about this particular doctor, though, is that he went 30 for 30 with the injections. I mean, I’ve seen a lot of injection-happy doctors over here, but this was the first I’ve seen where literally every patient, no matter what they complained of, got the needle. Stomach ache, cough, sore throat, injured arm, it’s all the same, shoot ‘em up. As a perma-needio-phile (my own term for my perpetual and deep seated fear of needles), I broke out into a sweat and nearly started to cry just being in there.
Before I came to India, people told me that being here would open my eyes and change my perspective of the world. Well friends, let me tell you that has definitely happened. My definition of what it means to have access to healthcare has most certainly expanded. When I came here, health care access was synonymous in my mind with health insurance access, because at home, as long as you have the latter you automatically get the former. Here, the high cost of a hospital visit and the idea of having insurance to protect against future health problems is the last thing on most peoples’ minds. For these people, heath care access means not walking over an hour to get to a government clinic only to find that the doctor hasn’t shown up all week because he gets paid even if he isn’t at work. For those who can afford it, a private clinic offers an alternative in which they can actually see a doctor, but in some cases his diagnosis and treatment are so far off he can actually make them worse. Now that is a healthcare access problem. We had a sense that we would find these kinds of things, but our study is the first to survey both households (to find out how they choose which doctor to go to) and medical providers (to find out how much they know and how they treat patients) in order to try and come up with the most efficient (economists love efficiency after all) and effective solution. Even without having to pass legislation through both the House and the Senate, it’s still easier said than done.