Medicine - INDIA Volunteer Stories

2 Week Special Medicine in India - George Couch

I was first introduced to Projects Abroad by a friend of mine who is now studying medicine at Imperial College London. He recommended doing a 2 week special project primarily as an excellent experience, but also as it is something few other medicine applicants will have done anything similar to, which one is always on the lookout for when hoping to apply to read Medicine.

I arrived in Kerala at 4am, to be greeted by one of the Projects Abroad staff. The whole two weeks was wonderfully organised, and that could be seen right from the word go. The entire trip was packed with activities and placements, with the staff working constantly to allow us to do exactly what we wanted to do. We got to know some of them really well, and all of them were wonderfully friendly, always aiming to please.

We spent much of the day taking in the scenery as we drove to Tamil Nadu, on the other side of Southern India. India is a truly spectacular country, and even the tiny section of the whole that we visited had everything from rainforest to desert. The people were always pleasant, more curious about us than anything else. Cultural differences were explained, and we had many a trip to temple, farm and spice garden interspersing the placements.

Curry is one of my favourite foods, which is just as well, seeing as we had it for breakfast, lunch and dinner every day. The curries are completely different from anything we have in the UK, and the range is enormous, with even the subtle changes in spice blends between chefs producing completely different flavours and experiences. The trip also improved my dexterity, as Indians only eat with their right hand (and no utensils) - curry, rice, breads and all.

I had done a significant amount of work experience before my project - shadowing cardiac surgeons, placements in GPs, volunteer work in a nursing home for people with dementia - so I had a reasonable basis for comparison. The differences are as stark as the contrast between driving in the UK and in South India. There is no national standard for medical practice, and there is very much a 'the doctor is always right' culture. People are too poor for private medicine (which costs about 30p a go), and there are so many people per doctor that queues for the government hospitals stretch out of the door and down the road.

Consultants spend most of their time as GPs. Patients are seen for 10-30 seconds on average in my experience, and will usually be prescribed something, even if it is simply a placebo, just to get them out the door. Children are berated by threatening to take them to the doctor. Obviously, there is none of the politically correct, communication orientated, caring focus that we have in the West, which has both benefits and drawbacks. Medics obviously care about all their patients. They try to treat as many people as possible per day, however the lack of communication results in occasional misdiagnosed or undiagnosed illnesses. There is also a huge disparity in surgery between South India and the UK - mostly caused by the economy difference and lack of technologies that we take for granted. Air-conditioning suddenly becomes very important in 50°C and high humidity with a patient open in front of you, least you find yourself sweating profusely into the wound. Also, a constant electricity supply would be handy.

I did vast numbers of placements in the two weeks, including those with orthopaedic surgeons, cardiologists, and general surgeons. I also did a few days in both a leprosy clinic and an Ayurvedic treatment centre. Leprosy is reasonably difficult to catch, and you need to be very young, old, or ill to be susceptible - so by no means be put off by that. We had lectures and saw the patients, observing their dressings being changed - possibly gorier than the surgeries I saw. We also had great fun playing badminton with the staff.

The Ayurvedic centre was much more dubious. With a western education, and reasonable pre-university scientific-medical knowledge, the treatments seemed to my eyes at best pointless or placebos, at worst positively harming patients. During a lecture, we enquired as to the reasoning behind some treatments, and were confronted with some truly horrendous arguments that both restricted the options, and confused necessary and sufficient conditions. However, what it really is, is a historical part of their culture, and whatever my personal views, I cannot envisage it being ethically sound to abandon it altogether.

We spent a weekend in Kerala for a boat trip and a walk, in which we had the not so pleasant experience of feeding the local wildlife - leeches. We also saw one of the longest footbridges in the world, and took a quick ride on an elephant. The evenings were filled with card games, chatting, and general jovial good times.

The two weeks flew by - great fun and truly informative. India is a truly astounding place, with awesome sights and astonishing scenery. I learnt a great deal about medicine from the consultants I visited, and about the cultural and economic differences of medicine in South India compared to the UK. I am very seriously planning to go back there, and would whole heartedly recommend this placement to anyone considering medicine as a career.

George Couch