Being Indian and having been to India multiple times to visit relatives, I didn't expect there to be much that I would see that would really shock me in terms of the way Indians work, think, and go about their every day lives. And for the most part I was right. The dirty roads and living conditions, the animals roaming around with free rein, the spicy and heavy food. It was as familiar and comforting as I had remembered it to be.
But the medical system in India, particularly in rural India, was something I had never witnessed before. And honestly, I didn't think I would be too shocked by what I saw there either. Of course they would reuse disposable equipment, of course the rooms and beds would be dirty, of course there would always be a never ending stream of people filing into the hospital. Even having two patients being operated on simultaneously in the same OR wasn't too shocking. Just another example of people trying to do the best they can with what they have.
What was shocking to me was how some of the patients were treated. Women in labor were pushed, pulled, shoved, slapped, shouted at. "Why are you taking so long to push this baby out! Do you want to stay in here forever?" Doctors would climb up onto the delivery bed and push on the mother's stomach from above. Pain medication, though found on the equipment tray, was rarely administered even though episiotomies were so common they were not even considered to be complications during childbirth. It was completely jarring after having seen how the obstetric department is run in the US. Every mother has her own room, full of monitoring equipment for her and her baby and medications to make the delivery as fluid as possible. Patients are constantly updated on the health of their child, how they are progressing, asked if they would like anything to make them more comfortable. A midwife or nurse stays by the mother's side during the delivery to offer words of encouragement or praise. What I always considered to be standard care for a woman in labor seemed to be a luxury that would be unheard of here.
What really made the experience even more heart wrenching was the game of "what ifs" I couldn't stop playing. What if my parents hadn't moved to the US? What if my mother gave birth in a hospital like this? What if she was treated like this? How would she have been cared for if there was a complication? What if I had been born in a facility like this? It was all too easy to imagine and imagining was all I could do for the rest of the day.
And it's not as if you can necessarily put the blame on the doctors. When you have women in labor scattered down the hallway floor because there aren't enough beds for everyone, when you have to deal with classes and clinic and projects and presentations and going home to a husband or wife and taking care of the house on top of your hospital shifts, when you haven't had time to eat or sleep or take a break, when you're performing your 11th cesarean section of the day. When no matter how many deliveries you perform and how many complications you deal with during a case, there are always 10 more women to take the last woman's place. Is it possible to always stay cheerful and polite and kind? Of course, there are many doctors I met who are this way, always smiling, always joking. Treating their patients with respect and kindness. But it really feels like the whole system has to change in order for things to get better. There needs to be more manpower and better infrastructure to handle the large masses of people who visit a hospital in a given day. More importantly, there needs to be a way to make it so that time is not such a rare commodity that a patient can't even be treated with basic manners and respect.
But the medical system in India, particularly in rural India, was something I had never witnessed before. And honestly, I didn't think I would be too shocked by what I saw there either. Of course they would reuse disposable equipment, of course the rooms and beds would be dirty, of course there would always be a never ending stream of people filing into the hospital. Even having two patients being operated on simultaneously in the same OR wasn't too shocking. Just another example of people trying to do the best they can with what they have.
What was shocking to me was how some of the patients were treated. Women in labor were pushed, pulled, shoved, slapped, shouted at. "Why are you taking so long to push this baby out! Do you want to stay in here forever?" Doctors would climb up onto the delivery bed and push on the mother's stomach from above. Pain medication, though found on the equipment tray, was rarely administered even though episiotomies were so common they were not even considered to be complications during childbirth. It was completely jarring after having seen how the obstetric department is run in the US. Every mother has her own room, full of monitoring equipment for her and her baby and medications to make the delivery as fluid as possible. Patients are constantly updated on the health of their child, how they are progressing, asked if they would like anything to make them more comfortable. A midwife or nurse stays by the mother's side during the delivery to offer words of encouragement or praise. What I always considered to be standard care for a woman in labor seemed to be a luxury that would be unheard of here.
What really made the experience even more heart wrenching was the game of "what ifs" I couldn't stop playing. What if my parents hadn't moved to the US? What if my mother gave birth in a hospital like this? What if she was treated like this? How would she have been cared for if there was a complication? What if I had been born in a facility like this? It was all too easy to imagine and imagining was all I could do for the rest of the day.
And it's not as if you can necessarily put the blame on the doctors. When you have women in labor scattered down the hallway floor because there aren't enough beds for everyone, when you have to deal with classes and clinic and projects and presentations and going home to a husband or wife and taking care of the house on top of your hospital shifts, when you haven't had time to eat or sleep or take a break, when you're performing your 11th cesarean section of the day. When no matter how many deliveries you perform and how many complications you deal with during a case, there are always 10 more women to take the last woman's place. Is it possible to always stay cheerful and polite and kind? Of course, there are many doctors I met who are this way, always smiling, always joking. Treating their patients with respect and kindness. But it really feels like the whole system has to change in order for things to get better. There needs to be more manpower and better infrastructure to handle the large masses of people who visit a hospital in a given day. More importantly, there needs to be a way to make it so that time is not such a rare commodity that a patient can't even be treated with basic manners and respect.
This is a very thoughtful and beautifully written commentary Mihika, and gives us lots to think about.
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