Observing Rural Healthcare in Villages (Part I)

Our day at SEARCH, a healthcare facility in Shodgram (Maharashtra), was our best opportunity to understand village life in India and the problems that exist within the scope of healthcare.

We started the day with a tour of the facility. This site was constructed in 1986 by Drs. Abhay Bang and Rani Bang, with the goal of providing health services to rural and tribal people in the Gadchiroli district. Our first stop on the tour was a small temple near the entrance of the compound for villagers to pray upon entry. As we soon learned, the entire hospital was designed to provide a comfortable setting for villagers and tribal people. From low roofs instead of the more common multi-floor hospitals found in cities to the names of each building based on religious goddesses that were chosen by village leaders, each detail was carefully planned. There were also multiple buildings constructed for families of patients to stay in during treatment periods or for a pregnant woman to remain close to the hospital when she was expected to deliver soon.

We were shown the two operating rooms that are used on rare occasions. Here, there are very few surgeons available in the area so instead, the hospital has implemented health camp programs. Throughout the year, the hospital coordinates transportation for villagers to come to the facility and receive treatment from Mumbai-based specialists who fly in for a month. Depending on the needs of patients, these specialists can come from fields of spine surgery, dentistry, hernia repair, and urology.

Then we had a chance to meet with Dr. Abhay Bang, the founder of the facility. He was raised in Sevagram and his philosophies and practices at SEARCH draw deeply from Ghandi’s teachings. He explained how he wanted to construct a facility in line with Ghandi’s famous quote, “India lives in her villages”. That is why SEARCH is based in Shodhgram, surrounded by the communities and villages it has served over the past three decades.

He also provided some insight and reflection on the research practices of the United States compared to that in India. He remarked, “here, you can pick up a stone, throw it, and you will find a huge problem to work on.” It is most definitely true, in India there is no shortage of challenging and rewarding problems to dedicate your life’s work to. At many universities within the US, students will spends months or years looking for a particular question within a subfield that they will work on in their pursuit of a PhD. It was an interesting comment, especially coming from Dr. Bang who received an MPH from the Hopkins’ Bloomberg School of Public Health.

We also met with Yogesh, a researcher and neurologist that was trained in both India and the United States. He jumped around from Immunology to Neurology and finally returned to India to work at SEARCH with a focus on Public Health. His research primarily deals with non-communicable diseases such as hypertension and diabetes. These conditions have become more prevalent within India and require attention because they can often place a burden on the economic health of families in villages. Hypertension treatment for a year can cost about 6% of their annual income and diabetes may cost up to 12% of their earnings. He explained that in most patients other interactions with healthcare, they usually have a fever, take medication, and are soon fully cured. Instead, he is used to hearing things like, “I took medicine for 2 months, why do I need to take more?” So he is working on education platforms and looking for devices that can help patients manage their condition and understand that their disease requires concern and attention for the entirety of their life.

Before separating, he shared some surprising facts about the state of neurological care in India. Within the entire country, there are only 1100 neurologists; stated otherwise, there is 1 neurologist available per 850,000 people. The major concerns he asked us to consider were debilitating headaches, epilepsy, and stroke. At the end of our discussion he added, “changes will come faster, maybe if they came in 30 years, now they will come in 10”, reflecting his own expectations for the next generation that often looks toward the West for influence and innovation.

(please follow along with Part II, which will be posted soon…)