Tuesday, June 24, 2014

Internship Week 1

16/6 Busy clinic. Observed.
17/6 Slow clinic day.  Looked through a leprosy presentation, observed, and read leprosy textbook.
18/6 Observations, slow clinic, finished textbook.
19/6 Observed diagnosis, treatment, and disability prevention/rehabilitation, went to Bandra clinic (satellite clinic)

This week's experience at the Bombay Leprosy Project has been extremely eye opening.  I did not realize how complicated leprosy was, and the amount of care that it required.  When I was corresponding with Dr. Pai, before the internship, I specifically told him that I studied leprosy as part of GPP 105, and that I did not need to spend the first couple days learning about the disease, the treatment, or the disability prevention/rehabilitation program.  I, however, was wrong.  There are so many different types of Leprosy, and each type has its different signs and treatment regime.  Although I've already spent the week learning about the disease, and observing the physicians, there are so many questions I have, such as why are there still reactions after treatment, and what causes relapses.

However, even with all that I'm learning, spending my time observing is stressful, especially when I hear about all the other projects that the other students in the Global Internship program have started.  Work culture here is also extremely different.  The US work culture is more monochronic, where people are always focused on one task and work at a fast pace.  Nevertheless, India has a polychronic work culture in which the employees will work on multiple activities at a slower pace.  People in India also value building relationships a lot more than getting work done as quick as possible.  As a result, there are several tea breaks throughout the day, and the employees will pause to talk amongst themselves.  The laidback feel that the physicians and employees have is extremely different from the hustle and bustle of a doctor's office.

It is amazing how many people are affected by Leprosy, each person extremely different from the other.  One thing that stood out to me was two 18 year old females.  One had no lesions, but had a clawed (disfigured) hand to the point that there was almost no muscle in her palm.  She waited 5 years to come to BLP, and even with reconstructive surgery, her hand would probably only return to 20% function.  Another girl presented with several lesions, hinting at a type II reaction.  To me, nothing looked wrong with her apart from her lesions on her arm, showing me how difficult it is to diagnose and treat for Leprosy.  Both cases showed me how the same disease can affect two people so differently.

The highlight of my week was the Bandra Clinic, most likely because it was something that was different from the main BLP center.  Because it was part of a government hospital, the doctors from BLP would rarely go to the clinic.  As a result, the patients were already waiting for the us when we arrived.  At the clinic, I witnessed various cases of Leprosy, and the severity of the disease when left untreated.  

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