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My Experience of Medicine in Madurai, India by Natasha

I spent from the beginning of January to the end of March 2009 in Madurai, Southern India, pursuing my interest in medicine by doing work experience in a hospital there.

I went with a company called Travellers Worldwide, which I found on the Internet while looking for medical work experience abroad. It had a variety of projects located in Madurai. When I arrived I was given the choice to stay in the same hospital for the whole three months or to move around. I chose to stay in one hospital for all three months, which I'm glad I did since the longer I was there the more interesting were the activities that I was allowed to do.

My Work

Natasha with Dr Ramesh and his teamMy schedule consisted of going into the hospital for about two and a half hours in the morning where I would sit in on patient consultations. All these consultations where in Tamil, the state language, but Dr Ramesh spoke excellent English and he always explained what had been going on afterwards. If there was a particularly interesting case I would be asked to come and observe or feel the problem. Dr Ramesh would describe what I was looking at or feeling and he would also direct me what to feel for in relevant cases. This way I became familiar with recognising hernias and swollen abdominal organs.

From the beginning I was taught how to take a blood pressure manually and in consultations it became normal practice for me to take the patients' blood pressure. In the afternoon there would often be surgery of various kinds occurring and if so I would go into the hospital around 3:30pm until 7pm.

Many of the patients attending the consultations came regularly every day to have the dressings on their diabetic ulcers changed. The majority of the population have diabetes in India since they are genetically more at risk, eat a great deal of sweet food and have a high carbohydrate diet. A high proportion of patients came in with ulcers on their feet since most people seemed to walk everywhere bare foot. With all ailments, but especially these ulcers, patients didn't come to the doctor until they absolutely had to, so their symptoms were almost always acute. This was particularly instructive for me, however, as the worse the case the more interesting the diagnostic and treatment processes. I particularly liked to see patients during consultations and then see them a few days later in surgery, as I then knew exactly what was wrong with them and what was being done to correct the problem.

I enjoyed watching the surgery more than observing consultations as I found seeing the many structures and organs in their proper places within the body fascinating. At first I was only allowed to watch from the side-lines, but I was in the operating theatre and could see well since I could move to any position around the table and come as close as I wanted, providing I didn't get in the way or touch the sterile area of the table. This was perfect at the beginning since I had never seen human surgery and didn't know how I would react to it the first few times.

After a month or so I was allowed to scrub up occasionally and helped the surgeon by holding instruments and grips and passing items to the operating staff. I loved this as I was as close as possible to the action and could see exactly what was happening inside. On these occasions I was also allowed to gently probe inside and actually feel what the various tissues were like. Most of them felt much tougher than I expected. Dr Ramesh and his anaesthetist always explained to me what was going on, as did his wife whenever I watched one of her surgeries, and I was encouraged to ask questions. Towards the end of the three months I was scrubbing up for almost every surgery and on one occasion I was allowed to do a few stitches.

I was so lucky to be able to experience a range of surgical techniques as the Indian medical profession are in no way behind the West in this respect.

Since the operating theatre was so good Dr Ramesh would often get visitingNatasha witnesses a successful delivery surgeons in to perform surgeries that were not his speciality or that he could not perform himself. I also saw all his wife's surgeries that included hysterectomies, terminations and caesareans and witnessed orthopaedic surgery and a few different kinds of plastic surgeries. Since Dr Ramesh was an urologist I saw a great deal of abdominal surgery such as hernia reparations. I really enjoyed watching an appendix removal as that is the only major surgery that I've experienced and seeing what it entailed was fascinating.

Accommodation

Travellers Worldwide offered the option of living with a host family or living in the Travellers house, which was in one of the nicer suburbs of Madurai. I chose to live in the house which consisted of a three bedroom house and a two bedroom flat just across the road. There are many projects that Travellers offer and so the people I shared the house with were very diverse. When I first arrived one girl had been working in the orphanage for six months, but the majority of the volunteers stayed anywhere between one and two months with a few staying just two weeks and a few others doing three months like me. I really enjoyed living with other westerners.

In the house we had a lady who cooked for us and was always in the house. She was called Jeya and acted a little like a mother, cooking our favourite meals and so on.

Travel around India

During the three months I was in Madurai I took the opportunities provided at weekends to travel around the south of India a little bit. I managed to get away four times. For the longer weekends I took the Friday off work.

Conclusion

I strongly feel that my time in India was everything I hoped it would be. I managed to see and experience so many medical and surgical procedures and cases that would never have been possible in the UK and I had a fantastic time as well. I've stayed in touch with many of the people I met in the house and I hope to remain in touch with Dr Ramesh and the Nursing Home. I would certainly like to re-visit and explore more of Southern India and I would also love to go back in the future, perhaps on my elective period during medical training. I am certain that this unusual experience helped me to obtain the three offers that I have received following interviews at my chosen universities.

Natasha Bell's placement in southern India was arranged through Travellers Worldwide