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Bidada HospitalSummer 2008
Research in the use of Allopathy and Naturopathy in rural Gujarat,
India
Where In the World?
Bidada Village
Located in:
Kutch District,
Gujarat state,
India
The Researchers
Matthew Lilley
MS III
Priyanka Wali MS III
The Kutch• 1.5 Million
inhabitants
• 45,652 km²
• Semi-arid
70% lives in rural setting
Agrarian economy
New influx of industry
Average wage 90 Rp/day ($2.25)
Jainism is primary Religion
Industry & Economy of Kutch
• Rapidly growing industrial development as India modernizes
• Future site of largest coal-power plant in all south Asia• Rapidly increasing energy demands for manufacturing
The Hospital•Founded in 1970 by Gujarati business men
•Formed Bidada trust to address health care needs of peasant population
•Employ Five physicians, Two dentists, and two physiotherapists
•Doctors see roughly 75-100 patients per day.
Shree Bidada Sarvodaya Trust• The hospital runs almost
entirely on the charity of wealthy Indian donors
• The hospital bills patients what they can afford
• Office visits=$3-5, Rx=$1-$1.50, Surgeries=$50-$500
• But the trust will waive fees altogether in many cases
Most Common Pathologies Seen
• Tuberculosis
• Malaria
• Renal failure
• Cataracts
• Congenital Deformities
• Rheumatic Heart Disease
• AIDS
• Vitiligo
Departments
• General medicine• Gynecology• Ophthalmology• Dentistry• Naturopathy• Visiting specialists
and Surgeons
What We Did• Descriptive study- We created a rough video
documentary giving a western view of how the hospital operates.
• Allopathy vs. Naturopathy- We ran a comparative study surveying patients in the general medicine dept. as to why they chose to see an allopathic physician rather than a naturopathic physician.
Descriptive StudyWe studied everything from how physicians practiced, to hospital funding to how the local environment affects health
Modernization is one of the major influences affecting the health of the Kutchi population
• As the Kutch industry is further developed, more and more people from out-of-state move to the area.
• This results in increased demands for water, so each year the water table is dropped, yielding brinier water for drinking and the agricultural irrigation.
• This “harder” water introduces water-specific pathologies, such as renal failure and cataracts.
How the hospital copes• Rx drugs are incredibly
cheap in India• Doctors see many
patients (about 70/day) focusing mainly on Acute conditions, no continuity of care
•The hospital works with large Indian corporations (many of the trustees hold stakes in them) to solicit donations.
Allopathy vs. Naturopathy Study
• Hypothesis: Patients will find obtaining allopathic care at Bidada more difficult than obtaining naturopathic care elsewhere due to travel cost and time.
Allopathy vs. Naturopathy Study• Problem 1: We didn’t
speak the language. Our mentor sent us under the presumption that many translators would be available.
• Our guide, who spoke Gujarati and English, wasn’t inclined to talk to the patients; there was a clear division in class between trustees, staff, and patients.
Allopathy vs. Naturopathy Study• Problem 2: Cultural
differences between us and the patients & the physicians.
• Although the physicians could translate for us, they didn’t understand why two Americans would come to India to speak with patients, definitely a class issue.
-Some of our survey asked about costs of transport and medicines, to see if these were determinants for care.
-The patients interpreted these questions as if we, as wealthier westerners, were offering them money for their visit and transportation
The Results• Our hypothesis was
incorrect.
•Kutchis overwhelmingly had greater access to allopathic care at Bidada. They needed quick fixes to acute conditions in order to return to work.
Wealthy tourists from Mumbai were the sole patients at the Nature cure clinic curing chronic ailments or trying to follow weight loss regimens.
What we learned
• Cultural difference between way patients are seen at Bidada & the US
• Difficulty of doing a project in another country (no familiarity)
• Complexity of health care in the developing world (not as simple as working with limited supplies)
What we enjoyed most about Bidada
• Playing cricket with kitchen staff• Camel ride on Mandvi beach• Seeing one of the last remnants of traditional India• Eating dates with an Mumbai billionaire on his estate
Possible projects for Summer 2010 and beyond
• Continuing study of traditional Indian medicine
• Work in Children’s Health Screenings at local school (perform basic eye/neuro exam)
• Environmental Study-Related to water supply or traditional medicine use in Indian homes.
• January Camp (over 120 physicians from around the world treat 20,000 patients)
January Camp
• Annual event throughout the month of January
• More than 20,000 patients from 1200 villages
• 120 US physicians and volunteers
• 20+ medical & Surgical specialties
No
Medical Camp Periphery Examination at Bidada Surgery
1 Urology Dec, 31 Jan 1,2,3
2 Cardiology Jan 1, 2 -
3 Pediatric Cardiology Jan 1, 2 -
4 Asthma & Allergy Jan 3 -
5 Rheumatic Heart Disease Jan 3 -
6 Squint Eye Jan 3 Jan 4, 5, 6
7 Endocrinology Jan 4 -
8 ENT Jan 3 Jan 4 Jan 4, 5, 6
9 Diabetic Jan 5 -
10Orthopedic
Jan 5 Jan 6Jan 7, 8, 9
11 Arthritis / Rheumatology Jan 6 -
12 Rehab Medicine Jan 6 -
13 Speech & Audiology Jan 7 -
14Pediatric (surg, onc, uro, neuro, ortho
Jan 9-
17 Dermatology Jan 9 Jan 10 -
18 General Surgery Jan 11 Jan 12, 13, 14
19 Cancer Jan 12 Jan 13, 14
20Breast Lump Checking For Malignancy
Jan 13, 14-
21 Gastroenterology Jan 13 Jan 14 Scopy
22 Eye Jan 11,12,13,14 Jan 14 Jan 15,16,17,18
23 Dental Jan 11,12,13,14 Jan 14 Jan 17,18
24 Psychiatric Jan 17 -
24 Gynecology Jan 18 Jan 19, 20,21
25 Cancer Awareness & Checking Dec, 31 to
Jan, 12-
26 General Camp Dec, 31 to
Jan, 21-
33 Children Health Care Project Dec, 31 to
Jan, 21-
34 Pathology / Radiology / X Ray Dec, 31 to
Jan, 21-
35 Prosthesis & Orthosis Dec, 31 to
Jan, 21-
