Indian Perspectives on Health and Populations Robinson ScholarJillian Bauhs University of Kansas School of Nursing Vellore, India
Robinson Scholarship • Founded in living memory of • Dr. David Robsinson, MD • Dr. Mani M. Mani, MD • Burn and Plastics specialist from Kerala, India • Change-agent for the nations • Christian Medical College (CMC) • Vellore, India
Christian Medical Collegeest. 1900 • 2,234 bed hospital • 9 campuses • 95 recognized programs for education in medicine, nursing, and allied sciences with additional growth to several post-graduate curriculums • On average, one day at CMC serves 4814 outpatients, 1787 inpatients, and 34 births.
India’s population • Total population: 1,121,800,000 • Nearly 40% of Indians are younger than 15 years of age • Only 2.4% of world’s land area supports over 15% of the world’s population. • 70% of the Indian population live in rural villages, the other 30% in 200+ towns • 18 official languages • 83% Hindu, one of the world’s largest Muslim communities numbering >120 million, plus a smattering of other religions: Christians, Sikhs, Jains, Buddhists, and Parsis. • Literacy rates: 65% Female, 80% Male
India faces the continuing challenge of fighting infectious diseases like malaria, tuberculosis and leprosy alongside increases in lifestyle related problems faced by the developed world, such as cancer, cardiovascular disease and diabetes. Leading morbidities Anemia Respiratory infections Undernourishment Diabetes and Hypertension Leading Causes of Mortality: 1-Bronchitis and asthma 2-Prematurity 3-Diarrhea 4-Suicide 5-Heart Attack Morbidities and Mortality
Daily Stressors • Poverty • Malnutrition • Disease and illness • Employment • Family systems • Marriage at young ages • Wife leaves home to live with husband and the in-laws • Child-bearing young age
Community • Cohesive and family-based • Large family units: parents, grandparents, children, extended family • Arranged marriages • Religion-supporting community • Hindu temples throughout a village • Muslim-based,Koran-focused schools • Mission hospitals sponsored by local and international churches
Communication Stories • Blessed Interpreters! • Mobile phones • Tamil • Sarp ting la? Have you eaten? • Vonakkum. Welcome. Hello. • Vanga = come • Ponga = go • Une, rende, mune, nala, anje
Crime and Safety • Petty crimes • CMC campuses are closely monitored, typically gated • Karma • Spousal abuse • common • Particularly toward women • Interventions • Female Police Station • CHAD’s newlywed classes
Mental Illness and Disability • “Deaf and Dumb” • Program CODES provides opportunity for individuals who have rehabilitated from disability or attained job skills through training • One operation for CODES success stories are attendants in Phone Booths
Availability and Condition of Housing • IF you have _________, then you are living above most of the rural population’s standard of living • Fire outside of home; even better if you have a gas stove • Television • Running water • Toilet/outhouse
Water & Sewage: Health impact • H20 not safe to drink • Open drainage systems • Pollution HIGH, littering HIGH • Parasites, cholera, other GI complication • Population density magnifies problems • Other pollution problems: noise, animals and insects
People relations Smaller “personal space” bubble i.e. bus and auto rides Shared responsibility for care of children, animals, etc. Paternalistic cultural tendencies decisions are made by family unit, not individuals Dowry system
Food…mmm…my favorite! Typical Thali meal
Transportation Buses, bikes, mopeds, motorcycles, bipedals, bullacarts, “autos”,
My typical day 6 AM-Up (unless it’s Pongal and then it’s usually 4:30 with the Temple! 7AM-Breakfast Johnson House (or the Canteen) 7:40AM-Staff bus picks all volunteers and visitors at North Gate 8:05AM-Arrive at CON (sometimes arrive earlier for presentations given by staff and grad students beginning at 7:30) 9AM-Bus departs to villages, Paired with a nurse—we’ll be going to conduct a morning antenatal clinic and afternoon home-visits 9:30-1PM—See more than 100 women at AN clinic, 2 are at term and are given instructions about delivery. Bathroom is constantly full with women giving urine samples…bugger I drank so much OJ for breakfast! LUNCH! 2:00 Begin homevisits. Two post-natal visits and a hypertension patient. 4:00 Bus picks us up again to return to CMC and the CON. 5:30 Tea time with friends 6:30 Go to computer lab to begin homework, emails, etc. 8:00 Get texted by friend to arrange special Fudge cooking session next day!
Thank you for coming! Please ask if you have any questions about the Robinson Scholarship or any other part about my presentation!