Bidada Hospital

Summer 2008

Research in the use of Allopathy and Naturopathy in rural Gujarat, India

Bidada Village

Located in: Kutch District, Gujarat state, India

Where In the World?

The Researchers Matthew Lilley MS III Priyanka Wali MS III

The Kutch

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1.5 Million inhabitants

70% lives in rural setting Agrarian economy New influx of industry Average wage 90 Rp/day ($2.25) Jainism is primary Religion •

45,652 km²

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Semi-arid

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

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Tuberculosis

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Malaria

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Renal failure

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Cataracts

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Congenital Deformities

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Rheumatic Heart Disease

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AIDS

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Vitiligo

Departments

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General medicine Gynecology Ophthalmology Dentistry Naturopathy Visiting specialists and Surgeons

What We Did

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Descriptive study-

We created a rough video documentary giving a western view of how the hospital operates.

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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 Study

 We 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

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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

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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

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Problem 2: Cultural differences between us and the patients & the physicians.

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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

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The Results

Our hypothesis was incorrect.

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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

21 22 23 24 24 25 14 17 18 19 20 10 11 12 13 1 2 5 6 7 8 9 3 4 26 33 34 35

No Medical Camp

Urology Cardiology Pediatric Cardiology Asthma & Allergy Rheumatic Heart Disease Squint Eye Endocrinology ENT Diabetic Orthopedic Arthritis / Rheumatology Rehab Medicine Speech & Audiology Pediatric (surg, onc, uro, neuro, ortho Dermatology General Surgery Cancer Breast Lump Checking For Malignancy Gastroenterology Eye Dental Psychiatric Gynecology Cancer Awareness & Checking General Camp Children Health Care Project Pathology / Radiology / X Ray Prosthesis & Orthosis

Periphery

Jan 3 Jan 5 Jan 9 Jan 11,12,13,14 Jan 11,12,13,14

Examination at Bidada

Dec, 31 Jan 1, 2 Jan 1, 2 Jan 3 Jan 3 Jan 3 Jan 4 Jan 4 Jan 5 Jan 6 Jan 6 Jan 6 Jan 7 Jan 9 Jan 10 Jan 11 Jan 12 Jan 13, 14 Jan 13 Jan 14 Jan 14 Jan 17 Jan 18 Dec, 31 to Jan, 12 Dec, 31 to Jan, 21 Dec, 31 to Jan, 21 Dec, 31 to Jan, 21 Dec, 31 to Jan, 21

Surgery

Jan 1,2,3 Jan 4, 5, 6 Jan 4, 5, 6 Jan 7, 8, 9 Jan 12, 13, 14 Jan 13, 14 Jan 14 Scopy Jan 15,16,17,18 Jan 17,18 Jan 19, 20,21

Contacts

• Priyanka Wali [email protected]

Go to www.bidada.org

•Matt Lilley [email protected]