A More Diverse Patient Population

On one of the last medical days, we set up right next to a mandir, or Hindu temple (talk about using religion to get people mobilized). The area was not in the heart of the slums as our previous medical camps were, but still high numbers of people showed up. It seems that word of our organization has really gotten around, not only because of constant high turnout but also we have been getting many requests to serve areas around Kolkata. We noticed that this particular crowd did have many impoverished individuals, but there were also a good number from lower-middle class households. We could tell this was true a few different ways:
They were definitely more well-nourished than many of the patients we had seen thus far; some of the young and middle-aged were even pre-hypertensive or hypertensive, overweight or obese, mirroring many of the problems we see in the U.S. today, probably due to relatively easy access to commercially available high glucose and high sodium foods, which these people could afford. We also had a handful of teenage girls come in with high anxiety, very little appetite, dizziness and insomnia, and when we questioned them further it seemed that this was due to approaching entrance exams (the doctor I was working with called it "exam-o-phobia" and proceeded to prescribe some vitamins and calcium while laughing at his own terrible joke). So clearly they were financially comfortable enough to stay in school, whereas many of the slum children simply cannot afford to go to school because of family pressures or the pull of domestic work once they reach a certain age. Finally many of them were coming in with previous hospital records, which very few of the really poor individuals had, and many were anxious about their blood pressure readings. In the poorest slum regions, many did not know what was a good level or even what the blood pressure implies. Finally, the doctor I was working with put down his work phone number, so that patients could come to him in the future, ostensibly to pay for his services this time rather than receiving them for free this time. I had worked with this doctor before and had never seen him do this with poorer individuals.
Even though we may have sacrificed reaching some poorer individuals in North Kolkata, it was interesting for me to get exposure to a different class of patients who were experiencing a different class of health problems.

That said, we did see a few really interesting cases. One older gentleman had a heart murmur, which was cool to listen for. This patient's heart sounds were not the typical "lub-dub" but had an extra sound to it, which is due to a heart problem emanating from old age, infection, or disease. Another 18 month old infant had an encephalocele, which is a rare congenital defect during the neural tube development characterized by protrusion of the brain and membranes that cover it through openings of the skull. Basically, the outer covering of the boy's brain was jutting through the skull because of a developmental defect that occurred while he was in his mother's womb. If allowed to get worse, the boy's physical and cognitive development could be severely impaired, not to mention the increased chance of infection of the brain (encephalitis). Pretty crazy stuff. We decided to fund his surgery and set it up with a neurosurgeon at a local government hospital before we left. It's nice to be able to use Pratit funds not only for primary care diagnosis but for changing the life of one individual who is suffering.