“Health inequities are the differences in health that are not only unnecessary and avoidable, but in addition unfair and unjust.” – Margaret Whitehead
Last week in Bahraich we visited four different institutionalized health centers, a school for disabled children, an NGO, and two villages. We compared and contrasted the different hospitals as well as the two villages. The two villages we visited were the Tharu village and the Risia village. Both of these villages were different within their infrastructure. The Tharu village had establish sustainability within their community,like having more stable homes than the people in the Risia village. However both villages had a great sense of community. We also visited the services that D.E.H.A.T offered to the people in the forest. D.E.H.A.T provides children in villages a place to attend school (especially for girls that have dropped out originally or have never went) as well as a place to learn about their rights as children. It was impressive to meet the young girls and boys that were in a Children Rights Group because they were knowledgeable on the issues within their community and their country. After meeting these amazing children, one starts to think of their own country. In the United States, children are worried about the next technological device or the next video game but they don’t realize that as children they have their own duty.
The World Health Organization suggests that four percent of a country’s GDP should be used to provide the minimum amount of health care; however India uses about two percent of their GDP for healthcare within in their country. Altogether, India supports 1.2 billion people and has a GDP of 1.8 trillion (USD) but only two percent is used for healthcare. All of the centers we visited had poor infrastructure, shortage of health workers, and the least possible support from the government.However, India provides absolute free healthcare to their citizens that live “below the poverty line (BPL)”. Citizens that are above the poverty line only have to pay small fees for hospital services. Also, the government is using monetary incentive to convince women to have institutional births by giving women 1400 rupees after every birth at a health center. We visited four types of public hospitals within the rural area: District Hospital, Community Health Center, Primary Health Center and Sub Center.
A secondary level hospital, it serves about three to five million people and has a total of 201 beds. The district hospital had two different hospitals, a main one and a woman hospital. This type of hospital has both an Emergency Room and ODP (outdoor patient) which people see before they are treated on a specialized floor. Compared to the hospitals in the United States, the district hospital had sex segregated surgery wards. However, it was the only type of hospital we saw in Bahraich that was gender separated. The “Sister of the Ward” which is the head nurse was taking care of 30 patients although one nurse should only be taking care of ten patients. Also another thing we noticed is that a patient can choose between three different levels of beds within the hospital: Private, Paying and General Ward. I valued that there were two different hospitals and one was specifically for women’s needs. The services they offer include delivery, post/anti-natal, family planning services, and immunizations.
Community Health Center
The second center we visited was the Community Health Center (CHC); they serve about 150,000 people and have a total of 40 beds. They have a small surgical facility and they have a “24 hour delivery person”. The provide immunizations two days out of the week.
Primary Health Center
The third center we visited was the Primary Health Center (PHC), which serves 50,000 people and have four beds in total, however there is no “in-patients” because the center has a closing time.
The fourth center we visited was the Sub Center, which serves 5,000 people and has no beds; it is the lowest health care delivery in India. Both the PHC and the Sub Center provide immunizations once a month. All these centers run a medicine room.
We also visited our Academic Director’s home village as well as the school he created, The Global School of Learning. We arrived on the day where they celebrated their 1st Annual Day of Celebration which included performances from all of the classes. During the performance we were served a typical Indian snack, dessert and bottled water. After the performances, we walked around his village and made conversation to women about their lives and their access to basic healthcare. It was surprising to see that many of the women do not have bathrooms within their homes so they are only able to use the bathroom twice a day out in the field before and after dark. However, what I loved about the women of this village is that they were proud of everything they had and they wanted to show us their lives. Also the women of the village performed for us folk music and we performed the Jackson 5, ABC 123 song.
Kasturba Gandhi Vidhayalay for Disabled Kids
I personally had an emotional time at this institution because of the injustice that disable kids receive. Many families with special needs children do not support them and leave them to either fend for themselves or keep them hidden within the home. In India, schools for special needs kids are rare to find. The school we visited was the only school out of four districts that helped kids with special needs. Disabled kids in India are more likely to have accidental deaths and fall into poverty. While at this school, we danced and learned with these kids and they were just like the rest of us! I had the best of time but it was hard to realize that I was that ignorant person a few years back that was afraid to understand disabled kids. It definitely was a great learning experience.
Tourist Side of Uttar Pradesh
Not only did we observe hospitals, NGO’s and villages, we also saw the “touristy” side of one of the largest populated states of India. We visited the border of Nepal, drove through a safari, we went gator hunting, we went to Shravasti, the famous Buddhist pilgrimage site and visited the Bodhi tree and we had bonfires EVERY SINGLE NIGHT.
Next week I am off to the state of Rajasthan. Phir Milenge!