"This town is so small" is a phrase I have heard over and over again since arriving at the hospital. The population of Vijayawada is only 1,491,202 people. This shows how perspective matters. Winston-Salem, NC where I am currently settled is the largest city I have lived in. The population of Winston is 234, 349. Imagine how small that city would seem to the people here. Even smaller is the town where I grew up, Washington, MO a thriving metropolis of 13,918. Yet I wonder if using population is not a reasonable comparison between the two cities. Yes Vijayawada may have six times the amount of people as Winston-Salem but that doesn't mean the cities have comparable resources or amenities. Take the average population density of India (364 people per sq km) compared to the US (34 people per sq km). It seems India has 10 times as many people living in the same sq km as America. No wonder a town can be labeled small but still have a population over a million.
The population of India is booming and has been one of the assets and pitfalls to the county as a whole. The population is diverse with a robust culture and traditions leading to an undeniable pride in their country. However, the enormity of the Indian population also results in limited resources with a majority of the people living in utter poverty. According to the World Bank report in 2010, 32.7% of the Indian population falls below the international poverty line of making less than $1.25 USD a day, while 68.7% of the population lives on less than $2.00 USD a day. A majority of the people in the area here including the city and surrounding area fall in the category of making less than $2 USD a day. They are daily wage workers in the agriculture industry, domestic helpers, or stay at home to while the husband works. That makes affording hospitalizations, medical tests, and treatments difficult, frequently draining the families savings. Below is a breakdown of just a few of the costs for medical tests:
CBC 180 Rupees $2.91 USD
Renal Profile (Na, K, BUN, Cr) 225 Rupees $3.64 USD
Liver function test 300 Rupees $4.85 USD
Finger stick blood sugar 30 Rupees $0.48 USD
Urine analysis 80 Rupees $1.29 USD
Lipid profile 250 Rupees $4.04 USD
Chest X-Ray 125 Rupees $2.02 USD
Abdominal Ultrasound 500 Rupees $8.09 USD
MRI Brain with DWI 2,800 Rupees $45.24 USD
It is a struggle for both the families and the hospital, the hospital gives charitable care but has its limits. In the end the hospital has to be fiscally sound to keep operating and delivering care. When a family can not afford the care here at this private hospital their other option is the government run hospitals. However, I have been told by numerous people on separate occasions these are less than stellar. At times there are not enough beds for patients so they are sleeping on the floor. Treatments are not available and evidence based medicine is an afterthought. I'm not saying all are like this but the nearest one here falls into that category. I guess that is perhaps where I tend to get discouraged. There are needs that need to be met around every corner and how do you say one is more important that another. How do you pick and choose? The amount of need is overwhelming and at times can seem like no matter what action is taken is there really a difference being made? When the medical team receives a smile from a mother who's 16 year daughter has recovered from high fevers and low blood counts I answer yes, a difference has be made. There may be no definitive diagnosis of which virus caused her symptoms but for that family they have their daughter. Major change is happening at this institution but perhaps like a ripple in the water we are in the early stages and the difference will take many years to manifest. That is my attitude, that is my hope and that is my motivation.
The population of India is booming and has been one of the assets and pitfalls to the county as a whole. The population is diverse with a robust culture and traditions leading to an undeniable pride in their country. However, the enormity of the Indian population also results in limited resources with a majority of the people living in utter poverty. According to the World Bank report in 2010, 32.7% of the Indian population falls below the international poverty line of making less than $1.25 USD a day, while 68.7% of the population lives on less than $2.00 USD a day. A majority of the people in the area here including the city and surrounding area fall in the category of making less than $2 USD a day. They are daily wage workers in the agriculture industry, domestic helpers, or stay at home to while the husband works. That makes affording hospitalizations, medical tests, and treatments difficult, frequently draining the families savings. Below is a breakdown of just a few of the costs for medical tests:
CBC 180 Rupees $2.91 USD
Renal Profile (Na, K, BUN, Cr) 225 Rupees $3.64 USD
Liver function test 300 Rupees $4.85 USD
Finger stick blood sugar 30 Rupees $0.48 USD
Urine analysis 80 Rupees $1.29 USD
Lipid profile 250 Rupees $4.04 USD
Chest X-Ray 125 Rupees $2.02 USD
Abdominal Ultrasound 500 Rupees $8.09 USD
MRI Brain with DWI 2,800 Rupees $45.24 USD
It is a struggle for both the families and the hospital, the hospital gives charitable care but has its limits. In the end the hospital has to be fiscally sound to keep operating and delivering care. When a family can not afford the care here at this private hospital their other option is the government run hospitals. However, I have been told by numerous people on separate occasions these are less than stellar. At times there are not enough beds for patients so they are sleeping on the floor. Treatments are not available and evidence based medicine is an afterthought. I'm not saying all are like this but the nearest one here falls into that category. I guess that is perhaps where I tend to get discouraged. There are needs that need to be met around every corner and how do you say one is more important that another. How do you pick and choose? The amount of need is overwhelming and at times can seem like no matter what action is taken is there really a difference being made? When the medical team receives a smile from a mother who's 16 year daughter has recovered from high fevers and low blood counts I answer yes, a difference has be made. There may be no definitive diagnosis of which virus caused her symptoms but for that family they have their daughter. Major change is happening at this institution but perhaps like a ripple in the water we are in the early stages and the difference will take many years to manifest. That is my attitude, that is my hope and that is my motivation.
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