This was a busy week at the Mata Jai Kaur hospital. At our weekly antenatal clinic, Sandeep – our volunteer nursing student – gave our patients a basic presentation on pregnancy and nutrition. On top of that, we started surveying the approximately 200 mothers that delivered through our facility. With the extra people at 35BB on Sunday, and the various villages and towns across the Ganganagar district that we visited, it proved to be intense and challenging week.
To help us with our task Banth Bhaji and I recruited Sandhya, a nurse working in the nearby village of Arayan, and my niece, Arshdeep to join us for the week. So far, we’ve been averaging about 200 km a day tracking down our patients in towns and villages to gather vital information that will tell us how we’re doing and to inform our expansion.
Not everything went smoothly – Bhaji’s trusty Bolero jeep lost a fan-belt in a remote village near the India-Pakistan border, and often we’d have to scour villages for patients whose full names and contact information we didn’t have (“like finding a needle in a haystack”, as Bhaji would say).
As tedious as it’s been, we’ve been having good success and the experience has been very rewarding. So far we’ve surveyed over 70 patients, all of whom were very tolerant of our intrusion into their daily lives. As per local hospitality we have drunk enough cha (tea) or thunda (usually Fanta or Mountain Dew) to keep our sugar and caffeine levels high enough to make an elephant’s heart palpitate for a week.
Fortunately, we also had the privilege this week of hosting Dr. Hillary Lawson – a Canadian physician currently living and practicing in Delhi – who was kind enough to join us on clinic day and lend a hand with our survey on Monday. Hillary has been a tremendous advisor for the project and it was a pleasure to have her out here getting her hands dirty.
We’re still hoping to reach a lot more villages and there’s a lot of analysis yet to be done, but in this post I’d like to present a few initial impressions of what we’ve seen during the survey.
First, more accessible and higher quality postnatal care is very much needed. A large number of the women we interviewed reported health problems among themselves and their infants including things associated with premature maternal and child death such as infant diarrhea, fever and various postpartum complications.
Significantly, a large percentage of women also reported not getting a single postnatal check-up for themselves or their babies six months after delivery. The gap in postnatal care that exists is likely due to a lack of awareness of its importance as much as a lack of availability. With proper planning, we hope our Mata Jai Kaur Hospital can fill this gap.
Second, it was interesting to observe the variety of households from which families came to seek our services. Although it’s hard to determine how wealthy families are (unless they’re very poor) it is obvious that our patients come from a range of income levels (interesting side note: poorer women are far more bedecked with gold and silver ornaments – they wear their wealth because they don’t have bank accounts).
We visited patients in crumbling, mud-walled huts as well as in nice concrete-and-brick homes. India is known for its rigid social stratification so the fact that people of different backgrounds are willingly coming to us may be a sign that we’re offering something that many people, not just the poor, need and want. It would be great if we can serve both rich and poor, possibly having the former subsidize the latter using some kind of fee structure – something we’ll have to decide on later.
Third, I’d like to comment on how utterly satisfying this process has been. Although it’s hard to ensure unbiased responses to the question – “how did you like us?” – there’s so far been universal gratitude for our efforts among those we’ve talked to. Hopefully we can keep it that way. The main criticism we’ve received so far is that we should provide delivery services on-site in 35BB – something we’re already working towards. It’s also been very gratifying to see the concrete outcomes of the hard work being put into the Mata Jai Kaur project. I defy you to look at the pictures of the babies and moms in this post and not have your heart melt a little bit.
Before I sign off I’d like to pull back and offer a bigger picture observation on what this week means for us. The survey and our discussions with our patients is an important part of our due diligence in ensuring our project does more good than harm. It’s also a humble, early step towards making the Mata Jai Kaur project an evidence-based health initiative – an idea that I think everyone buys into but something that will take a lot of effort and time to perfect.