Brain drain

Hello

Another hot sunny morning here in Vellore, but the clouds have come over and it looks as though it could rain again today. Yesterday's downpour was well received (by me) as it cooled the temperature significantly and managed to have a good night's sleep for once. Still finding the sights and sounds and roads of India quite daunting, but beginning to come to terms with things. Lots of interesting stuff happening in Casualty this week, quite a lot of RTAs, a good few of which Dead on Arrival (somewhat less "interesting"), some overdoses (apparently the area around here is the suicide capital of the world...see BBC News), a couple of cases of malaria and a good few ordinary medical problems too such as food poisoning, heart attacks, strokes and the like. Fortunately none of these things have happened to me yet, although I've felt close to death at many times when I've been in an 'autorickshaw'. Story of the day was a guy who was a driver of one of these autos and was driving along when his vehicle hit a bump and he hit his head off the roof and was knocked unconscious and stopped breathing; he was pronounced dead when he arrived. I'll have to make sure I hold on tightly. It's quite a different medical system to the one I'm used to in the UK, I had never quite appreciated the difference having a national health service made, even more so here when the people have little or no savings and every investigation, every needle, every drug and every bag of fluids has to be paid for. In fact the way it works is that the doctor writes the prescription and the family has to go out and queue up at the pharmacy where they are given the syringes, fluids, venflons etc. and pay in advance for any bloods or imaging that is going to be carried out. It is not until they bring these items or the receipts in that treatment is started. Also referral for further treatment, e.g. ICU, is often based on who can pay rather than who needs the treatment. I have heard the argument that because CMC is a Mission Hospital they should pay for the treatment (and they do for the most needy of patients - discerning these patients is the difficulty, especially in an acute situation) but it would cost an awful lot of money and wouldn't be sustainable for very long. Otherwise I am very impressed with the standard of care, they have CTs and MRI scanners and all the results are available almost as soon as the scan is taken (depending on payment of course), there is good teaching from the senior staff and the junior staff all seem to have a good level of knowledge. It is also interesting to see the interactions between the doctor and the patient/relatives - as I don't understand the local language here I am judging mainly on body language, but it seems more up front than the "touchy feely" approach we are taught in Dundee. Anyhow, rambling aside.

Also managed to bump into the self-titled "laundry man" today to whom I am paying the equivalent of £4 and he'll do all my washing for me for the 4 weeks I'm here. Sounds pretty good to me.

I'm sure I had more to say but half an hour in the sweltering computer room and my brain is mush. No sign of that rain yet.

May be off to Ooty this weekend as long as I get a ticket - I'm currently on the waiting list, so hope that works out or I may be staying here looking round Vellore Fort in the centre of town, which would be ok.

Anyhow. All the best.
Dave.