burundi to sargur(rural karnataka)

burundi on top, rural karnataka below.

Eventually Burundi spills into Karnataka spills into Haiti which spills into so many places where people crouch next to roofs slightly higher than than their head and come out of the darkness into the Sun. A Sun that blares belligerent onto any forehead but can’t seem to get into the space inside the house. The house is for lizards or rainwater to drip in damp but not the sun. The deeper into the forest of southern Karnataka the more it looks like Sub Saharan Africa. There are a good amount of tribal folks here. In the hospital all the patients have a weather worn appearance. A spine that protrudes. Skin like it is slapped in between ribs like paper mache, skin like chappati dough roled too thin that a hole is going to emerge if stretched a centimeter more. The diseases are the same. The malnutrition is less here, especially among children. And there are far more doctors in India, but they are still overwhelmed.

I am currently in rural South India with a local NGO trying to support the organization by seeing patients and going into the field, connecting the social-economic impacts of health with classic biomedical treatment of diseases of poverty.

The thing I find impressive about this organization is that in a mortality conference when someone dies, they look at why they died, ie if all medical decisions were timely and appropriate. But they don’t stop there. They ask if a community health worker could have identified the 6 year old girl with malnourishment long before she developed disseminated TB. They look at potential government policies that are not being implemented and could be a source of intervention. The root cause, the root cause is the mantra. So simple, but so far different than most of us docs have been trained.