Community Health and Other Things that Frustrate Me

As Brain (the Indian spelling of Brian) alluded to in his post yesterday, we visited the Department of Community Health on Wednesday. It was an interesting session. The assistant professor who took us through the department’s museum (basically a room with a bunch of models of different diseases, sanitation systems, water filtration systems, etc.) was willing to answer our questions, of which I had many. It seems in India, community health is an integral part of the medical school curriculum. They learn about how to treat the drinking water, how and where to dig latrines, entomology & the use of insecticides to kill vectors of disease, in addition to things like diet and cancer prevention. Needless to say, these subjects not usually covered in the U.S. medical school curriculum, but in the developing world they are integral. It is much cheaper to treat the source of the problem than the complications.

Over dinner that included one suspect pina colada and a round of cognac, we discussed the challenges of public health in the developing world.  I am no Infectious Disease specialist, so while discussing the intricacies of HIV treatment are interesting to me, I feel more drawn to the issues of preventative medicine (must be the internist in me).  I brought up the example of some Sub-Saharan African countries who are spending most of their health care budgets (with many of the dollars coming from the American and European NGOs)  on the treatment of HIV.  Not to belittle the problem of HIV, but these same countries that are spending millions treat HIV lack the basic infrastructure (ie clean water, sewage systems, schools to educate the masses on public health issues) needed to live a healthy life.  In India, the challenge challenge of changing public health is very complex and would require changing cultural habits (ie defecation on the street, not washing your hand in the hospitals, drinking nasty water, penning your animals) and huge monetary investments in basic infrastructure (ie underground sewage systems, water treatment plants, schools, developing a health care system that includes primary care). In some senses, it would be easier to just open a clinic and treat HIV, TB, diarrhea, and malaria, than to try to treat the underlying problems.  And that is what frustrates me about Community Health in the developing world.

Other things that frustrate me:

1.) We went to a lecture for 4th year medical students yesterday. The professor PIMP’ed me relentlessly while Paras, Brian, and Alicia sat quietly. Makes me wish I had a 3rd year to PIMP.

2.) Cost of CT head in India: 1000  rupees (~$30) ; CT Head in US: ~$1000.  Cost of Plavix in India ~10 rupees/day; in the US, ~$4/day.  I may fill my suitcase with Plavix and sell it on the black markets of Cleveland.

3.) Losing access to your UHHS e-mail account while in India. Can we outsource the UH computer help desk to India, so it would be a local call for me here? If anyone needs to reach me, send e-mail to tfernan295@yahoo.com.

4.) The Internet dying in the middle of writing long blogs and losing what you have just written.