JIPMER, Part 2

Dr. Subhash Parija is an expert in parasitology. The focus of his research lab is to develop diagnostic methods for more rapid and accurate detection of parasitic infestations. He walked me around his lab and had the head of each section describe the equipment and the types of studies performed. In Bacteriology, they use a Bactec system, including anaerobic cultures. Both of these characteristics are found in few clinical labs here in India. They also make much of their own agar and other culture media. We went to Virology, Serology, the TB area, and the molecular biology area. They also have a tissue culture area that is currently maintained only for educating the microbiology residents (there is a residency here separate from path for persons who want to be MD microbiologists). This area, consisting of two rooms, is slated to be completely renovated in the next few months. Dr. Parija’s lab is going to be a referral center for avian flu for all of South India. They have funds to renovate as well as get two real-time PCR machines and other fancy pieces of equipment.

We then went out the front door of the building and headed to a smaller structure that is dedicated to HIV testing and counseling. Dr. Parija heads up the newly created HIV Cell at JIPMER, and maintains a separate lab area for all HIV-related specimens and assays. Finally, he showed me the animal facility, which he also heads. There they house mice, rats, guinea pigs, rabbits and sheep. They used to have non-human primates, but decided that it was too much for now.

I am impressed with JIPMER and with Dr. Parija. It is an institution where research efforts are valued and prioritized, and one that has a long tradition of excellence both in research and the clinical arena. I am going back Monday to meet with Dr. Hamid from Internal Medicine. He sees most of the HIV-infected patients.

JIPMER, Part One

MGMCRI is situated about 16km from downtown Pondy. It is at the border of a rural area, and is flanked by vast streches of mostly open space, dotted with coconut and palmetto trees. It is the southernmost of the 7 medical colleges in Pondy, and the oldest private medical college. As was mentioned earlier (I think), in private hospitals, patients pay for everything. Insurance in Hyderabad is <1%, and is negligible here in Pondy. MGMCRI is about 7 years old, and its wards are not usually full. It does much better, I am told, than the other private colleges here, because it is more established.

Dr. U.K. Singh, the Head of Microbiology at MGMCRI, kindly arranged for me to meet his opposite number at JIPMER this morning. I got into a car at the medical college, accompanied by one of the tutors (instructor-equivalent at CWRU) as my guide. There were two other assistant professors in the car, headed to Pondy to do some other work.  Halfway to our destination, the front passenger tire blew out, so we had a 20 minute delay for a tire change. As my wife has no doubt already guessed, I concluded that I could have done it faster.  My conversation with my companions was illuminating. Money drives the medical college construction. Completely. There are few patients at most of these colleges. The colleges make their money by charging students exorbitant sums to matriculate and study there.  The income from patients is negligible.  This seems to dilute the quality of care as well as the quality of the medical education here in Pondy at these brand new schools.  A new government medical college is also being constructed. This one should have no problems filling up with patients, however, since it will primarily serve the poorest of the poor. There is no shortage of those persons here. 

The Jawaharlal Institute of Postgraduate Medical Education and Research is oone of the two established government hospitals. It is about 6km north of the heart of Pondy, and is thus situated in a more urban setting. Its sprawling (by Indian city standards) campus is separated from the city by a compound wall. There is lush vegetation between the buildings, and the place is bustling with people, inside and outside.  JIPMER’s capacity is 1000 beds, and it routinely has a census of 2000. Don’t know who is holding that transfer pager. My guide and I entered the main building, opposite the Administrative building, and made our way to Microbiology on the second floor. The hallways have the unmistakable look, color, and feel of non-private Indian hospitals; something the CIT1 crowd, among others, can appreciate. The major difference here is that the anatomy lab is on the first floor, and the smell of formaldehyde penetrates all four floors above it.

Dr. Parija is the head of Microbiology at JIPMER. He came here as a freshly-graduated resident (MD in Microbiology) and is now in his 28th year at the institution. He was not in his office when we were shown in, so I had the opportunity to get to know him first from the things in that room. The room itself was large, maybe 20 feet by 20 feet, and was lined with cabinets and shelves on every wall. Numerous certificates and plaques adorned the wall space above the lower lying cabinets. Dr. Parija was clearly a speaker in high demand. A relief map of Nepal just next to the door suggested his place of origin. His desk was oversized and trapezoidal, with a matching glass top. On one corner was an atlas of parasitology, recently published, authored by Subhas Chandra Parija. The computer was on a desk behind his chair, and sported the blue screen of death. We sat down in two of the four chairs across from his desk and waited. It was abundantly clear that he was a highly accomplished man. In India, as elsewhere, this usually means that a big ego is in tow, and that Gopal will have a rough time of it during talks of collaboration. After about five minutes, he entered quietly and, over the next three quarters of an hour, dispossessed me of my assumptions.