Health and Economics - Tuesday part 2
After visiting the old people's home, we continued on to see some more economic activities before visiting a couple of hospitals.
First on the list for economic activities was the market. We had previously seen sericulture taking place in the villages, and now we were seeing the next step. Inside a market warehouse, bundles of silk cocoons were heaped in trays and on the ground. This raw silk was sorted by colour - some is white while some was a yellowy shade - and by quality.
Electronic screens displayed silk prices, and bundles of silk were sold by weight to be taken onto the next stage of processing into silk thread from which saris can be made.
We walked all around the warehouse, and it was interesting to see all of the little silk bundles, referred to by people here as 'eggs' because of the shape, and to think of how they start off with a fat pale caterpillar, and go on to become vividly-coloured and intricately-woven saris.
Following the silk market, we went to another industrial area just a very short drive away, where a whole series of small godowns was sited. Outside on the ground, a group of mostly women were sitting and picking the stems off chilli peppers in preparation for the peppers to be dried.
We met with a man, who was Ratnamma's grandson, and he worked at another larger warehouse in this complex. He took us to show us inside his warehouse, which was 8 floors high and was cooled. Outside an ox cart was being loaded with produce, while inside the 8 floors were crammed to the rafters with large sacks of chillis and tamarind. As we went inside and began to climb the stairs, gradually one by one we all succumbed to runny noses and fits of coughing due to the essence of chilli in the air. I definitely never want to be pepper sprayed after that experience!
Back out in the fresh air, We passed a lot of closed and inactive godowns which, it was explained, were for tamarind, and now was not the tamarind season hence they were all closed. We did get to spend some time watching the work of sorting and preparing chillis, all done by hand, and were shown a local variety of chilli which is apparently extremely hot. Andhra Pradesh likes hot food, so I'm not surprised their local chillis are hot...
Next on the agenda was lunch, which we ate in a local roadside hotel (many cafes here are called hotels), before we visited the government hospital.
I didn't take any photos inside the hospital out of respect for the patients, but I will try my best to describe things. Out the front, groups of family members were huddled on the steps against the rain. Apparently many people have to come to hospital and cook food outside for their sick relatives inside. The building itself was recently expanded to have some additional floors, and it was fairly modern inside. Large areas of the roof were open though, which is unlike any western hospitals I've seen.
We were shown into an area where there were wards for sick children, paediatric intensive care, and neonatal intensive care. We were taken into a neonatal intensive care ward, which was fairly small and had individual cots surmounted with heat lamps against each side wall. The infants, who were all born underweight, premature, or otherwise ill, were not in incubators as they would be in a western hospital. Their cots were open and they had woven cotton sheets, with the heat lamp above. The concerned new mothers were either sitting awkwardly in uncomfortable-looking chairs, or were sleeping on the floor next to the cots containing their babies. I spent a little time with one mother, whose first baby had been born early and underweight. Our common language was limited, but I think that the baby had so far been in the hospital for a month. I tried to ask if the mother also held the tiny baby, as I have heard that being held, especially against the mother's skin, is very good for sick babies. I wasn't able to get an answer to this question, but the mother seemed happy to touch her baby in the cot so with this confidence it is possible that she also held her infant as well. I was really affected by the sight of these anxious mothers and their vulnerable babies, and I felt scared for them at the apparent lack of infection control in the ward and the hospital. I was also concerned for the comfort of the mothers, but not many poorer people in India seem to have the luxury of comfortable chairs and beds in their homes, so maybe these women are accustomed to plastic chairs and the floor. The hospital is also apparently in a much better condition than even a few years ago, and so at least progress is occurring in these regional hospitals.
After the government hospital, we next visited a private hospital for contrast. The state of the building of this particular hospital didn't actually seem as good as the government hospital, but we didn't get to see much of the patients' areas - not that this was a problem, as my previous healthcare training and experience in a western setting makes me a firm believer in patient dignity and confidentiality.
Within this particular private hospital, the head doctor lives in apartment actually within the hospital building itself. The doctor's youngest daughter, who was 9 years old, came out to meet us and invited us in to their home to show us her pet parrots. She was clearly quite a spoiled child, but she was also kind of cute and charming, very cheerful and enthusiastic, and she had very good English - all of which made her a pleasure to talk to after the strain of trying to discuss difficult issues across a language barrier earlier in the afternoon. I realise that sounds a bit callous, but self-care is important to people who work with the problems of others, and if something has affected you deeply and you find some light relief, then I don't see a problem with using that light relief to your advantage.
The doctor's wife offered us all tea and a sweet desert, and when the doctor arrived we had a short time to discuss things with him and to ask a few questions before he had to return to work. When I asked about the main differences between this and the government hospital, he responded that in the government hospital there can often be a long wait for a doctor to actually arrive, even if there is quite a serious need for a doctor's attentions. Sometimes there is even no equipment available, because it has been sold or stolen - some government hospital doctors also have their own private practices, and it is not unheard of for them to take government supplies to their own clinics and then fail to treat in the free government hospital, only offering treatment in their own pay clinics. A very shocking ethical practice to someone who grew up in the UK, where healthcare is seen as a basic right to all people, regardless of ability to pay, and where most healthcare workers passionately believe in and uphold this right.
The private hospital doctor has also done health camps in the villages, where he will take supplies and medicines and visit villages to provide healthcare to the poorer people for free. This is an incredible initiative for people who can be living in extreme poverty, and would not otherwise even be able to travel to a hospital, let alone pay for treatment or medicines.
The trips to the hospitals left me with a bitter-sweet feeling. It was good to hear that progress was happening, and heartening to hear of people actively working to bring healthcare to the poorer people of the villages. But at the same time it was heartbreaking to me to see people suffering in preventable ways, and to hear of unethical practices occurring that further exploit people who are desperately vulnerable already.
First on the list for economic activities was the market. We had previously seen sericulture taking place in the villages, and now we were seeing the next step. Inside a market warehouse, bundles of silk cocoons were heaped in trays and on the ground. This raw silk was sorted by colour - some is white while some was a yellowy shade - and by quality.
 |
| White silk in the foreground, yellow behind |
Electronic screens displayed silk prices, and bundles of silk were sold by weight to be taken onto the next stage of processing into silk thread from which saris can be made.
 |
| Carrying bundles of silk to the weighing room |
We walked all around the warehouse, and it was interesting to see all of the little silk bundles, referred to by people here as 'eggs' because of the shape, and to think of how they start off with a fat pale caterpillar, and go on to become vividly-coloured and intricately-woven saris.
 |
| Silk 'eggs' |
Following the silk market, we went to another industrial area just a very short drive away, where a whole series of small godowns was sited. Outside on the ground, a group of mostly women were sitting and picking the stems off chilli peppers in preparation for the peppers to be dried.
We met with a man, who was Ratnamma's grandson, and he worked at another larger warehouse in this complex. He took us to show us inside his warehouse, which was 8 floors high and was cooled. Outside an ox cart was being loaded with produce, while inside the 8 floors were crammed to the rafters with large sacks of chillis and tamarind. As we went inside and began to climb the stairs, gradually one by one we all succumbed to runny noses and fits of coughing due to the essence of chilli in the air. I definitely never want to be pepper sprayed after that experience!
 |
| L-R: Ratnamma's grandson, Ratnamma, Govindamma, Manni, Radha |
Back out in the fresh air, We passed a lot of closed and inactive godowns which, it was explained, were for tamarind, and now was not the tamarind season hence they were all closed. We did get to spend some time watching the work of sorting and preparing chillis, all done by hand, and were shown a local variety of chilli which is apparently extremely hot. Andhra Pradesh likes hot food, so I'm not surprised their local chillis are hot...
 |
| The local chillis... |
Next on the agenda was lunch, which we ate in a local roadside hotel (many cafes here are called hotels), before we visited the government hospital.
I didn't take any photos inside the hospital out of respect for the patients, but I will try my best to describe things. Out the front, groups of family members were huddled on the steps against the rain. Apparently many people have to come to hospital and cook food outside for their sick relatives inside. The building itself was recently expanded to have some additional floors, and it was fairly modern inside. Large areas of the roof were open though, which is unlike any western hospitals I've seen.
We were shown into an area where there were wards for sick children, paediatric intensive care, and neonatal intensive care. We were taken into a neonatal intensive care ward, which was fairly small and had individual cots surmounted with heat lamps against each side wall. The infants, who were all born underweight, premature, or otherwise ill, were not in incubators as they would be in a western hospital. Their cots were open and they had woven cotton sheets, with the heat lamp above. The concerned new mothers were either sitting awkwardly in uncomfortable-looking chairs, or were sleeping on the floor next to the cots containing their babies. I spent a little time with one mother, whose first baby had been born early and underweight. Our common language was limited, but I think that the baby had so far been in the hospital for a month. I tried to ask if the mother also held the tiny baby, as I have heard that being held, especially against the mother's skin, is very good for sick babies. I wasn't able to get an answer to this question, but the mother seemed happy to touch her baby in the cot so with this confidence it is possible that she also held her infant as well. I was really affected by the sight of these anxious mothers and their vulnerable babies, and I felt scared for them at the apparent lack of infection control in the ward and the hospital. I was also concerned for the comfort of the mothers, but not many poorer people in India seem to have the luxury of comfortable chairs and beds in their homes, so maybe these women are accustomed to plastic chairs and the floor. The hospital is also apparently in a much better condition than even a few years ago, and so at least progress is occurring in these regional hospitals.
After the government hospital, we next visited a private hospital for contrast. The state of the building of this particular hospital didn't actually seem as good as the government hospital, but we didn't get to see much of the patients' areas - not that this was a problem, as my previous healthcare training and experience in a western setting makes me a firm believer in patient dignity and confidentiality.
Within this particular private hospital, the head doctor lives in apartment actually within the hospital building itself. The doctor's youngest daughter, who was 9 years old, came out to meet us and invited us in to their home to show us her pet parrots. She was clearly quite a spoiled child, but she was also kind of cute and charming, very cheerful and enthusiastic, and she had very good English - all of which made her a pleasure to talk to after the strain of trying to discuss difficult issues across a language barrier earlier in the afternoon. I realise that sounds a bit callous, but self-care is important to people who work with the problems of others, and if something has affected you deeply and you find some light relief, then I don't see a problem with using that light relief to your advantage.
 |
| The doctor's wife and daughter |
The doctor's wife offered us all tea and a sweet desert, and when the doctor arrived we had a short time to discuss things with him and to ask a few questions before he had to return to work. When I asked about the main differences between this and the government hospital, he responded that in the government hospital there can often be a long wait for a doctor to actually arrive, even if there is quite a serious need for a doctor's attentions. Sometimes there is even no equipment available, because it has been sold or stolen - some government hospital doctors also have their own private practices, and it is not unheard of for them to take government supplies to their own clinics and then fail to treat in the free government hospital, only offering treatment in their own pay clinics. A very shocking ethical practice to someone who grew up in the UK, where healthcare is seen as a basic right to all people, regardless of ability to pay, and where most healthcare workers passionately believe in and uphold this right.
The private hospital doctor has also done health camps in the villages, where he will take supplies and medicines and visit villages to provide healthcare to the poorer people for free. This is an incredible initiative for people who can be living in extreme poverty, and would not otherwise even be able to travel to a hospital, let alone pay for treatment or medicines.
The trips to the hospitals left me with a bitter-sweet feeling. It was good to hear that progress was happening, and heartening to hear of people actively working to bring healthcare to the poorer people of the villages. But at the same time it was heartbreaking to me to see people suffering in preventable ways, and to hear of unethical practices occurring that further exploit people who are desperately vulnerable already.
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