Student Perspective: Free Healthcare in Andhra Pradesh

When I visited my family after the STEM Reverse Innovation program ended, I had the opportunity to shadow my cousin Kishan who was doing his Residency in the surgery department at a government hospital in Vijayawada, the capital city of Andhra Pradesh. My family joked that I would not continue to want to be a doctor after seeing the conditions of the government hospital, but I braced myself and powered through to explore what the government of India is doing for the healthcare of the poor.

Kishan had “injection rounds” that evening, basically checking on patients and providing painkillers for pain management of post-operation patients before the attending physician’s rounds. People often say that visiting India overwhelms your senses, an understatement when visiting the government hospital. Words cannot describe the unimaginable combined smell of wounds festering in the humid heat, of body odor of patients and families who have not showered in days, of bathrooms not cleaned for who knows how long, and of expired antiseptics. Families wailed at the bedside of hundreds of patients while nurses clamored around to appease families and communicate with other nurses about patients. Visually, all of the equipment was dilapidated, from the beds that looked like they belong in a World War II movie set to yellow-brown respirator tubes. The hospital provides completely free medical services to anybody who shows up at the door, typically geared toward those at the poverty line and below. As a consequence, government hospitals are overflowing with patients but lacking adequate supplies to provide them full medical attention.

As Kishan and the other residents started filling syringes for painkiller injections, it quickly became apparent that any sterility guidelines were thrown out the window. Filled syringes were tossed on the table that was clearly nowhere near clean, much less sterile. The tops of glass medicine vials were hacked off and onto the floor for janitors to (probably not) sweep up later. Exam gloves were not even in sight. When I voiced my concerns, the residents replied that the sheer volume of patients that they go through does not allow the time or resources to be sterile. One resident shrugged off my appalled look, saying that during a surgery earlier that day, HIV-positive blood was dancing on her bare hands. Bare hands. During a surgery. They went on to tell me that I came on a good day, at the beginning of the month when they still had supplies. The hospital receives about a week’s worth of supplies and drugs that have to last a month. The shortages get so bad that syringes and needles will be kept with the patient to reuse them for a couple of rounds of painkillers. Some days, the residents are forced to inject only saline and pretend that it’s pain medicine (which often still alleviates pain but that’s not the point).

Despite such challenges, the doctors were clearly brilliant and practiced excellent medicine. We saw patients recovering from miraculous surgeries, ranging from limbs that could have been amputated to brain tumors cleared right up. Naturally, such working conditions and stress from overwork put these doctors and nurses in terrible moods, but they treated each patient with the utmost respect and embodied the humanistic side of medicine that is increasingly absent today. If the attending physicians saw or heard about any nurses or residents putting in IV ports too roughly or snarking at patients or families (even something as minor as using informal rather than formal pronouns to address), they got an earful in front of everybody. Likewise, most patients treated the doctors with respect and adoration. As soon as a white coat strolled into the room, hands go up in Namaste to greet the doctors who don’t have to work here, don’t have to put up with frequent patient and family abuse, and don’t have to endure these working conditions to help people who are way below them in caste (a system still strong in the minds of many Indians). The ability to give hope to people who have nothing is why my cousin purposefully picked the government hospital over private hospitals for his residency, and that wholehearted Namaste is his reward.

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