Notes on a rural hospital


Anything that’s tagged both travel and science pushes a lot of my buttons. While I was in Nepal and India, I had a chance to spend a few days with a doctor at a regional hospital in the state of Tripura, in Kanchanpur. India may be rural, but has a strong central government and orderly state budget; some of these observations may not apply elsewhere.

The facility sees 100k patients a year, with separate words for men, women and pediatrics. The infrastructure may be a bit messy, by American standards, but is not a problem the doctors or patients see.

Lab capabilities are for basic fluids: blood and urine. Strips are common for tests. There’s an X-ray shop (one chest scan costs 150 rupees, of which the patient pays 10-20), but no CT. There’s also a full surgery suite, but no staff.

The doctor confides that most unsolved medical problems are not technology problems, but are cases where social ties and communication breaks down. The underserved don’t know when and don’t know how to go.

I saw a striking example: a five-year-old had a bad case of TB; the chest film showed the entire right lung was full. The kid hadn’t been seen until it was late; I later found out that he did survive, but not without pulling a severe fever for a week.

So there’s your technology problem to solve: how about a cheap go/no-go test, to help the unwell in rural communities make better decisions about making the trek to a doctors.

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