Lessons From My Trip to India on Understanding Our Patients

— Learning first-hand about rural or diverse communities is key to addressing health inequality

Last Updated July 27, 2022
MedicalToday
A photo of village life on a street in Dhariyawad, Rajasthan, India

Recently, I traveled to India to visit family for the first time in 5 years. As a child, I would make yearly visits during the summer, and with each trip, I was always mesmerized by the novelty of being in a new country and experiencing a new sense of "normal." My trip this year, however, was different from trips of the past. Visiting for the first time as a medical student and with a broader perspective of the world, I realized that parts of India felt like an extension of the world I was living in back in the U.S. Urban cities have rapidly developed over time to match advancements in other parts of the world, and it took an experience like this for me to realize how small this seemingly big world is becoming.

It also made me realize that globalization and growing disparities in healthcare ironically come hand in hand, and that this isn't a problem unique to any specific country. Rather, it's an issue present throughout the world. During my visit, I had the chance to visit the village where my grandfather grew up. Driving along one of the main roads, I saw many small shops lined alongside. While there was an abundance of shops for food and clothes, I didn't see a single health clinic or hospital building. The village itself was vibrant and many of the elderly people I met had lived in the village for the majority of their life, having grown accustomed to the tranquility and familiarity of the places around them. When I asked about how they receive healthcare, I learned that many did not, in fact, receive any care. The closest hospitals were an hour away in a town with more resources. Access to transportation was difficult as well, and it left me wondering how people in the village who were my grandparents' age were taken care of, especially during emergencies. Did families find ways to arrange for transportation and just hope for the best? Was there even proper knowledge of what constitutes a healthcare emergency? Who was there to take care of the residents of the village?

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This colorful temple, in the village where my grandfather grew up, represents the heart of the village and serves as a place for the community to gather and host cultural celebrations.

Villages are the backbone of India, with agriculture being one of the core professions strengthening the country and its economy. However, they're also one of the more neglected parts of the country, receiving very little, if any, resources from the government for improvement of healthcare and lifestyle. Because disparities are present in all facets of life in such underserved areas, developing solutions to bridge gaps in care requires a multipronged approach, creativity, and careful analysis of allocation of resources.

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This is a view from my grandparents' current home located in a nearby town.

As a medical student passionate about utilizing platforms in healthcare to advocate for vulnerable populations, I know more work can be done to address systemic inequalities. One of the most important aspects of the solution is education. Creating community-based initiatives to educate community members on the importance of getting health checkups and understanding one's own health can allow individuals to take accountability for their health and reduce hospital emergency visits. Additionally, in medical student training, while clinical rotations in community and academic hospitals are important for students to gain clinical knowledge, implementing mandatory rotations in rural or underserved areas could be equally as important for students to be able to apply their medical knowledge for those who may need care the most.

As an undergraduate student studying in Chicago's South Side, I learned about the healthcare disparities disproportionately affecting underserved neighborhoods. I contributed to hospital-based initiatives to increase access to education regarding certain health conditions, and at the time, I thought I had an in-depth understanding of how healthcare disparities affect individuals. However, visiting the village where my grandfather grew up made me realize that in order to get a broader understanding it's important to be physically present in the community and interact with its members. This also fosters an appreciation for the culture and unity of the people of a community. Understanding communities can allow for more creative and effective approaches to tackle inequities. Without a thorough understanding of diverse patients' backgrounds and situations, we cannot provide them with the best care possible.

As future physicians and leaders, the onus is on us to understand the needs within our own communities and to do our part in effecting change with the knowledge we've been privileged to obtain.

Pranati Movva is a medical student at Michigan State University College of Osteopathic Medicine.