Introduction to pediatric cardiac care in India
Walking
into the hospital in the morning, I immediately begin to feel calm. The busy hustle of patients and
providers rushing to their appointments; academic presentations of recent
journal articles during morning conference; the complex yet highly structured
ways in which medical information is communicated: these are things I
know. Having arrived in India just
this week, I am grateful for these familiar rituals. For the next 4 weeks I will be based in Kerala, the
southwestern most state, at the India at the Amrita Institute of Medical
Sciences. A private hospital with
over 1,000 beds, Amrita has a strong charitable program that helps to serve
those who cannot afford healthcare.
In the past
week, I have had just enough time to see one cardiac surgery, five complicated
procedures in the cardiac catheterization lab, and over 50 echocardiograms of
children with incredibly complex congenital heart disease. I have shadowed rounds in the pediatric
cardiac intensive care unit, impressed that I understand as little here as I
would have in the CICU in Boston.
I have met an incredible team of attending physicians and fellows, whose
physical exam skills give me pause about what I have been learning in my
medical training for the past eight years.
Yet why
travel so far when I work with some of the world’s leading experts in
cardiology in Boston? The fact is
that the majority of people who have heart disease do not live in Boston. They do not live in developed countries
with functioning healthcare systems that allow access to high-quality,
sub-specialized care. They live in
poor countries that often lack access to even basic medical services. I came to India to learn how pediatric
cardiac care might be realistically delivered in poor countries, where access
to highly trained medical staff exist- but resources are profoundly limited.
Although
comforted by the daily routine of the hospital, there is nothing routine about
the practice of medicine that I am witnessing here.
Jennifer Lewey
Resident in the Brigham and Women's/ Children's Hospital Hospital Med-Peds Program
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