Measuring “illness” and treatment-seeking behavior in rural India: a qualitative study of malarial infection among marginalized populations, Gadchiroli, Maharashtra, India.
Radhika Sundararajan MD PhD
PGY3
Harvard-Affiliated Emergency Medicine Residency Program
Over half of my time here collecting qualitative data has passed, and
we are finishing up our interviews this week. Spending time in this
area has given me an appreciation for the realities of rural life in
India (and a healthy appreciation for bug spray!). The villages here
are quite remote, separated by tracts of thick forest. These areas are
dotted with Primary Health Centers, where medical officers and nurses
are staffed. However, these centers are supposed to serve villages
located over 20 kilometers away, and the vast majority of villagers do
not own a motorized vehicle. Transport is accomplished by walking,
bicycle, hitching a ride on a bullock cart, or by public bus (which
I’m told exists, but I’ve never seen). This is the same hurdle faced
by community health workers, trained by the government to do active
surveillance for fever and test for malaria. These workers are meant
to monitor a population of 3,000 people on a weekly basis, but when
villages are as small as 60-75 people, this responsibility can
translate into a heavy travel burden, particularly in the absence of
mechanized transportation. The community health workers told me they
often walk between villages, which is actually quite dangerous as the
forests are full of poisonous snakes. In fact, there have been 12
poisonous snakes found in my camp in the past 16 days. Not
surprisingly, snake bite is a common (and potentially fatal) health
hazard in this region.
The landscape here is really serene and beautiful, with thick green
forest dotted with small villages and rice paddies. It’s the most
peaceful part of India I’ve ever seen.
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