I recently took a short journey of three flights totaling thirty hours of travel time to study abroad at the National University of Singapore. I took the course ‘Health of the Poor in Asia’ under the Saw Swee Hock School of Public Health, and attended field school at Christian Medical College (CMC) Vellore in Tamil Nadu, India.
It’s hard to boil down the rich and immersive experience of being in India down to a few hundred words for a blog post, but I’ll do my best. Our class, a tightly knit group of nineteen students and two spunky professors, travelled to various CMC sites in Tamil Nadu. We took bumpy van rides from the sprawling blocks of Vellore district out into the rural Jawahdi Hills. Our mission: to conduct qualitative research on patients, doctors, public health workers, nurses, dieticians, anyone who could talk to us, to identify which public health strategies were employed in Tamil Nadu and why they were successful or how they could be improved.
I left India with the greatest feeling of hope. Although it was heartbreaking to see how poverty has shaped the lives and healthcare-seeking behaviors of the people in Tamil Nadu, there are many people working towards the common vision of a healthier future. Problems may exist, but progress can and will be made.
The best example of this in action is elder health. India faces the unique issue of facing an epidemiological transition: it is being hit by a new wave of non-communicable diseases (NCDs), such as Type 2 Diabetes and diseases associated with the aging population like Alzheimer’s. However, it is difficult to allocate resources to combat NCDs, because India is still coping with communicable diseases on the other side of the spectrum. For instance, India is working towards better immunization rates and probing for sanitation solutions.
Due to limited resources, the unfortunate reality is that many elders have been neglected by their families and communities. To alleviate this issue, CMC has set up various Elder Care Centres. I learned two important lessons from our visit to an Elder Care Centre. Firstly, poverty does not necessitate poor healthcare. In fact, some regions in India have healthcare standards as high as in developed countries. The successes of any healthcare system depend less on money and more on how organizations can use available resources effectively. Rather than being run directly by CMC, Elder Care Centres are run by Women Self Help groups – another CMC initiative – in local villages. This partnership is highly efficient. The Women Self Help groups lead tasks like preparing nutritious foods, identifying appropriate sites for the centres, and encouraging the elders to use medical services such as CMC mobile clinics. They also coordinate the elders to take part in income-generating activity, such as producing paper bags.
My second takeaway message is social connection is powerful. In the limited time they shared with us, the elders emphasized their wish for us to keep in touch with our own parents. The effects of social isolation trickled down to impact their mental, emotional, and physical well-being. I realized that just having the company of people who encourage you, inspire you, and care about you is essential to good health. Health is not merely the absence of disease.