Field Experience: India

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Field Experience India

• Presented by
• Mandi Proue Terra Carey

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Presentation Outline

• Objectives
• Objective of Field Experience
• Terra and Mandis objectives
• How funded
• How chose organizations
• General Overview of Indian Healthcare Systems
• Mandis Experiences
• Terras Experiences
• What we learned
• Suggestions Advice
• Questions?

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What are the goals of a field experience?

• Goals of the Field Experience
• Overall Goal
• The overall goal of the field experience is to
  bring public health to life, and specifically to
  help students strengthen their philosophy and
  understanding of public health and to begin to
  identify themselves as public health
  professionals. The field experience enables
  students to learn first-hand about organizations,
  operations, and special activities of selected
  agencies, institutions, and industries concerned
  with public health practice.
• Other Goals
• The field experience will provide opportunities
  for the student to
• Apply the knowledge, theory, concepts, skills and
  abilities acquired in the academic program.
• Be personally involved in developing, planning,
  executing, and evaluating activities with and for
  groups and individuals.
• Gain additional insight into programs, personnel
  management, governmental relations, public
  relations, legislative support and, particularly,
  knowledge of special investigations conducted by
  these organizations.
• Increase the student professional self-awareness
  and accumulates experience that will enhance job
  competence and/or placement following the
  completion of the program.

(http//www.sph.umn.edu/current/fe/home.html)
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Mandis Objectives

• Work within a local grassroots organization
  understanding processes, strategies, and
  challenges present in the field of public health.
• Develop an understanding of India's
  infrastructure and how it is related to health.
• Gain knowledge of the health problems faced by
  women and children living in rural Rajasthan.
• Understand how a sustainable approach to health
  development is possible along with it's
  challenges.
• Enhance my personal, professional, and academic
  commitment to sustainable development.

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Terras Objectives

• Compare Maternal Child Healthcare Needs and
  Services in Relation to
• Geographic location
• Educational status
• Employment/Economic status
• Governmental and non-governmental resources
• Observe Healthcare Delivery Methods at
• Charity Hospitals
• Non-governmental Organization
• Private Physicians Office
• Governmental Clinics
• Private community clinics, educational centers
  and hospitals

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Paying for the Experience

• School of Public Health Scholarships
• Mandis Experience
• Foundation for Sustainable Development (FSD)
• Terras Experience
• Affiliated with the University
• In addition to the SPH scholarship
• Judd Award
• NWA Airline Voucher

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How we chose our organizations

• www.idealist.org
• FSD
• Interdisciplinary approach, practical experience,
  in-country support
• University contacts

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Overview of the Indian Healthcare System
Private Care Providers
Medical Training Centers Colleges
Tertiary Care Hospitals
District Hospitals
Family Culture
Primary Health Centers and Urban Health Centers
Charitable Organizations
?
NGOs
Community Health Workers
Traditional Providers (Quacks)
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Overview of the Indian Healthcare System Continued

• 6-30 of all centers are without doctors and
  those with posts with assigned doctors report
  doctor absenteeism rates between 29-671
• Overall Mortality Rates1
• Maternal mortality 407/100,00 livebirths
• Infant Mortality 58/1000 livebirths
• Huge socioeconomic gaps throughout the country,
  not just between the rich and the poor. These
  differences become evident in differing rates
• Childhood Immunization Rates2
• Overall 44 (58-39 Urban vs. Rural)
• Rajasthan27 (44-22 Urban vs. Rural)
• Uttar Pradesh23 (33-21 Urban vs. Rural)
• Karnataka 55 (60-52 Urban vs. Rural)
• Put things in context
• Medical Schools
• History
• Traditional beliefs

• Indias Government Aim to Improve Rural Health.
  The Lancet. 368 October 28, 2006. 1483-84
• Ministry of Health and Family Welfare, Government
  of India National Family Health Survey-3 Fact
  Sheets (Provisional Data), 2005-2006.

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Mandis Experiences

• Udaipur, Rajasthan
• Host Family
• Culture Training
• In-Country Support
• Development Training
• Host Organization
• Action, Research, Training for Health (ARTH)

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International Volunteer Organization Foundation
for Sustainable Development

• Supporting sustainable solutions for the
  developing world.
• Development Issues
• Micro-enterprise/Microfinance
• Environment
• Health
• Youth and Education
• Womens Empowerment
• Community Development
• Human Rights
• www.fsdinternational.org

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NGO Action, Research, Training for Health (ARTH)

• Technical resource for organizations engaged in
  improving health among the less privileged.
• Mission To help communities to access and
  manage health care according to their needs and
  capacities by using research and training
  initiatives.
• Offers health service, training, and surveillance
  programs in southern Rajasthan.
• Programs and Activities
• Community Action for Safe Motherhood
• Home Based Care of Young Infants
• Copper T Choice Quality Project
• Intervention and Advocacy for Continuum of
  Maternal Newborn Care in Rajasthan- MacArthur
  Grant

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Terras Experiences

• Independent Travel
• Mostly arranged my own schedule (with the
  assistance of professors/preceptors)
• Hands-on Observational Experience
• Wanted to view different types of healthcare
  delivery systems
• Charity Hospital
• NGO
• Private Physician
• Medical College
• Government Clinics

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Shanti Mangalick Charity Hospital

• Charity hospital opened by one-time Minneapolis
  Resident Shri P C Mangalick
• Full-service hospital
• Emergency, ICU, Surgery, Radiology, Outpatient
  Services
• Physical Therapy, Dental Clinic, Eye Clinic
• OB-GYN, NICU, and Pediatric Departments
• Conducts rural health camps and offers
  referrals to the main hospital for follow-up
  services
• Houses a School of Nursing

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NGO Private Physician's Office

• North vs. South
• Private vs. Public
• Visit to ARTH
• Mandi
• Dr Santhan Gopal
• Bangalore
• Ophthalmologist

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Kasturba Medical College

• Healthcare delivered to areas villages through
  collaboration between KMC and several rural
  clinics
• Bring the doctors to the patients
• Goal All women receive antenatal care, births
  attended by physician, and children immunized
• Highly trained support staff is available 24
  hours a day at rural clinics
• Primary, Secondary, and Tertiary care centers are
  available
• Services available at low cost and reduced prices
  to villagers

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Governmental Hospitals and Clinics

• Visited several clinics and hospitals throughout
  Karnataka
• In collaboration with physicians and social
  workers at KMC
• In general
• Limited resources
• Low staff morale
• Fairly low citizen interest

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A picture is worth.
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So, what did we learn?

• Development work is hard
• International work cannot be romanticized
• The importance of sound leadership and continued
  investment
• Health issues can not simply be addressed by
  providing medical care and treatment
• New situation

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Suggestions Advice

• Be open minded
• Have zero expectations
• Be motivated and seek out resources
• Think about your own situation and what you want
  and hope to learn from the experience
• Decide to do this all alone or with a group
• With the university or independently?

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• Questions?
• Feel free to contact us
• Mandi Proue proue002_at_umn.edu
• Terra Carey carey094_at_umn.edu