Bidada Hospital
Summer 2008
Research in the use of
Allopathy and Naturopathy in
rural Gujarat, India
Where In the World?
Bidada
Village
Located in:
Kutch
District,
Gujarat
state,
India
The Researchers
Matthew Lilley
MS III
Priyanka Wali
MS III
The Kutch
• 1.5 Million
inhabitants
70% lives in rural setting
Agrarian economy
New influx of industry
Average wage 90 Rp/day ($2.25)
Jainism is primary Religion
• 45,652 km²
• Semi-arid
Industry & Economy of Kutch
• Rapidly growing industrial development as India
modernizes
• Future site of largest coal-power plant in all south Asia
• Rapidly increasing energy demands for manufacturing
The Hospital
•Founded in 1970 by
Gujarati business
men
•Formed Bidada
trust to address
health care needs of
peasant population
•Employ Five physicians,
Two dentists, and two
physiotherapists
•Doctors see roughly 75100 patients per day.
Shree Bidada Sarvodaya Trust
• The hospital runs almost
entirely on the charity of
wealthy Indian donors
• The hospital bills patients
what they can afford
• Office visits=$3-5, Rx=$1$1.50, Surgeries=$50-$500
• But the trust will waive
fees altogether in many
cases
Most Common Pathologies Seen
• Tuberculosis
• Malaria
• Renal failure
• Congenital
Deformities
• Rheumatic Heart
Disease
• AIDS
• Cataracts
• Vitiligo
Departments
•
•
•
•
•
•
General medicine
Gynecology
Ophthalmology
Dentistry
Naturopathy
Visiting specialists
and Surgeons
What We Did
• Descriptive study- We created a rough video
documentary giving a western view of how the
hospital operates.
• Allopathy vs. Naturopathy- We ran a
comparative study surveying patients in the
general medicine dept. as to why they chose to
see an allopathic physician rather than a
naturopathic physician.
Descriptive Study
We studied everything from how
physicians practiced, to hospital
funding to how the local environment
affects health
Modernization is one of the major
influences affecting the health of the
Kutchi population
• As the Kutch industry is
further developed, more
and more people from
out-of-state move to the
area.
• This results in increased
demands for water, so
each year the water table
is dropped, yielding
brinier water for drinking
and the agricultural
irrigation.
• This “harder” water
introduces water-specific
pathologies, such as
renal failure and
cataracts.
How the hospital copes
• Rx drugs are incredibly
cheap in India
• Doctors see many
patients (about 70/day)
focusing mainly on Acute
conditions, no continuity
of care
•The hospital works with large Indian
corporations (many of the trustees hold
stakes in them) to solicit donations.
Allopathy vs. Naturopathy Study
• Hypothesis: Patients will find obtaining allopathic
care at Bidada more difficult than obtaining
naturopathic care elsewhere due to travel cost and
time.
Allopathy vs. Naturopathy Study
• Problem 1: We didn’t
speak the language. Our
mentor sent us under the
presumption that many
translators would be
available.
• Our guide, who spoke
Gujarati and English,
wasn’t inclined to talk to
the patients; there was a
clear division in class
between trustees, staff,
and patients.
Allopathy vs. Naturopathy Study
• Problem 2: Cultural
differences between us
and the patients & the
physicians.
• Although the physicians
could translate for us, they
didn’t understand why two
Americans would come to
India to speak with patients,
definitely a class issue.
-Some of our survey asked about
costs of transport and medicines, to
see if these were determinants for
care.
-The patients interpreted these
questions as if we, as wealthier
westerners, were offering them money
for their visit and transportation
The Results
• Our hypothesis was
incorrect.
•Kutchis overwhelmingly
had greater access to
allopathic care at Bidada.
They needed quick fixes to
acute conditions in order to
return to work.
Wealthy tourists from
Mumbai were the sole
patients at the Nature cure
clinic curing chronic
ailments or trying to follow
weight loss regimens.
What we learned
• Cultural difference
between way patients are
seen at Bidada & the US
• Difficulty of doing a
project in another country
(no familiarity)
• Complexity of health care
in the developing world
(not as simple as working
with limited supplies)
What we enjoyed most about
Bidada
•
•
•
•
Playing cricket with kitchen staff
Camel ride on Mandvi beach
Seeing one of the last remnants of traditional India
Eating dates with an Mumbai billionaire on his estate
Possible projects for Summer 2010
and beyond
• Continuing study of traditional Indian medicine
• Work in Children’s Health Screenings at local school (perform
basic eye/neuro exam)
• Environmental Study-Related to water supply or traditional
medicine use in Indian homes.
• January Camp (over 120 physicians from around the world
treat 20,000 patients)
January Camp
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•
•
•
Annual event throughout the month of January
More than 20,000 patients from 1200 villages
120 US physicians and volunteers
20+ medical & Surgical specialties
Medical Camp
Periphery
Examination at Bidada
Surgery
No
Urology
Dec, 31
Jan 1,2,3
2
Cardiology
Jan 1, 2
-
3
Pediatric Cardiology
Jan 1, 2
-
1
4
Asthma & Allergy
Jan 3
5
Rheumatic Heart Disease
Jan 3
-
6
Squint Eye
Jan 3
Jan 4, 5, 6
7
Endocrinology
Jan 4
-
8
ENT
Jan 4
Jan 4, 5, 6
Jan 5
-
9
10
Jan 3
Diabetic
Orthopedic
Jan 5
Jan 6
Jan 7, 8, 9
Arthritis / Rheumatology
Jan 6
-
12
Rehab Medicine
Jan 6
-
13
Speech & Audiology
Jan 7
-
14
Pediatric (surg, onc, uro,
neuro, ortho
Jan 9
17
Dermatology
11
18
19
General Surgery
Cancer
20
Breast Lump Checking For
Malignancy
21
Gastroenterology
Jan 9
Jan 10
Jan 11
Jan 12
Jan 13, 14
Jan 12, 13, 14
Jan 13, 14
Jan 13
Jan 14 Scopy
Eye
Jan 11,12,13,14
Jan 14
Jan 15,16,17,18
23
24
24
Dental
Psychiatric
Gynecology
Jan 11,12,13,14
Jan 14
Jan 17
Jan 18
Jan 17,18
Jan 19, 20,21
25
Cancer Awareness & Checking
26
General Camp
33
Children Health Care Project
34
Pathology / Radiology / X Ray
35
Prosthesis & Orthosis
22
Dec, 31 to
Jan, 12
Dec, 31 to
Jan, 21
Dec, 31 to
Jan, 21
Dec, 31 to
Jan, 21
Dec, 31 to
Jan, 21
-
Contacts
• Priyanka Wali
pwali@usc.edu
Go to www.bidada.org
•Matt Lilley
mlilley@usc.edu