My experience of JSS Health Centre, Bilaspur, India |
| It was another scalding hot day as we disembarked the train at Bilaspur Junction station. The journey from Kolkata had been comfortable, but long and we had whiled away the hours watching TV and chatting with the other passengers. One elderly gentleman was a retired engineer on his way to visit family who had shared lunch with us and debated politics with Alok, our resident small talker. As Dr Yogesh later told us in one of our many morning discussions, Indian trains had a way of drawing the deepest conversations about passenger’s lives. People often finish the journey having revealed secrets about themselves that their own friends and family may be unaware of. |
| If you have never visited India before or you haven’t had much experience on the roads there, this will be a quintessential experience. A narrow road carries traffic to and from Ganiyari with slow moving and larger vehicles blockading the whole lane, leaving only enough room for dangerous and erratic overtaking manoeuvres as you weave in and out of oncoming traffic. This led to several near misses as suicidal drivers on two wheelers passed too close for comfort considering the speed and lack of protection their vehicle afforded them. As we pulled into the campus for the first time I was taken aback by the size of the whole operation. The site is made of a pleasing red brick and I was interested to learn that even this choice was a conscientious decision. The buildings were designed as they were to reduce the paranoia and suspicion associated with modern healthcare by the population that frequented JSS. I was even more interested to learn that this medium sized clinic by western standards covered a population an order of magnitude greater than several of the largest hospitals in London combined. With a total coverage of 1.5 million residents of Chhattisgarh and Madhya Pradesh, the limited number of beds were stretched to the limit 100% of the time. |
Outside both the outpatient centre and booking reception, stretched a large queue of patients hoping to be seen during that day’s outpatient clinic. This was not like any other queue I had ever seen. The waiting area for the OPD was more likened to a campsite than a doctor's waiting room. People had bedding, cooking utensils and food supplies and were often accompanied by several members of their family. This was a part of the patient journey (more literally than figuratively) that Dr Yogesh emphasised on an almost daily basis. The cost of travel and opportunity cost (in terms of income lost) of attending JSS was often too high for many of these people to attend until the illness had progressed to the point of being debilitating. People were having to wait in line for upwards of a week in addition to undertaking journeys taking in excess of days and costing more than the household’s entire weekly income. All this effort to be seen in the ever-surging outpatient department. The disruption this had on their lives was almost too much in some cases and often illness was left alone until it was too late. As someone trained in a system of relative plenty, this experience could only be described as a medical culture shock. | |
| It would be extremely cliché to say that visiting JSS changed my life but it would be a lie to disregard the impact it had on me. From the moment I started medicine I had the intention, as many of my selfless colleagues share, to take part in providing care to an underserviced community. I had assumed that I would join one of the common and famous institutions that specialise in such provision such as MSF but now having spent time in Chhattisgarh I have no doubt that I will make every effort to return. In the 17 years since its inception, JSS has made strides towards its key objectives. Yet I feel there is, as always in the medical field, huge room for improvement which, in part, drives my desire to return as I gain experience throughout my own medical career. And I hope that I can play a meaningful part in something as important as what JSS is aiming to achieve in the heartland of my country. |
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Thanks to Tom Pietrasik for photographs of JSS
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