Home Visits: Day 1 (Uzhamalakkal)

Today I traveled to Uzhamalakkal with Dr. Broderick and a group of 4 other students for our first day of home visits with the Pallium India team. We began the day by having breakfast at one of the volunteer’s homes, which was a very nice home. We met his family, including his young daughter, who was very cute and playful. I gave the daughter a Hawkeye tattoo that I had brought along and explained how to put it on with water, and I think she was pleased. I was astounded that the man, who was retired from his career, was not only volunteering his time to travel to the home visits with the palliative care team, but was also offering up his house and his family members were offering their time and labor preparing meals for the team. If I understood correctly, they provide the team with both breakfast and lunch each time they travel to Uzhamalakkal.

We saw 8 patients, all females, who had conditions varying from diabetes, heart failure, and cancer, to just general old age. Between the language barrier and my limited knowledge of pathology and pharmacology at this pre-nursing point in my educational career, I wasn’t able to absorb the “nitty-gritty” of each case, but I’ll outline some general things that I observed today.

I was surprised by the width of the range of socioeconomic statuses of the patients we saw. Some of them lived in very small, open-air homes in the woods with no electricity or running water, and others lived in very nice, air conditioned middle-upper class homes with more modern amenities. That being said, we saw a very poor woman who was very well taken care of by her family members with fewer resources, as well as a woman who was in a very poor and unhygienic state despite her more appropriate living quarters and greater familial salary. For the patients of lower salaries, Pallium India would supply them with the medications that they needed, but for the more wealthy patients, the team would write them a prescription so that they could go to the pharmacy and get it filled themselves.

I was also surprised by the willingness of the patients, many of which near death, to allow a large group of foreigners into their homes who didn’t speak their language and who were constantly asking questions and requesting photos. I think it shows not only the culture of humility and openness that exists here, but also the appreciation of education in that the patients knew we were there to learn, and were willing to sacrifice some of their privacy in order to allow us to do so.

After we had completed our home visits, we returned to the home of the volunteer to a lunch that was waiting for us on the dining room table atop a plate of banana leaves. They explained that they had toned down the spice for our bland American palates, for which we were thankful, and they taught us how to eat with our hand, as is the traditional Indian way. The daughter had put the Hawkeye tattoo that I had given her on her arm, and after we had all finished up, we said our thank yous and goodbyes and headed back to the hotel for the day. Overall, I had a very interesting, enlightening, and fulfilling day.

We drove by a local school yard in between two of our home visits, and the students were all extremely excited to see American people, so much so that they swarmed our van and were jostling for position as we took photos!

I brought several small trinkets to hand out to patients and their families. In this case, the daughter loved the color pink, so I gave her a "Team Pink" wristband to wear with her pink skirt. 

A very typical house for a lower class patient and their family.

A typical bed that our patients spend most of their time in. They may be made of wood, or in some cases concrete, and may or may not have a mattress or padding to lay on.

The volunteer family taught us the traditional Indian method of how to use our hand to eat our meal, which was served atop a banana leaf. 

The lunch that the volunteer family provided for us.