Future Focus: Saleha Khan

Saleha Khan, final year medical student at Bond University travelled to Gujarat, India to undertake her four week elective at Deesa Ghandi Lincoln Hospital. 

Saleha encountered a variety of situations while working in the hospital as well as when she accompanied the mobile remote clinic visiting rural villages to deliver healthcare to those with limited access to resources.

The cost of healthcare

My elective took place between 1st October 2022 and 30th October 2022 for a duration of 4 weeks at Deesa Gandhi Lincoln Hospital in Gujarat, for a community and hospital-based placement in rural health care. As part of the program, I shadowed medical practitioners in several departments including General Surgery, Obstetrics and Gynaecology, Paediatrics, General Medicine, Ear/Nose/Throat and Orthopaedics. In Deesa, doctors are challenged to treat more than 100-200 patients a day. Additionally, most patients are treated free of charge, or as little as 10 rupees (approximately AUD$0.20), for medications and investigations. The key focus of the program was to look after some of the most vulnerable people in Gujarat without access to large tertiary hospitals.

This elective provided a surreal experience that provided a stronger insight into the global challenges humanity face within a rural setting, specifically in a third world country. I was able to learn to provide healthcare services by navigating through barriers such as limited resources, poverty and racism.

Scarce resources

It was exceptionally eye-opening to witness the vast array of complications of uncontrolled chronic diseases such as diabetes, high blood pressure and cholesterol and the detrimental impacts these posed such as: gangrenous peripheral vascular disease, necrotising fasciitis, critical limb ischemia, severe diabetic foot ulcerations and recurrent cellulitis or infections. With such limited resources, surgeons had to conduct surgical operations such inguinal hernia repairs or testicular hydrocele repairs with solely one local anaesthetic injection and one suture. It was fascinating to witness first-hand how high-quality and affordable services can be provided in situations with limited resources.

In one such instance, I recall meeting a middle-aged man within the Emergency department who came in with diabetic foot. Upon inspection, and to my surprise, the tendons and flesh beneath the skin and toes was completely necrotic and exposed and I noticed multiple tiny maggots wriggling within the wound bed. I now fully realise the burden of illness endured as a result of social and environmental factors. Many patients are severely disadvantaged and have far worse outcomes as a result of unhygienic housing, inadequate amenities, and cleanliness, as well as a lack of knowledge.

This exposure and training within Deesa Hospital allowed me to appreciate the need to advocate and educate about early recognition of disease management and health promotion.

Beyond the hospital walls

I also had the unique privilege to accompany mobile remote clinics that provided healthcare to people with limited resources and geographic disadvantage in the nearby villages of Radhanpur and Kotra. The doctors' altruistic and excellent care for patients from low socioeconomic backgrounds, who could only afford as little as 10–20 rupees for medical treatments, humbled me. I contributed by providing vaccinations, general health checks and chronic disease management plans. During week 3, I travelled on a 4-day trip to Bihar, Bodhgaya for a Medical Eye Camp where each day, 1,000 cataracts were operated on. Here, I saw cataract, pterygium and glaucoma operations being performed within 3 minutes in the surgical theatre with 4-5 patients within one Operating Theatre. Unfortunately, in Bihar, most cases of blindness are preventable, and cataracts are still extremely common. As a result of their accessibility to rural and isolated areas, the Ophthalmologist employed by the Bhansali Trustee Organisation is essential to the provision of safe and affordable ophthalmic care. I had the opportunity to help with preoperative eye exams, local anaesthetic injection assistance intra-operatively and bandage wrapping post-operatively. Here I witnessed Ophthalmologists overcoming challenges and barriers to offer healthcare to those in need, and was able to fully comprehend the nature of health inequity in large populations.

Conclusion

I experienced tremendous growth, both personally and clinically as a result of this elective in India. I was able to expand my learning through first-hand experiences dealing with some of the region’s most complex public health challenges. The devotion of every single doctor, nurse and member of the hospital staff was extremely inspiring! After graduation, I hope to apply this knowledge to the Australian settling when consulting patients from different ethnicities or from Indigenous descent. I also look forward to utilising these skills to manage various medical presentations with limited resources in rural communities of Australia. This experience has allowed me to work better as part of a team, be more future focused and mould these life-long lessons into my ongoing practice within Australia.

I cannot thank BOQ Specialist enough for providing me with the support to venture on this life-changing and surreal experience. This will without a doubt have a significant impact on my future and my decision to pursue a career in international medicine.

Developed exclusively for medical and dental students, each year the BOQ Specialist FutureFocus grants provide students with the opportunity to undertake an elective so that their commitment to helping others can be realised. Applications for our FutureFocus Grant open in May and close in August. 

You can also access funds to help undertake an overseas placement, with our Student Banking Package.