My first year of medical school ended on a Friday, and by Saturday I was on a plane flying over 7,000 miles across the world. After a year of feeling mentally drained from studying and the constant flood of e-mails and appointment reminders that comes with medical school, I was entering a month of virtually no electricity, running water or connection to the outside world. I was on my way to meet meet up with my cohort of around 35 medical students (including a nursing student and occupational therapy student) and six attending physicians in Chandigarh, India, for a Spiti Valley, Himalayan Health Exchange (HHE) expedition. This trip would help me reconnect with why I chose medicine, as well as underscore the importance of serving the underserved.
Going to India was not my first exposure to global health – I had previously taken two trips to Port-au-Prince, Haiti, in 2012 and 2013 – but the two experiences were very different. The Spiti Valley in the Western Indian Himalayas is a majestic landscape, with towering 21,000-foot peaks intersected by many cliff-side roads. The scope of the natural world there made me feel miniscule and mortal but also more alive than ever. Haiti also has natural beauty of its own, but carries some palpable scars from both Mother Nature and years of human destruction. Along with their landscapes, the two places have very different patient populations. With 140,000 people per square mile in Port-au-Prince, there is an obvious but still shocking shortage of all necessities. I classify the patient population that I worked with in Haiti as acute and “sick.” Every morning by 5 a.m. there were hundreds of sick patients camped outside of the clinic’s gate, with toxic looking infants begging to be seen. One morning I was sent out into the street with a thermometer and instructions to pick the sickest looking patients. The memory of being engulfed by cries and moans, and grabbed at by those desperate for help, still sends humbling chills down my spine. No amount of medication, education or compassion could provide much more than temporary relief to the 200 or so patients we saw per day in clinic in Haiti, but I know that the care we were able to provide was better than nothing.
Unlike Port-au-Prince, there is approximately one person per square mile in the Spiti Valley, contributing both to the vastness of the landscape but also to the limited access to resources like healthcare and food. Since snow on the high elevation Rohtang and Kunzum Passes make the Spiti Valley inaccessible from fall until June, individuals in the villages we visited depended on their once yearly check up from the HHE medical camps. We weren’t there to save any lives; we offered preventative health care while addressing any ongoing or acute problems that needed treatment beyond what was offered by a local physician or ayurvedic medicine. After all, the iconic phrase of the Spiti Valley – one that the population embraces – is “Come to Learn, Go to Serve.” During our time there the patients, teachers, local doctors, and even head lamas were eager to learn how to live healthier lifestyles. Although I provided a lot of important hands-on care, such as diagnosing and treating parasitic worms in a malnourished child, the most rewarding part of the month was meeting with the lama of the town where malnourished children lived, along with the children themselves, to talk about supplementing the school’s lunches with vitamin rich lentils. We gave out sunglasses and taught patients that protecting their eyes from the sun when they worked in the fields was important in preventing pterygium and eventual blindness. We were welcomed into nunneries, monasteries, schools and hospitals as friends, to share information that would improve health and well-being.
My trips to Haiti planted a seed – a need to keep traveling, to experience different cultures, and to meet beautiful people and understand how health care manifests in different places. In Haiti I fell in love with people and medicine, and after navigating through the first year of medical school I found myself in need of an awakening, one that the Spiti Valley helped to provide. From Haiti and Spiti I’ve learned the importance of accessing those who are off the grid or forgotten due to lack of government resources, natural disaster or harsh landscapes. These experiences are in no way about imposing Western medicine and treating all those that need help; rather they are about supporting the local health care system, and connecting isolated individuals with the education they need to stay healthy.