Tuesday, March 15, 2011

Early Adventures in Assam

We’re in Guwahati! We’re amazed at how widespread Rishshaw Bank rickshaws are around here. As soon as we drove out of the airport in our Tata Sumo, we saw some parked on the side. They are easily distinguished by a large triangle towards the front. We don’t know the purpose of the triangle although we hypothesize it’s convenient for the drivers to rest their feet up there.

Rickshaw Bank rickshaw.

Getting stuck in traffic isn't always boring. There are nearly always cows and dogs around us. Sometimes, we're joined by an occasional elephant, or two.

The Guwahati Medical College (GMC)—primarily a hospital—was an interesting experience. Imagine the two most crowded markets you have ever seen. Now squeeze them together in half the space: that’s what the emptiest wards in the GMC look like. Being a government hospital, the doctors are not allowed to turn a single patient away even if they are filled beyond capacity. They often admit more pregnant mothers than they have beds, and sometimes have to ask some to sleep on the floor with their new born baby. The wards are not always sanitary because it is impossible for a small number of attendants or nurses to stop over 100 people in a small room from spitting tobacco on the walls. Not all wards are overflowing though: the busyness and hygiene varies from section to section and divisions like cardiology are less crowded and often even have empty beds.

[ GMC picture to come]

Our potential partners are amazing! Yesterday, the GMC interns (GMC graduates who are interning at the hospital for a year) briefly showed us around the hospital and discussed healthcare with us. We also talked to senior doctors at the GMC and the Azara Primary Health Care (PHC). It is interesting to note that generally, while the supervisors and senior doctors seem to sugarcoat (and censor) information they give us, the interns are much more honest and speak frankly. We visited Mirza, a village with a Center of Rural Development (CRD) office. Here, we interviewed rickshaw pullers and neighboring families—essentially a group representative of rural low-income people. We found a wide range of responses from this confined group itself about their attitudes towards healthcare and uses of medical options. We offered each family a free general checkup (courtesy of the GMC intern doctors) that they were pleased to benefit from. We were surprised to learn that the majority of these families would even be willing to pay a small nominal fee for a regular checkup, even though they currently never visit the doctor until they have serious symptoms. We are unsure whether this is representative of the general low income population and we will test this finding again this week.

Dr. Anirban Chattarjee checking a rickshaw puller's blood pressure.

Mirza village boys hanging around their house. Everyone liked pictures taken.

We are struggling to be efficient and productive here. So much time is wasted in small talk, or navigating through traffic that we can’t help but feel frustrated with only minor chunks of progress each day. However, we had our most productive meeting EVER today. After our user interviews, with the GMC interns, we debriefed, discussed “surprise findings,” developed personas, identified problems and areas of opportunity, and brainstormed solutions all under 1 hour 20 minutes! We even color coded our post-its during this time.


Yay, Post-Its! :)

Today, we ate at a Dhaba, a roadside informal restaurant. We have discovered a convenient secret about Varun. Feed him anything paneer (especially paneer tikka) and he will be smiling all day. Tiama was followed by a whole army of children. They smiled and ran behind her rickshaw. A little girl, poking her head out of her classroom, made the “ok” sign (which translates to super here) and said, “Didi, aap bahut sundar lag rahe ho,” (Sister, you look very pretty). A man at the CRD even asked Tiama for her picture, and all the other people were crowding around his cellphone to see her beautiful face later! Jake was sick in his room, otherwise I’m sure he would have stolen all the attention. The Guwahati locals are having a hard time understanding Sam's (or Shyam, as they mistakenly say) identity—little kids sing him Bollywood songs when they think he is Chinese or Assamese, but quickly switch over to staring and smiling when they realize he’s American. Even though Sam was mistaken for Assamese, the one time he tried to speak in Assamese, it was mistaken for Arabic.


Jake, feeling a little sick.

Tiama's fan following.

Now, I’m signing off to play with my awesome new red remote control car that Mihir bought me for my birthday!

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