Pediatrics

Tuesday and Wednesday Courtney and I were assigned to the pediatrics department. We went to the outpatient department in the morning and waited for the doctor to come. After waiting a bit one of the residents asked us if we had been to the in-patient ward and when we said no he took us there. We then met 2 of the doctors and then walked around with 1 of the doctor and some of the residents on rounds. The doctor did a great job of explaining what diseases the patients had.

The first part we were in was the ICU and the patients had diseases that really aren’t seen in the US, because we have better access to healthcare and also get things treated earlier. The first patient had rheumatic heart disease, which happens typically when a strep throat infection isn’t treated and develops into rheumatic fever and can lead to rheumatic heart disease.  Then we saw a patient with Guillian-Barre syndrome, which I have only heard of before because it was a complication of campylobacter, so there was a question about it on the form that I used when I interviewed patients at public health. Anyway it is a nerve disorder that can cause paralysis and the doctor described it as similar to polio. The other patient had a congenital heart defect and had a hole between the two ventricles. Then there were quite a few patients with dengue fever, which is transmitted via mosquitoes. Most of the children in this area seemed to have their symptoms improving and the doctor seemed pretty positive about their survival.

Next we went to the NICU and saw lots of little babies. Most of the babies had birth asphyxia so they didn’t get enough oxygen to the brain during birth. There were also babies that were premature and had other things that I can’t really remember. This area of the pediatric ward was a little more depressing because some of the babies didn’t seem to be doing very well.

We also saw the area where the babies were after they left the NICU and were still gaining weight and stabilizing before they are allowed to be discharged. They were all their with their moms.

They then took us to the maternity ward and we were able to see where all of the healthy babies are. They keep all babies and moms in the hospital for at least 3 days after birth to make sure everything is ok. If the mom had a c-section then they make them stay for at least 7 days. We also went into the labor and delivery room. This is also much different than in the US in the fact that there is a room of beds and all the moms are in active labor. Once they are ready to deliver the baby then they are moved to the delivery room. We walked into the delivery room right after a baby had just been delivered. Unfortunately the baby didn’t make it and the doctors said they thought it was a stillborn and had died a few days ago so that was really sad.

Back at the outpatient pediatric department we observed the residents talking with patients. There were so many cute kids and so that made the day go much faster and was really fun to smile and wave at all of the children. One of the residents showed us how they test small babies reflexes so that was really interesting.

After lunch we met up with one of the doctors and she talked with us about vaccinations. She told us about the diseases that they vaccinate children for as well as the schedule of vaccination. Most of this was review as I can give immunizations in the US and so took a class on this. Then we sat in on a case presentation about a baby who was born to an HIV + mother and was loosing weight and started having a fever and cough and was eventually diagnosed with protein energy malnutrition. They discussed how they did the initial history as well as physical exam. They also discussed how they would treat the baby as well as a variety of other things.

Wednesday after slight communication confusion we met up with the doctor again and she talked to us more about vaccinations. Then she went through what drugs they typically use in peds in India as well as some things about nutrition. We also discussed pediatrics in India and what things they need to tell the mothers after they give birth so they can take care of their babies well. She was a very sweet woman and did a great job of teaching us things about the Indian healthcare system. We found out that infant mortality is still pretty high, but she said that is has been reduced significantly since she starting practicing 20 years ago. We also exchanged email addresses and so I hope to keep in contact with her.

When we went back in the afternoon we thought we would be meeting up with her again and then attending a seminar or something. Instead we spoke with another doctor for a little while about what we had learned in peds and compared the immunization schedule between the US and India as well as the use of antibiotics. Then we sat in the outpatient room for the rest of the afternoon. No one really talked to us, but we ended up making the most of our time by discussing random things about life and our futures so it ended up being a productive afternoon.

Immunization Schedule