Week Eleven from the Field: General Hospital Kochi

This last week was amazing. I was actually disappointed that I wasn’t able to get this post up sooner but that’s the way things go.

I have been so inundated with new opportunities that I’ve found it hard to focus on anything other than research. Now that I am done with my interviews and the collection of some 300 surveys has gone pretty seamlessly I’ve found it easy to catch up on some of the more extraneous parts of this experience. This post however is being focused on an amazing experience that I had last week visiting a Government Hospital in the neighboring state of Kerala.

Where we live in Tamil Nadu is in close proximity to the neighboring state of Kerala by only about a 30 min bus ride to get to the boarder. Last Thursday I got together with Emma to take a short trip over to the capital of Kerala, Kochi. We went to take advantage of an offer that I got to visit one of the Government Hospital. I received this offer from a young and amiable doctor that I met at Ortho One Hospital here in Coimbatore. His name is Dr Cherian and he is an orthopedic surgeon at the hospital. He offered to give Emma and me a private tour when I told him about our research projects. Emma came along to get a separate tour of the maternity ward and the gynecology department. It was an amazing trip.

In one day I got to see so intimately the workings and structure of one of the hardest to enter facilities in India. The fact is that there is a lot to be done. I realized after my visit that a General Hospital is a scary and hard place to go into and not come out a different person. 

I have visited once the main medical college here in Coimbatore and the comparison even between the two was dismal. The general hospital in Kochi is supposed to be the best in India. Thus as far as General Hospital standards go it was excellent but in all reality they know and the government knows that there has to be huge strides made in medical care if they are to provide a place of safe reliable medical care for their citizens.

I was also able to tour the Operation Theatre. In a matter of an hour and a half I saw 5 surgeries. The doctor then had one of the administrators of the hospital lead me around for the rest of the day. After the surgeries we watched in the morning, Emma was taken straight to maternity ward and spent the rest of the day with the gynecologist. I was able to see everything from, the optometrist’s operation theatre to the nuclear medicine department where the best attempts of oncology procedures are taken out. It was quite the afternoon and I really began to see and understand the struggles that each of the department was facing with limited and under qualified staff. I was also able to observe the ever constant need for more and more resources from the Government that weren’t being allocated correctly. I found it insightful to take some time and talk with the patients about their experience in the hospital. Most of the reports were pretty depressing as they explained that they came as a last resort. However for all of the heartbreaks, the silver lining was that the general hospital in Kochi still outperforms many private hospitals all over India. I am hoping to use the interviews with Dr Cherian and the literature that they gave me for my lit review for my final paper. It has also been a huge help to see the workings of all these systems to make a more accurate evaluation of the status of healthcare currently in India.

This will be my second last blog due to the ending of our projects. We leave next week, which will mark our 13th week in the field. Look out for one more post before I return home.

Week Nine From the Field: Mid Semester Retreat - Research Update

Blog # 5

This weekend was great. We got to go see some of the best sites that Southern India has to offer. All five of us went together and we went to Kanyakumari first. We took a sleeper train down there Friday morning, stayed two nights and got to see some really great stuff. I know that the office wants our Mid Semester retreats to be an escape from our projects but since I am interested in alternative forms of medicine I was constantly on the look out for healers and different places where people could receive medical care in the city. Kanyakumari was beautiful in one aspect but as far as Indian cities go, it was also lacking a lot. The city is more of a tourist destination than anything and the infrastructure and systems are sorely outdated. The general hospital is small and outdated. In order to receive any substantial medical care you would need to be transported all the way to Trivandrum in the next state over almost 90 km away to get decent attention.

We also were able to stay in a really nice hotel on the top floor for the equivalent of around 3 us dollars per person. The views were immaculate and the sunsets and sunrises, which are what Kanyakumari is known for, were breathtaking. We left the next night for Rameswaram the next night on another sleeper train that went through the night saving us more money on hotels.

When we arrived at 5 am in Rameswaram the city was already buzzing. There were people everywhere and we went pretty much unnoticed. We ended up next to the section of the Rameswaram bay that is considered holy water and were very entertained by the religious washing practices of the people there. It was interesting to see. The men strip down into either a Lungi or their underwear and women go in wearing a full saree. They go under several times using buckets to dump the holy water on their heads with their hands and or plastic containers that the poor sell on your way to the water.

After that ceremony is done you walk sopping wet to the temple in the middle of the city, which is beautiful and you go through a 22 step process of ceremonial washings to cleanse you of any bad or evil spirits. This belief is derived from a long held cultural belief in the significant events that took place in Hindu and Indian history on the island of Rameswaram.

We spent the rest of the first day on the beach at Dhanushkodi, which is the point of the island closest to Sri Lanka. I was also to contact some medical providers and I had the rickshaw driver tell me stories about medicine during all of the driving we did that day to get down to the beach. I was able to visit and look around some of the medical facilities in Rameswaram and it was an interesting contrast to the city hospitals that I always visit here.

We took another train from Rameswaram the night after we got there and went straight to Madurai. We all had tickets to leave Madurai the next morning but I had to come back early so I went ahead and booked a ticket that took me straight through to Coimbatore. It was pretty expensive because there were no more sleeper car spots so I paid 8 US dollars to get an AC sleeper car that was super nice and worth every penny of it. I made it home yesterday morning and went straight back to the hospital to continue my rounds.

The research is going well and I even made plans yesterday to take a trip to Kochi next weekend to tour the major General Hospital there with one of the head doctors who I ran into at Ortho One here. I will be doing that for two days next week and the gentleman has offered to put me up. I will find out more when he emails me back but he is expecting me next Thursday at the hospital.

Well I am still ling here in my hammock and I couldn’t be hungrier. The group all just got back and I am going to head in to the city to meet up with Steven and the girls for lunch after Steven gets done with shadowing doctors/dentist in the city. Things are going great and we are all nice and relaxed ready to blow this research out of the water in the last couple of weeks that we have here.

Week Seven From the Field: Medicine

My time here has been fascinating, I really have loved to getting to know more and more about the Indian healthcare systems here in India. I have really focused in the last two weeks on defining my parameters in what types of Indian medicine I am including in my research. This is particularly interesting when I consider what type of care I am looking at studying as a part of my research. 

I came across and article earlier this week by a doctor here in India that was a comprehensive outline at the status of the healthcare programs in India. It is fascinating and I have gleaned a lot of important information from it. I want to out line some of the interesting things that I have learned from reading this paper. I will also include several things that I have learned through my own research as well. I am going to share them here to follow.

One of the biggest things that I have come to understand is that in India there are several healthcare types from different cultures that have left significant impressions on the healthcare status here. The Indian Government recognizes several of these alternative types of healthcare as falling under the acronym AYUSH, Ayurveda, Yoga, Unani, Siddha and Homeopathy.

I knew when I got here that I would be focusing on Ayurveda and Homeopathy but due to the nature of my research it has become very important that I utilize the other specialties. I will use the other specialties in my definition of the healthcare systems here in India. I guess I’m lucky that I went ahead and included the other slot on my survey questions. It is true that Ayurvedic is the one main other type of medicine but I have learned so much about the others as well that it would not be appropriate to leave them out at this point.

In other ways this trip is also really starting to shape up as well. I love the culture and people here so much. I constantly am taken aback as to the genuine and sincere attitudes of the people that I have met here in Tamil Nadu. I catch myself thinking just how lucky I was to be here and have this wonderful experience. I have learned so much and the status of my research reflects that.

Things are going well and I love the place more and more the longer I am here. It has an interesting hold on you like that and I am completely ok with it.

Week Five From the Field: Progress

Blog #3

Besides of spending a lot of time shadowing doctors and getting to know the medical systems a little bit better I got my survey completely translated into Tamil and back translated, so now I am ready to go. It was interesting that in the prep course we focused a lot on how hard it was going to be to get the survey translated but in all reality it was actually super easy. The members of the church here have proven to be an invaluable resource. They know people and service for everything that you want to do. I also have several of them helping me gain entry to their social groups and places of education and employment so that I can administer my survey in other places than just the hospitals in which I already have permission and contacts to administer surveys.

My initial thought upon arriving here in India was that it would be somewhat difficult to learn all the systems of how things work and how the culture really works. I have learned that through working with people on the ground here and with our friends who came with us we can accelerate the process of getting to know the culture and how things work in the city.

I feel very blessed to have come with the group that I did. I love being able to get their insight and work with the group to make sure that we are all doing well and staying on top of things in the culture. I couldn’t have asked for a better group here in India. We all have become fast friends.

Really all is going well. The people are great. The food is awesome. I haven’t been sick really since the first week, which is nice. Things are going smoothly and although I feel that there is still an infinite amount of information that I need to know about the culture and the people I am really excited to get moving.

One last thing, in order to show an appropriate amount of reciprocity for the service that the branch and the members have been we are working with the priesthood leaders in the branch to set up a service project for the Chavadi Branch. The branch president is so great and he is so willing to help us with anything that we need. It only seems right to help them in a similar manner to how we have been helped out here. It has to be something thought out and long term so we are working through some ideas and ill follow up in later blogs.

Week Three From the Field: KG Hospital

Blog #2

Well its coming up on the start of our fourth week in India and I could not be more impressed and in love with this place. I had an experience just this past Tuesday that I want to blog about and outline some of the wonderful experiences that I have been having here in India. In order to prep my story I want to first outline some of the things that have kept me so focused and happy as I work to complete my research. Its all about the people. The countless numbers of people that I get to associate with on a daily basis have really shaped my experiences here. 

Matthew and Giva are so kind and understanding to all of our needs and we have fun teaching their kids English. It’s a wonderful relationship where Giva even commented the other day that in her opinion Edwin (her oldest son) trust our group more than any other group that has ever lived in the village. She said the way that him and Pria both have gravitated towards us makes her trusts us and she really wants us to focus on helping him with his English. What an incredible woman who loves her family so much. We also spend time learning from all the family members, whether its how to open a coconut from Isaac (the uncle) or if its talking with the neighbor who is also a member of the church about her soon to be new baby. Talking with her and the girls about here hopes and fears for the baby are possibly the most heartwarming conversations that I’ve had. Then there are the countless people that I have talked to in the streets of Coimbatore. I have adopted the policy that there is no need for maps or other directories of restaurants and places of interest because the people in the city are so kind and considerate. Most of the time they can’t understand a word of what it is that we are saying but they always go out of their way to help in any way possible. For example a man that Josh was having a conversation with the other day offered him a ride home. Josh declined at first but the man insisted. The man drove Josh all the way to the village and dropped him off our front door. Josh had money to pay him but he refused to take it. He just rode off into the night.

I want to now share my story of how this kindness, genuine respect and mutual friendship helped me have the best hospital tour of my life this past Tuesday. Here is the excerpt from my Journal regarding what happened to me as I went to request the opportunity at K.G. Hospital to shadow and observe their doctors and staff.

“After I had my meeting with Ruben I went to another meeting that I had with the Chairman of the K.G. Hospital here in Coimbatore. It was so incredible. I went and I was directed to go and speak directly with the COO of the Hospital and he told me that the Chairman wouldn’t be available for another hour. The chairman was teaching a class to some newly enrolled medical students in the auditorium in the hospital. The COO offered for me to go down and sit out side of the auditorium and to wait for the chairman, I consented and willfully went down to wait on the chairman. Once I got there I was almost immediately rushed in to talk with him up on stage. After he asked who I was and why I came to the hospital I sat down in a chair along the wall. I figured he would continue his lecture but instead he pulled another chair off from the side of the stage and had me sit down with him in front of the crowd of budding medical professionals. Not knowing a thing about me and not having any idea from where I came or why I even wanted to see him, he asked me a series of questions and presented me honorably to his medical students. It was quite possibly one of the most unique and impressive things that anyone has ever done for me in such an impromptu setting.

After my brief introduction of 5 or 10 minuets he took the woman that was a hospital employee and instructed her to give me a complete tour of the hospital and all of the different facilities and laboratories in the entire facility. It was an extremely exhaustive tour. The doctor in the first lab took me around and showed me all of the laboratory equipment and described in detail the science and job of each piece of equipment.

We then went through several operation theatres and various other labs and rooms, I had to scrub up once to enter the clean or room of the cardiothoracic surgery, the doctor who was showing me his operating room let me wear his personal scrubs (an extra pair obviously) and gave me the mask and head covering. It was incredible how much they let me see and participate in.

After my tour I was directed back to the auditorium where I was first introduced to the Chairman. I was once again brought up on stage and given a microphone this time. I then was put on the spot to describe who I was and what I was studying and where. He was very full of adoration and showed me a lot of respect and he spoke very highly of the United States and gave me the full go ahead to and shadow or observe any doctor in the Hospital. All of this is still in front of the class of medical students. He then had me tell everyone in the room how I was financing my education and why I wanted to practice medicine. He was so interesting and nice. He commented on how impressive it was that I took out loans to pay for school and how the students should be more like the American and be creatively engaged in making them selves and extraordinary person that in my opinion was a bit over the top but he made some great points. At the end of the little show he had me describe my impressions and feelings about KG Hospital. I told him that I was blown away with the authenticity and sincere goodness of everyone that I met. The fact that I had the COO the Chairman of the hospital and countless doctors and nurses showing me the entire facility was unimaginable in the United States. I was incredibly grateful for all of their kindness. I then continued to dramatically and emphatically describe how great their hospital was. The Chairman was moved. The amount of rapport built in that moment was incredible. I would have done anything for that hospital and the Chairman and I could tell that he felt the same about me. I was just grateful for the opportunity to meet him and in hearing his description of the medical field was nothing less than impressive.

After the class was dismissed I went with the Chairman to the office and he had me talk to his personal secretary to fill out all the paperwork I would need to start observing doctors in the hospital(this meant that I took blank paper and wrote my schedule and contact information while they photocopied my passport and ID. Then the most interesting thing happened. He had a visitor who came and with me still in his office, the visitor offered financing and a partnership with his larger hospital in Delhi to expand and create a more profitable enterprise for KG Hospital. The Chairman respectfully declined his offer on the grounds that KG Hospitals only goal is to help as many people as possible and he would not partner with anyone who’s business was business. He said if we cant offer our services for free under this agreement to those poor and underprivileged citizens of our community then I wont sign. The man hesitated and made some comment about profit margins. The Chairman then told him very bluntly that he didn’t need any profit margin as long as he could stay in business and that his business was helping people. He restated that he would not jeopardize that aspect of his business for unnecessary new facilities and more profit. The man was with out words and he was respectfully ushered out of the room! I was again speechless. Here was a man that was just offered part in a merger that would not only increase his next worth who knows how much but would also allow him to probably retire instantly (the chairman was in his early 60’s I’m guessing) and he turned him down on the premise that he wanted to give his money and services away not to hoard more. He then explained that they do over 2500 complex surgeries and somewhere in the range of 15,000 and 20,000 routine operations and checkups annually.

After this conversation he brought in his board of directors and several other top employees and said, “Tell them what you told the medical students earlier”. I chuckled inside at the offer and sat and explained my adoration and respect for the entire program and people that I had met. They all showered me with questions and about 15 minutes later they returned to their jobs. I was flabbergasted at this point wanting nothing more than to learn as much about this entity as I could.

I filled out a schedule for the next five weeks to work in the hospital and to see what the operations and administration of the hospital entails. I got it all approved to see several different aspects of the hospital and he wants me to come present again to another class Friday morning at 8. This should be great relationship with KG Hospital.”

These people never cease to impress me and I feel like I have so much to learn as I keep working on my research here. I just hope that in some way I can reciprocate the wonderful things they have shared with me in some unique and personalized way to each of them.

Week One From the Field: May 5 2012

Friday May 5 2012

I left the states 9 days ago. The progression through many of the steps mentioned in the prep course has been rapid and thorough. I can’t believe that my entire trip is 1/10 of the way done but it has been so memorable thus far.  I want in this post discuss my progression through the cycle of culture shock. In order to describe more uniformly my descent and partial recovery from culture shock I will use terminology and quotations from Spradely’s Coping With Culture Shock.

It was almost 6 hours after arriving into Chennai India on April 28 2012 that the first stages of culture shock set in. Really it was probably a combination of several factors that led to my initial frustrations. Up until this point in my journey I had slept a total of maybe 8 or 9 hours sporadically over the last 4 days with some of the worst and most uncomfortable sleep on the plane from LA to Hong Kong. Then I had a man spill his entire cup of coke on my leg and into my shoe on the same flight. Hong Kong was in the middle of a monsoon type down pour that soak all of our bags and clothes when they were being transferred between planes. On top of all of that we had a delayed flight leaving Hong Kong that set us back 5 hours. Thus all of these factors along with the dismal living conditions, smells and unrelenting heat that welcomed us in Chennai I was a bit overwhelmed rapidly upon arrival. This was when I left the honeymoon stage and moved straight into the bottom of the Irritation and Hostility Stage. This lasted pretty intensely for the rest of the first night. Saturday was a hard day for me. I was in a lull for almost 4 hours and it was really hard for me to communicate and even function at sometimes. For most of the time anything I did was with very little enthusiasm or emotion.

I knew from the reading that this was just a temporary stage of anxiety and frustration but I wanted out of it as soon as possible. Thus I decided to do the one thing that was for sure to work. Once I returned to our hotel that night I got straight on my knees in the bathroom and offered one of the most heartfelt prayers of my life. I poured out my heart in hopes that it would alleviate some of the heartache and discomfort that I was going through. It worked! I felt the one constant and contiguous feeling that from my childhood has comforted me in my moments of utter despair and pain. The relationship that I cultivated with the spirit on my mission and through out my teenage years was the only thing that brought me through that first day in the field. I learned that even in foreign and alien lands we must rely on the companionship of the spirit to really help us overcome life’s more difficult situations. It is the only thing that I had to rely on in such a foreign environement.

Wednesday, April 11 2012

With such a hectic Wednesday I just realized that this blog never got posted. But here is what was saved in my drafts.
It's in, my last and final proposal draft to Margaret. It along with all of the scholarships forms and now this last blog post. Its amazing how even with the prepcourse coming to a close how much I had taken for granted the wonder addition that it was to my under standing to what was up coming in the field. I want to outline some of the last thoughts that I have before I blog in the field concerning somethings that need to be resolved before I go. The first thing that I have been stressing out about is the fact that my IRB is not yet turned into the ORCA office. After the miscommunication as to what was expected from some people in the fieldstudy's department I wasnt able to submit my completed IRB proposal on time. It was rather a stressful time but now that the next deadline is coming up and I have gone through so much to correct and refine my current proposal I hope that I will still have a proposal that doesnt go full board.
I recognize the importance of the IRB and I hope that by tomorrow morning I can get submitted all of the documents that they need. One thing that I realized just the other day is the need that ill have to update my consent form on the IRB. It wasnt writen in a language that is probably that understandable in the first place due to the formatting that is on the ORCA website but it is helpful to note that its really just a form that I can re fill out with the few details that have changed in my proposal.
Also the situation of my visa and its approval is getting kinda grim. I know that I have to get the forms in soon and the consulate is being so slow to respond with my forms. I really hope that everything makes it on time.
I can't wait for the field. I know that the things that I experience and learn out there will be of serious help and use to me as I seek to define what it is that I am studying. As I now go to prepare for the final it will be my last real chance to incorporate what I have learned and prepare to use those techniques in the field.

Monday April 9 2012

Friday I was able to present my project before several of my peers and a facilitator. This was able for me to be able to defend my project before an audience of my peers. I realize while doing the presentation that the reason why I was up there was not for them to critique or pick holes in what I was planning on doing but it was for me to do that exact thing. I no what it is that I want to do while in India but everything that I do for the prep course can actually get me much closer to realizing the difference between what I say I want to do and what I am actually planning on doing.

Last night I did a lot of research for an idea that Rem gave me during the presentation on Friday. As I was presenting he informed me that in India the participants/general population that I will be working with are not going to recognize my terminology but that they will recognize the concept. Specifically he was referring to the idea of western and traditional healthcare. I now know that when people refer to traditional medicine they say homeopathy. When they want to talk of wester medicine that say allopathy.

I did some quick research last night on homeopathy medicine and it was amazing how quickly I got real time current and up to date results back from on line. Here are some of the things that I found. "Homeopathy is a form of alternative medicine. Practitioners treat patients using highly diluted preparations believed to cause symptoms in healthy individuals similar to the undesired symptoms of the person treated." That is from Wikipedia page on homeopathic medicine. Here is another definition from another source, "Homeopathy, or homeopathic medicine, is a medical philosophy and practice based on the idea that the body has the ability to heal itself. Homeopathy was founded in the late 1700s in Germany and has been widely practiced throughout Europe. Homeopathic medicine views symptoms of illness as normal responses of the body as it attempts to regain health.


Homeopathy is based on the idea that "like cures like." That is, if a substance causes a symptom in a healthy person, giving the person a very small amount of the same substance may cure the illness. In theory, a homeopathic dose enhances the body's normal healing and self-regulatory processes."


Thus we see that it is not the exact same thing as ayurvedic medicine but it is similar enough that it would appear as if maybe the practices or even just the names are used interchangeably. I think there will be a lot of room to study both of them when I get on the ground. This will be the goal of my first few weeks or so on the ground in India. I hope to be able tor early define clearly what type of medicine is being practiced.

Friday April 6 2012

I just had a great strategy session. I talked with the Margaret and I realized that the survey that I am proposing to do in concept is great but the way that it is to be carried out needs to be very different. There is a good chance that with the survey questions(ill attach at the end of the post) that I’m proposing to conduct will be much better suited if it is given as a structured interview and not as a rigid survey. Also including something in my methods and procedures having to do with a period at the beginning of my stay, spending some time getting to know what is currently offered in the village of Chavadi and the city of Coimbatore. 

I really like this approach a lot because there is a lot of things about the medical system in India that I can't learn in medical journals or on wikipedia. I want to spend a couple of weeks documenting what is being offered and what people consider to be the appropriate forms of medicine then conduct my interviews and surveys with that in mind. There is a lot that can sway or disrupt my data flow and finding out half way through that people don’t even consider pharmaceuticals or some other predominate form of western medical care as such. That is my worry and the best way to prepare for that is to observe and gather information on what is performed first then go and set my own data points and coding for what kind of care people receive. That is way to much for what I want to do and I feel like this is a great step in making my data much more valuable.

I am for the first time in a while really getting excited about going to India. I never have been not excited but I can see clearly now what it is that I will be doing and I can see what will stand in my way. Knowing both are helping me really see what it is that I should do to get ready.

Wednesday April 4 2012

I have spent the last several hours refining my project proposal and here is what I have come up with. I had no idea what I was doing when I initially started this project. It is a great feeling to really feel like I am accomplishing something. I realize that there is a lot yet to be done and I know that the proposal that I currently have is not anywhere close to what I need to have but it is what I would consider a good start.

There are several things that I feel that I need to nail down and I will list them now.

First I need to be clearer in my declaration as to what I want to do with my statement of intent and the title of the project. I still really feel like there is a better way to put what I am trying to say in my paper. I have also attempted to make my statement of intent as personal as possible but I think that it lacks a certain academic edge that I also want to convey.

Second, My lit review and background is sorely under developed. I have a general idea as to what I want to do with this section but I feel that there is a lot of research that I have done in defining the two types of medical care that I will be analyzing and I feel like it isn’t pertinent enough to fit into my Lit Review or background. I hope to be able to explain in more detail what it is that I have learned about the topic of healthcare in india but I dont know how I can fit this into my project proposal.

Third I have a lot of loose ends and conflicting suggestions as to what I should do with other parts of my proposal. I hope to be able to straighten out these miscongruiencies and add some serious clarity as to my intentions in the proposal.

Monday April 2 2012

Its April already. March seemed to have flown by. In the rush to get several things done at the last minute in March I found my self striving to accomplish a lot in seemingly very little time. This all culminated this friday when I got the chance to catch up on a lot of my annotated sources and work on the over all direction of my paper. I really feel like the direction which I should go is an over all logical analysis of healthcare and health in general followed by a the definition of the two types of healthcare that I will be analyzing in order to be able to differentiate between the two when surveying the people.
Here is the general outline that I want my paper to follow.

Statement of Intent:
Personal reasons and specific scholarly reasons that I want to study this topic and live in India.

Lit Review:
Healthcare: Definition of Healthcare as a whole Health will be defined as well here
Two types of Healthcare in souther India and the current system for receiving healthcare in India.
Traditional:Ayurvedic
Western: US style medical atteniton
Current issues and problems with both
Combination of the two types of healthcare in India
Other forms of healthcare

Methodology and Procedures
Here I will describe in detail how I will distribute and conduct the survey that I have written up for the project above.
How I plan to locate my age group
Where will be established by locating different places where my potential age group exists
What I plan on doing when I find my age group

The rest of my proposal will come in a different blog post. This comprises parts A-C in order to give a good foundation for the research that I will conduct.

Friday March 30 2012

I am still stuck on how I am going to tweak my project to be focused on an aspect of neurological science. I sat down yesterday and talked with my primary mentor and we nailed down some of the details that he wants to see in my research while I am abroad. The ideas that he had proposed were great and they really helped me see how possible what he wants me to do. So spent some time and I’ve come up with a plan. I want to keep the project the same. I want to add just one line or part to the main hypothesis or idea that specifies the addition of neuroscience aspect to the research. This will look something like this, "What are the perceptions among college age students in Tamil Nadu regarding healthcare options, Traditional and Western, when faced with a neurological disorder."

I think that neurological disorder might be a little ambiguous and I want to focus on how I can make that more clear when describing what it is that I want to do. I really want to survey people that have some sort preconceived notion of neurological disorders and see what treatment method they would prefer. I realize that it will be hard to have them see what it is that I want to know so being overly clear in explaining what I want to know will be crucial. There will be a tendency to see what I am proposing as a type of western approach and depending on how I pose the question that I am asking I might sway the answers because of my apparent western look.

So the things that I need to focus on in writing my proposal hypothesis or focus are:

1 The clearness of what I am looking for

2 The absence of any bias on my part when presenting the two options.

3 Finding correct translations for terms and ideas.

4 Focusing on all people between the ages of 18-25 and not just those that attend colleges.

There is a lot to come but I realize that I have a lot to change and get approved before I leave. Hopefully I can come up with an appropriate proposal soon.

Wednesday March 28 2012

In all reality the only thing that I have been able to do in order to really move my project along since the last time I wrote was an intense overhaul in my ideas surrounding what I am supposed to be doing in India. I have decided that I want to focus on something a little more soft science angle as far as science goes with the Neurological disorder that I am going to choose so that almost instantly puts me into the depression or anxiety corner as far as what I want to evaluate as a part of my study. Here are my reasonings why.
1. I feel that if I am able to study the effects of anything I want it to be something that affects a lot of people, and depending on how the terms depression and anxiety are defined in India culture I should potentially be able to find plenty of people that have an opinion concerning one of the two. In contrast, autism and schizophrenia are much more localized and smaller scale problems that affect few people. Thus my pool that I will be able to pull from will be much larger.
2. There is a possibility that me asking questions about specific neurological disorders might bring up some hard feelings or even might create a problematic level of discomfort for my subjects. This is a possibility due to the level of investment and emotion that people usually devote to loved ones and close acquaintances that suffer from more serious disorders. I hope to avoid this problem altogether.
3. Anxiety especially can be put in to phrases that are just as easy as a serious really defined disorder if done correctly. I worry that I might not be able to communicate my intentions in asking why I am asking if they have felt down or sad. But I think that I can think of a way to phrase anxiety for the purpose of the study I might be able to have it be very non invasive and people should respond normally to it.

I do have other reasons that I will expound on later but I need to focus on what I am going to do and just move on it with regards to the amount of energy that I am spending in defining the word. It might be a good idea to figure it out with contacts that I can make now in India or here for that matter to determine in what way people will respond to my surveys and questions in the field.

Monday Mar 26 2012

Like I said on Friday this last week has been quite the week of deadlines and interesting events that have led to the near completion of my IRB. I spent much of the week pursuing the task of finding a mentor and locating someone who has a similar interest as me in this project. I have decided to take yet another turn in the direction of my project. Upon talking with my professors in the Neuroscience Department I have decided to do a health study that coorelates with the neuroscience curriculum. We commonly study neurological disorders and problems that are common in society so instead of studying just the general percetions of Indias regrading healthcare. I wish to survey them based on thier disposition to go and seek medical treatment for existing medical condidtions.

This only makes sense because medicine is what I want to study. The program requires that I do a course contract and that I focus on something within my discipline. Thus the idea of combining two great project ideas cant be overlooked.

See Annotated source for March 23 to see data that refers to the number of poor among americans that report their own depression.

The biggest thing that I am walking away with after this weekend is the need to really focus my self on how I am going to communicate what I want to know to the people that I want to know it from. In other words I am really worried about how I can tie any neurological disorder into my project with out it seeming overly invasive or overly intrusive. I realize that neurological disorders in any culture can be kinda taboo and I hope that I can sensitive in addressing in any culture. How that will be effected in the culture in which I will be living I still am not sure and I really want to find out in order to be as effective as possible.

Much more thought and planning will have to go into my research as I think about the thin line of ethics and appropriateness that I will be forced to walk now.

Friday March 23 2012

The IRB was due this week and we spent most of the day going in and out making the necessary changes to the protocol. I also was informed by the neuroscience department that the research that I was to be doing in India need to be related to Neuroscience.
I have been doing a lot recently to make my proposal and draft much more meaningful. I feel that with the addition of the Neuroscience aspect of my project there will be a lot that has to go into it in order to not only get it through the IRB but also to have it ready and prepared for the substance that will be used in the field in order to justify its validity in collecting viable data.
In order to make it fit under the new parameters that the Neuroscience department has put into place I will have to go in and adjust my project as a whole. Instead of gaging he perceptions of the citizens of the area I will now be analyzing the pre-dispositions of the subjects in selecting Western or Traditional healthcare options when confronted with a mental disease. Luckily on my part mental disease isn't as grim and gloomy as the word makes it seem. I can focus on something from depression or anxiety all the way to something as serious as schizophrenia or autism. So I haven't exactly decided yet what topic I want to chose when it comes down to what specific disorder I will be analyzing. However in any of my preliminary research that I have done regarding the topics of Depression and Anxiety, I have found mixed reports as to the status of the disease in India and or other south asian countries. I know or I can at least anticipate that there will be some sort of language barrier or cultural barrier when it comes to what I see as depression and or anxiety and what the people see depression and or anxiety to be when I get to the field. It will be interesting to see what exactly it is that is appropriate regarding depression or anxiety and what I can talk about openly with people. I know that depression has been proliferated significantly by western traditions and practices and I hope that I can keep that bias out of my research as I go forth looking for the subjects opinion on the matter.
I have so much to figure out concerning the direction that this new part or shift in my proposal is going to go that I really feel like more knowledge of neurological disorders really might help me on. I figure its back to the drawing board to see what will happen after this major tweak.

Monday, March 12 2012

I worked on the IRB this weekend in preperation for class today. I spent most of my time updating the methods and statment of intent secitons.

Monday March 5 2012

IRB rough draft

Friday March 2 2012

I have spent some serious time in updating and adding some breadth to my rough draft of my IRB. I have been able to see some serious worth in analyzing to a Tee what it is that my peers and other students in the past have done. I feel that some of the instructions have not been very clearly declared and I have to look and look for examples from past students as to what I should do concerning the right way to fill out an IRB.

I have three major things that I need to do in order to make the IRB as concise and powerful as possible.

First, I need to have a clear background and significance when I submit my IRB. Ill be the first to admit that I didn't really understand what this section entailed until I sat down to write it the first time. 

Second, There needs to be a bit more policing of the terms that are used. The last thing that I want to happen is miscommunication of my intentions on the ground and this thing to not get approved.

Third, I recognize that the confidentiality and several other sections should be filled out to some great extent. I haven't been able to look at other people’s ideas for keeping records safe and how to handle the information that will be gathered. I need to spend some serious time on this section and move forward in declaring my intentions.

Wednesday Feb. 29 2012

Today we did preliminary flight planning with Venkat. I wrote the second section of the proposal today. I feel as if the work that Is being done on behalf of the trip is really going well. I havent realized jsut how far we had come until earlier today when I was thinking about how we had already talked about two of the 9 sections of the proposal and pretty much nothing else. We have spent some time discussing appropriate methods on how to enter the community in which we will be living and how to gain rapport with the people.
I wonder how difficult it will be for us to gain the rapport with the poeple. I found it very easy on my mission to really get to know people and to gain rapport in a community or with a ward was as simple as being completely genuine, while loving those whom I was serving. I think that with the differences in culture and the obvious language barrier that will come up it will be quite the trick to gain serious trust.

Monday, Feb 27 2012

Aside from today being my birthday I have found it to be shaping up to have been really productive as far as India preperation is going.

Friday Feb 24 2012

This week with all of the inquiry conferences our class was canceled for the first two days. It wasnt until today that we returned to our regular schedule. I feel as if there is a whole lot to be done with class that it might not be the best use of our time to take two days off. It is highly inconvinient as well that classes from Tuesday are canceled and Monday is on Tuesday. That takes even more time from my open Tuesdays and makes me get everything done by today that I usually take five days to do.
After class today I really noticed what it is going to take to get to India. I feel like in the last 9 weeks that we only scratched the surface as to what is required of us. I love the things that we have learned but as for the mechanics of the IRB and all the other documentation that we have to ahve in order its pretty crazy to assume that we would have it all ready in time, unless of course the prep course were our only class at BYU.

Tuesday Feb 21 2012

Today I wrote my literature review. I have been very involved with other things lately that finally when I partitioned off my time to dedicate just to the literature review section of my proposal. I really feel that I learned a ton of what I expect of my self in writing the review. I know now that there are alot of holes in my project. There is a lot that I need to substantiate. I feel like it was a really good opportunity to learn what else I need to do to be ready.

Friday Feb 17 2012

Venkat (out Tamil Language teacher) is on the job of finding us tickets for cheap to Chennia on the 28. Other than that I have been pretty swamped with classes for the last two days and really only have had time to exchange emails with Venkat about the expected arrival times in the field.

I want to capture some of my current thoughts surrounding some of the stigmas that I am trying to overcome before I get to India. I feel like there will be a lot of logistics while on the ground that Ill need to account for before I land in the field. I want to know more about the relations between the male and female populations while in India. How is it that I want to take a sample of all of the different people in the 17-25 yr old generation and I cant even talk to half of them. I think that maybe collaberating with one of the females that are going with us might be my only option. Maybe if one of them needs to do some sort of resarch with males, I might be able to reciprocate that help along with them.

Wednesday Feb 15 2012

Ok so we finally got our leave date. We will arrive in Chennai on the 28^th of April. That is two and half months away! There is so much to do between now and then, most notably, we need to have a literature review done and in a presentable form before this up coming Friday. The methods section of the proposal looks like it will be a huge portion of the work that we will be required as well.

The more of the paper that I write the more I understand why it is necessary. I feel like I understand more of what I’ve signed up to do as I defend my ideas on paper. It is absolutely necessary to move forward as quickly as possible with all things that need to be done in order to consolidate my thoughts as well as possible.

Monday Feb 13 2012

We really need to figure out what day we are leaving for India. We are potentially three months from getting to the field and we still don’t have a leave date. Its great to know that Dave will be there but there has been no progress made on what day we will actually arrive and what the situation will be on the ground. I am feeling the logistics crunch. How can we possibly prepare for all of this research and methods practice when out hands are tied as to where and when we are going to be conducting such research?

I hope that the rest of this progress doesn’t prove to be so difficult as we progress to the field. It would be nice just to have clarity and mutual understanding with all parties involved.

From a more proactive position, It might be wise if we were to assert our selves more and make decisions for ourselves…

Friday Feb 10 2012

Today is the second time that I have really looked into my literature review. I spent some serious time last night filing through notes and pages trying to decipher the meaning of all the different articles that I have come up with. I have come to recognize that the difference between what I want to do and what has already been done is a target age group. I struggle however with the direction in which I’m going to go when I’m on the ground. Steve and I have talked a lot about the methods that we need to use in order to reach the target audiences.

Some of our ideas are as follow;

-Spend significant time with the students at the various universities in Coimbatore.

A reason to stick around the different universities is to be around civilians that speak English. Hopefully we’ll be able to find enough students at the various universities to be able to gather some significant data as to the rising trends surrounding our topics of research. For example, I want to know what people’s perceptions are on the ground. What group is going to be more affected or pressured to utilize western medical care over the students that are studying the various academic disciplines lead so to more western practices of living.

-Utilize the position we have as university students from the US to pursued doctors and clinicians to let us interview them and when appropriate their patients;

I want to see what doctors think is appropriate in India as far as a patients medical options are considered. Do doctors allow their patients the option of choosing between traditional or western medicine? Or does the fact that the patient came to said doctor imply that they have already chosen their particular healthcare option.

Wednesday Feb 8 2012

These last two days have been so full of other activities that I havent had a significant amount of time to really think a lot about what I can be doing to prepare my self more for my Field Study. The one big thing that I have been doing is focusing on the language. I realize that there is a lot that I can be doing and I am trying to tie up all the loose ends of, Trave, Couse Plans and Money, I realize that my experience will be based of how well I was prepared in all aspects of my preparation.
My goals currently outside of logistics are as follows:
-Develop further in the language. Be able to speak on the streets and as basic questions.
-Learn the basics of the customs regarding medical care and health in India.
-Read the Ramayana

Monday Feb 6 2012

Just realized that my post on monday never went up, here it is:

This weekend we had the assignment to do the Participatory Observation. At first I was skeptical as to the reasons behind why we would do a observation study. I felt that it was a bit arbitrary and wouldn't help me qualitate or understand anything about the world around me. I found that nothing less that the contrary was what I actually pulled from the methods practice.
I really for the first time in my life began to realize how intricate and involved we are as human beings in the social situation in which we are placed. Possibly the most eye opening aspect was the introspective viewpoint that I gained as I realized just how well that I had adapted to my own social circumstances. I know all the rules. I am completely comfortable in my own element and I really understand how effective communication relies so much more than on verbal communication alone. The way that I sit, move and communicate through my posture and gestures sends messages to everyone else in my social environment before I say anything.

I did the project on a different floor of the Library that is notorious for being the social floor. I decided that it would take me out of my element enough to be able to really observe others in their, environments but that it was still one that I would fit well enough into, allowing me to do an introspective look at my self simultaneously.

The biggest advantage that I saw from doing this assignment was the fact that in India I will have little to no understanding as to the real cultural mores and the stigmas that govern the ways that they interact with one another. It seems like a daunting task now to undertake such a large scale cultural assimilation with such little time. However now I feel as if I am prepared to work towards the goal of mutual understanding with the people of Tamil Nadu.

Friday Feb 3 2012

I started reading the Ramayana Wednesday night. I have studied several similar texts in the past and I really enjoy the ancient texts and their significance. I feel that in just reading the prologue and the introduction combined with the first 40 some odd pages really helped me understand a bit more about the culture that I am going to be immersed in.

In my first college experience I did the concurrent enrollment program and I was able to take a myths in human culture course at the community college in Charlotte where I grew up. I learned a ton about Native American text, Buddhist texts, Hindu’s text and early Christian texts as well. As I have re engaged myself in the Ramayana I really have begun to connect with all of the other early tests that I have had my eyes opened again to the parallels in the myths that ancient cultures posses. 

I do wonder how my knowledge of the people's traditions and religious history might affect the type of research that I will do in the field. I also realize that if I am to understand these people I will have to understand their traditions and customs.

Wednesday Feb 1 2012

I have been thinking a lot recently as to the status of financially how I am going to make ends meet in India. There is little to anticipate since we haven’t been able to talk much about the logistics at this point. I realize however that there is much to be anticipated and I really need to sit down and budget out an expense report.

I also have gotten a bit further on my proposed project topic. I had an interesting conversation with my grandmother the other day. She and I talked about the differences between Western healthcare and what I will be coming in contact with in Inida. Suprisingly enough she had done a bit of research (personal) on the Ayuveda and I really enjoyed talking with her about the differences. It made me want to investigate speciffically how at-risk group are affected by the practices of western of traditional health care. So instead of getting a general consensus as to the perception of medical practices, I would rather focus on the effects on those who are deemed at-risk. This would include pregnant, infant, children and seniors.

Monday Jan 30 2012

I received and interesting phone call last night from my sister-in-law. She is a postdoctoral research scientist at Vanderbilt university in Nashville TN. She is in my opinion one of the sweetest girls on the planet and not to mention the brightest. Her call was really quite an unexpected surprise for me as usually ill chat with my brother on occasion and when we are talking if she is around he will pass the phone and I’ll chat with her briefly. Her call was out of her concern for my India Field study this weekend. As she started off with her concerns regarding my proposed trip she outlined what would not be the usual concerns of a loved one when they are trying to convince you to not do something. Instead of her telling me that it might be dangerous or that the change in diet might kill me, she went off on how the kind of research that I would be doing in India would not be up to par or even close to the standards of scientific research that we can do here in the states. She was concerned that if I went and did some sort of hypothesis based research in India that I might come back with a stain on my resume instead of a positive experience.

As I listened to here opinion I realized that she had missed the entire point. She didn't know that I would be going to India to do a form of anthropological/medically-based research. My goal was to not document the protein structure of a particular vaccine. It was to go and see maybe how people feel about vaccines in general. Are they of any use to the people that I will be serving? Do they see westernized medicine in any for as beneficial or do they want to stick to their traditional medical practices? I found myself defending this opportunity that I have to do something great and I fell in love with the idea of effecting a change in the way that we view the people and culture of Tamil Nadu or Chavadi. 

Friday, Jan 27 2012

I spent about an hour last night researching a new medical code, or document that I found to be very interesting. I stumbled upon it after following up on a comment made by rem. He wanted me to look into Ayurveda. Here is what I found.

After looking up the Wikipedia article I spent some time on the library's database searching for articles and sources for the Ayurveda and I came up with some interesting facts that might help with the thought process behind the type of research that I want to do.

The first thing I came across was a stat behind how many people practice the Ayurveda.

According to the Britannica Encyclopedia 80% of the Indian population practices the Ayurveda.

That seems like a very high percentage and some of the studies that have gone into the medical methodology seem to be ambiguous at best. I feel like if I were to parallel the use of modern medical perception next to a more traditional method and see what people do in regards the their health to stay health might be a good direction to go into for a more specific project.

Wednesday Jan 25 2012

I have been pretty enthralled by our Tamil class that takes place every Monday Wednesday after the prep course section. Venkat is our teachers name and he is really a great man. I have thoroughly enjoyed learning the basics of the language and the basics of his culture as well. In my opinion he is a great choice in an instructor due to his high desire to have each of understand everything. 

I find myself focusing to much on the logistics of what I am going to do this summer more than planning for the impact that I am expecting my self to make. This is due to my nature as a more pragmatic and logically based individual. I feel that I need to focus more of my time defining my research methods and out lining what it is that I want to do on the ground in Chavidi more so that how I will get there and live when I’m there.

Monday Jan 23 2012

Our last class with Ashley was where we did the group discussion based on the readings that we were to do had me thinking a lot based on the project Ideas and the validity of how our methods in the field would support out proposal on paper. I walked away with such a feeling of uncertainty. Most of what I want to do is very scientific by nature. I have to re-evaluate the direction that I want to take my proposed project idea.

Some of my thoughts include the following,

-As I move to focus on the medical perceptions of the people in the Tamil Nadu region, maybe I should include an analysis of an anthropological aspect of their understanding or interpretation/definition of preventative medicine.

-Maybe it would be wise to do some sort of data collection other than just a survey. When drawing lines between the criteria that I have outlined it might be better to use observations of the people in health oriented locations such as hospitals and clinics.

-It might be wise to also use other sources of medical attention to outline my work. Asking the locals what is their first line of medical attention or whom they trust for medical tips and advice might also be very telling as to their perceptions regarding medical attention.