Dec 2, 2008

For Dr. Padma

Dr. Padma (back left), Kim Gutschow (back right), and the chowkidar or night watchman at Leh Hospital.

Picture this. The Sonam Norbu Hospital in Leh, Ladakh is one of only two hospitals that serve an area the size of Norway. This area is only home to 250,000 people, making it one of the least populated regions in India, with one of the lowest fertility rates in the nation.

Why so few people? Did I mention the forbidding desert landscape at 12,000 feet above sea level--- some of the lowest precipitation in India? Or the fact that many crops don't or can't grow that high or in such a dry climate? So why all this talk about altitude?

Imagine a hospital where electricity is imminent at times and the back-up generator takes 10 minutes to kick in, depending on how cold it is and whether they guy who is supposed to start it feels like getting out of bed in the middle of the night. Imagine doing a cesarean section by flashlight, as I have heard done in Leh.

Imagine having to beg the anesthesiologist repeatedly to come in just one more night, one more time, for one more emergency obstetric complication, and he is twice your age, and is better friends with your parents than you in a very small town.

Imagine a delivery room where the heating is spotty, the mother lies down on a cold rubber surface that was scrubbed by ice cold water that may or may not have been hauled there in a bucket when the pipes freeze.

And now imagine Dr. Padma, doing her morning rounds, after she has walked the 100 yards from her tiny one bedroom apartment that is in the staff quarters next to the hospital. Always cheerful, always professional, even in the coldest weather, or in the worst mood. She is happy to discuss each patients' progress, give the nurses their instructions one more time, clarify the meds that should and should not be administered, order another ultrasound, and then discuss the latest literature on corticosteroids with me.

She graduated from one of Delhi's most prestigious medical colleges and then left a fellowship at one of New Delhi's finest public hospitals---Safdarjung--- three years ago to return home, to Ladakh, to work at Leh's government hospital. She has never accepted payment under the table for her services as many do in India's public hospitals where the salaries are almost as poor as the infrastructure.

And tomorrow she goes back down to Delhi for another shorter fellowship. Let's hope she returns.

We need more doctors like her in Ladakh. And everywhere in rural India for that matter.