we left Secunderabad by train on sunday july 27th at night. the whole train fiasco deserves a post of its own, which i haven't written yet, but it is documented here. we arrived early in the morning in Eluru, which is a small-ish city in the state of Andhra Pradesh in West Godavari district, on the east coast of india (so it's quite a distance!). a driver was there to pick us up and drop us off at the convent/centre that we would be staying at. the centre had a building for accommodations, which was empty most of the time except for us, as well as a building in which people did work etc., social service stuff that was carried out by the nuns and other people who stayed at the centre.
during the 2 weeks we were following two nurse supervisors (who were also nuns) who lived at different convents from the one we were staying at. the 4 of us would eat breakfast at the centre, walk 1/2 hour to the bus stand to meet with one or both of the nuns and then we would take a bus to wherever we were going for the day. we would pack our lunches in tiffins that we bought for that purpose. We would get back to the centre in time for supper. Usually the power would be cut off for about an hour from around 7-8pm, so we would sometimes eat supper in the dark by candlelight or by torchlight. our nights were extremely early, as if we stayed up very long the mosquitoes which were horrors would eat us up so bedtime was between 8 and 9 pretty much every day.
we went to Eluru to learn about the PHC Enhancement Project, which is the training of "Nurse Practitioners" to (wo-)man Integrated testing and counseling centres where HIV testing is available, pre- and post-test counseling is done and a whack-load of other responsibilities are also carried out.
PHCs are little government-run hospitals or clinics where patients can come to see the doctor, get/fill a prescription, have a baby, have minor surgery etc.. They serve a population of around 50,000. The idea behind the Enhancement Project is to have HIV testing centres at the level of the PHCs to make them accessible to the people and increase awareness of HIV.
India has a reported HIV prevalence of 0.3%, which may not seem like much but if you consider the sheer population here, it's a lot! Andhra Pradesh, the state that i'm in right now has one of the highest prevalence rates in the country, and West Godavari, the district that we visited, has one of the highest HIV prevalence rates of all the districts in AP. in some places the hospitals/doctors/staff were reporting rates of around 3-5%. yowzers.
so they started this initiative about a year and a half ago to try and bring these rates down, and especially to reduce the rate of transmission from mother-to-child. the "nurse practitioners" are trained to conduct positive deliveries. they also do a lot of outreach work with the villages that fall under their particular PHC, conducting awareness seminars and doing teaching and counseling.
we followed nurse supervisors (the supervisors of the nurse practitioners) who would go visit various PHCs, check-in with their NPs and see how everything was shaking. we visited a bunch of them (7), plus a few district hospitals, some faith-based hospitals, a care and support centre for HIV/AIDS + leprosy, and went to a few outreach/community events in the villages. oh, and we also went to East Godavari to observe a training session for the NPs. overall it was a LOT of traveling. we learned a lot though.
it was interesting to see how theoretical concepts and program planning is actually being carried out and it was neat to look at some of the barriers and challenges that the different players faced in trying to implement the program and have it run smoothly.
we got back to Secunderabad on wednesday morning, presented to CHAI about our experiences and learning etc. on thursday, and today is friday, independence day for India.
sunday we leave for goa. the other girls are coming too, but while they are staying in hotels i will be staying with family.
anyhow, that's the update. i hope it makes sense.
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