Reading about it and discussing it in class was one thing, but nothing could fully prepare Summer Haddad and Sarah Haliburton for the poor living conditions they saw and the "lines and lines of patients' waiting on them for treatment of everything from infectious diseases and malnutrition, to burns from domestic assaults or suicide attempts.
The two students heading into their final year of the Bachelor of Science in Nursing Program completed a 10-week clinical placement with the Institute for Indian Mother and Child (IIMC) in Kolkata, India over the summer. They returned feeling more confident as nurses and also fortunate to be young women with autonomy, rights and educational opportunities in Canada.
"We met young girls who, despite all their pleas to remain in school, were pulled out by their families and married off before the legal age of 18. We spoke to illiterate mothers who work 18-hour days in the household,' said Haddad.
In the 20-bed indoor clinic housing patients with various skin infections and burns, the nursing students charted vitals, treated wounds, and completed rounds with doctors performing head-to-toe assessments, particularly of pregnant mothers. The IIMC also has five outdoor clinics where they worked with volunteers to provide wound care, injections, and record blood pressure for crowds of 400 to 500 patients in the span of a few hours.
Haliburton said it was difficult not being able to spend much time with each patient. "Adapting to that challenge means blocking out the external noise,' she said. "You have to focus on the one patient you're treating but there are so many disturbances, it's sensory overload. In India, there's sensory overload everywhere – the hospital, clinic, and going back and forth to my house.'
Haddad and Haliburton agree that the way women are seen as "third class citizens' in the rural communities they visited was most surprising to them.
"No one wants a girl child in India. Nutritious meals are saved for the males in the household while girls are often more malnourished than their brothers,' said Haddad.
"When you're at a lower status socially and economically, you have very little rights,' added Haliburton.
They said the mandatory international health course they took in the semester before their trip helped prepare them for the health issues they would face. "Of course, the sights and stories were still shocking, but less so, and I thought more about how the situation could be bettered rather than just being emotionally overwhelmed and dumbfounded,' explained Haddad.
They also gained a better understanding of the social determinants of health and saw first-hand how culture affects health.
"A health issue is never as it seems,' said Haliburton. "Someone might be malnourished, but why? Maybe they have no money, or no access to food. Maybe there's a shortage of food because of drought, or maybe there are nine children at home, or a lack of education or knowledge.'
Haddad remarked: "My trip to India emphasized the importance of primary health care over high-cost advanced medicine. You must treat poverty, illiteracy and gender inequalities to treat illness. This is as much the case for India as it is for Canada.'