Wednesday, June 19, 2013

Visiting the wards

This week, I drafted a questionnaire and current inpatients who were insured by a scheme were interviewed at the Narayana Cardiac Center. I was up on the 6th floor in the general ward. There, patient’s beds lie next to each other, much like an emergency room. Patients have the option of upgrading their rooms to shared double rooms, private rooms, and even executive and deluxe style rooms. However, this comes at a cost that many scheme-paying patients simply cannot afford. The questionnaire I drafted had information regarding age, gender, occupation, role in family, patient income and expenditures, family income and expenditures, level of completed education, community support, duration of illness, and existing burdens.

One of my biggest roadblocks included the questionnaires themselves. My research head decided that the best place to pull participants was from within the hospital itself. I interviewed current inpatient using a translator as my aide. This proved to be difficult as some of the participants became unwilling to provide information about their financial status partway through an interview. I think it’s possible that they feared aid being rescinded if they happened to make more income than they were supposed to. Another roadblock was finding eligible candidates for my study. Many cardiac patients were typically older, nominal heads. The nominal head was typically a retired grandparent who garnered respect from the rest of the family, but was not oftentimes involved in big decision-making discussions. They didn’t often have a comprehensive view of what the family finances looked like. Many patients had adult children (who were likely functional heads) accompanying them during their inpatient visit. My translator avoided all contact with any patients who had accompanying adult children nearby because he told me that they would cause trouble for me and ask too many questions. He insisted that they would be more trouble than they were worth. I worked with what I could and conducted my interviews with what was available to me.

 I preferred to conduct my interviews with the functional head of household over the nominal head because they tended to have the most information about the welfare of the family. Nine cardiac patients were sampled and the families had and average of 4.6 children each. I was surprised to see that the completed level of education for participants was so broad. They ranged from 3rd standard to a B.S. C. Family monthly income was also very broad with a range of 2000 rupees to 50,000 rupees a month.
Every participant claimed to have expenditure costs that were greater than their level of income. Despite the fact that private money lenders and self-help groups exist, patients insisted that these were not options that were available to them or options that they would consider. When money became a problem, they sold the land and jewelry they had and depended on their joint family members and adult children to aid them in their times of need. Family cohesiveness truly appears to be one of the most important values that upheld in the subcontinent.

I found that all patients reported that had they lacked an insurance scheme to ease at least some of the financial burden, they would either not be seeking treatment at a renowned institution such as Narayana Healthcare Hospital or pursue alternative methods of treatment such a managing their healthcare problems with medicines instead of more permanent and ideal treatments such as surgery.

The Mazumdar-Shaw Cancer Center where my research takes form.
Also, I had the honor of attending a traditional Indian wedding! Indian wedding festivities take place over the period of multiple days and are often large-scale affair. I am told that it is not uncommon to have 1000+ guests. In the past, wedding invitations were often addressed to the invitee’s “family and friends” but today, many people are scaling down and limiting the events to guests and their family members. It seemed that many of the attendees were unknown to the bride and groom themselves. The bride and groom sat on a decorated sofa on an adorned stage for most of the event. The bride wore a traditional red sari with lots of bangles and henna that went above her elbow. The bride and groom wore garlands made of jasmine and roses. Throughout the night, there were a variety of dance performances put on by close friends and family members of the wedding party. The bride and the groom put on the final performance to end the night.  While I didn’t recognize many of the songs, it was an amusing surprise to recognize Gangnam Style blaring over the speakers. Overall, the experience was quite pleasant. I was able to sample an array of spicy, yet delicious Indian foods such as gobi (cauliflower) and chat.

I’m wearing a traditional Indian Anarkali dress and some glittery bangles here. 

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