Sunday June 9th
Today Dasaradh and a driver took us to explore the city of Vijayawada.
Our first stop was a local Hindu Temple. The driver took us to a gate where we paid the 30 rupee entrance fee and then drove us up to the top of a small mountain overlooking the river. Two views stood out in my mind. The first was the view of the river. It was absolutely gorgeous. I wish I had thought of taking a picture, but I was quickly distracted by the second view. The parking lot was sheer chaos. If you think driving in india is bad, you should see parking in india. Cars, buses, bicycles, mopeds, and motorcycles were all pointed in various directions jockeying for the best parking spot or exit position. Pedestrians also littered the area which made the parking experience much more difficult.
The driver dumped us off as close to the entrance as possible. I was grateful for this because the ground was incredibly hot in the mid morning sun, and we had to remove our shoes in accordance with Hindu tradition. Dasaradh guided Arsen and I through the market area. This consisted of a few small shops hugging the cliff that was part of the mountain. The shopkeepers sold everything from food to trinkets that could be offered up to the priest for some sort of sacrifice or donation.
This visit was probably the most isolated I've felt in the country. The shopkeepers kept trying to pull Arsen and I aside, noticing that we were different from the rest of the crowd. Furthermore, (after paying an additional 100 rupees each), I was heckled by the priests who greeted worshipers who looked at me and playfully demanded "US dollar, US dollar!" All of the locals got a kick out of it and many smiled or laughed at me. This particular temple was absolutely packed. People stood closer than shoulder to shoulder and had to wiggle their way through the line. This is a cultural thing that Arsen and I have noted several times during our trip. Everybody rushed to the boarding line as soon as boarding was announced on each of our flights. Everybody picking up drugs at the pharmacy crowds the windows, and now everybody is extremely urgent to get into the temple. After finally getting to the front of the line, worshipers touched the floor at the entrance, walked into a small room, deposited 10 more rupees as they said an extremely quick prayer, and exited quickly.
I reflected that I could never worship in such a way. Everything felt so rushed. I could barely collect my own thoughts let alone try to speak to God. Anyways, I did my best to pray a non-denominational prayer for peace around the world and exited as those before me had.
After leaving the temple, we stopped downtown to get a Mango smoothie and do a bit of shopping. As we tried to return to the car, Arsen was approached by 2 women with children trying to beg him for money. They wouldn't even let him close the car door! The driver wound up getting out of the car and confronting the women until they left.
We made a bee-line back to NRI where we had a late lunch. Later in the evening, we went to Lotus. Lotus is a local restaurant with exceptional food at very low prices. Arsen, Dasaradh, our driver, and myself all ate for under $20 US.
Monday June 10th:
Today Arsen and I returned to CHIPS to finish some of our analytical work in the morning. We completed HPLC and also worked with the UV Spectrophotometer for a bit.
During the afternoon, we were reassigned to the pharmacology department. In this department they do animal experiments to determine the efficacy of drugs. I didn't take any pictures because I was somewhat uncomfortable during the encounter. Let's face it. CHIPS isn't on the cutting edge of drug development. The effects of diuretics, antidepressants, sedatives, and other drugs they were using are well known. I didn't see any merit in subjecting a poor animal to needle sticks to see how Lasix administration made them pee more.
This may have been our last visit to CHIPS. Sometimes with the language barrier it is hard to tell what our preceptor has planned for us.
Tuesday June 11th:
This morning we met with Dr. Raju Mantena. Dr. Mantena is the secretary for NRI and spent 30 years practicing medicine in St. Louis, MO. He looked over our itinerary and suggested some modifications. He also did a much better job of explaining the differences in pharmacy between the US and India to our preceptor without the language barrier that Arsen and I often face. We are hoping that some more clinical opportunities come out of our short meeting.
After departing Dr. Mantena's office, we headed back to the Main Pharmacy at the ground level. I swear you need ADHD to function in this setting. There are 6 dot-matrix printers that make a sound so old it's almost foreign to me, 6 pharmacists acting as tellers (making the bills, checking the work of those who retrieve medications from the shelves, etc), another 4 or 5 pharmacists retrieving medications, and a phone that rings incessantly. It is nearly impossible to focus on what Mr. Nayak is saying. But we soldiered on, and eventually were given the opportunity to complete the task of creating bills for transactions. The drug stock is far too extensive for Arsen and I to have mastered yet (all the different brand names, etc) so we were not asked to retrieve medications to prepare orders.
Before lunch, Mr. Nayak took Arsen and I to a small room on the ground floor where bulk IV fluids are kept. I noted some of the IV fluids are supposed to be stored below 30 Celsius (which the room wasn't). This is kind of a trend here with the warm weather, so I often wonder about drug stability in this hospital.
In the afternoon Arsen and I continued to shadow pharmacy staff and were showed how to generate a few more reports through the software system. The pharmacists decided to start teaching us Telegu (the native language in Andhra Pradesh) so our first word is Bonara (sp) which means "How are you?" When we got back to our room, Dasaradh decided to jump in and help and assigned us "Bonchesear" (sp) which means "Lunch".
Wednesday June 12th
Today was rather uneventful. We spent more time at the NRI Main Pharmacy which is open 24/7 and serves both inpatient and outpatient visitors.
Mr. Nayak showed us a prep book used by Indian pharmacists in advance of their license exam. We went through a few sections and refreshed ourselves on the latin abbreviations used in pharmacy. We also did a brief and unfocused pharmacology review. Mr. Nayak was impressed with our level of pharmacology knowledge. Between Arsen and myself, we may have only missed one mechanism of action in the list of drugs we spoke about.
At night, Dasaradh took us to the roof of the NRI hospital building. I wish my iphone picked up the lighting better, because the view was spectacular. Under the veil of dark, the poverty of the country disappears and you can see how truly beautiful this part of India is and the potential it has if it can emerge from the 3rd world.
I'm having some trouble today synching my photos from my phone to my macbook. Once I get that sorted out, I will edit this post to include some.
Today Dasaradh and a driver took us to explore the city of Vijayawada.
Our first stop was a local Hindu Temple. The driver took us to a gate where we paid the 30 rupee entrance fee and then drove us up to the top of a small mountain overlooking the river. Two views stood out in my mind. The first was the view of the river. It was absolutely gorgeous. I wish I had thought of taking a picture, but I was quickly distracted by the second view. The parking lot was sheer chaos. If you think driving in india is bad, you should see parking in india. Cars, buses, bicycles, mopeds, and motorcycles were all pointed in various directions jockeying for the best parking spot or exit position. Pedestrians also littered the area which made the parking experience much more difficult.
The driver dumped us off as close to the entrance as possible. I was grateful for this because the ground was incredibly hot in the mid morning sun, and we had to remove our shoes in accordance with Hindu tradition. Dasaradh guided Arsen and I through the market area. This consisted of a few small shops hugging the cliff that was part of the mountain. The shopkeepers sold everything from food to trinkets that could be offered up to the priest for some sort of sacrifice or donation.
This visit was probably the most isolated I've felt in the country. The shopkeepers kept trying to pull Arsen and I aside, noticing that we were different from the rest of the crowd. Furthermore, (after paying an additional 100 rupees each), I was heckled by the priests who greeted worshipers who looked at me and playfully demanded "US dollar, US dollar!" All of the locals got a kick out of it and many smiled or laughed at me. This particular temple was absolutely packed. People stood closer than shoulder to shoulder and had to wiggle their way through the line. This is a cultural thing that Arsen and I have noted several times during our trip. Everybody rushed to the boarding line as soon as boarding was announced on each of our flights. Everybody picking up drugs at the pharmacy crowds the windows, and now everybody is extremely urgent to get into the temple. After finally getting to the front of the line, worshipers touched the floor at the entrance, walked into a small room, deposited 10 more rupees as they said an extremely quick prayer, and exited quickly.
I reflected that I could never worship in such a way. Everything felt so rushed. I could barely collect my own thoughts let alone try to speak to God. Anyways, I did my best to pray a non-denominational prayer for peace around the world and exited as those before me had.
After leaving the temple, we stopped downtown to get a Mango smoothie and do a bit of shopping. As we tried to return to the car, Arsen was approached by 2 women with children trying to beg him for money. They wouldn't even let him close the car door! The driver wound up getting out of the car and confronting the women until they left.
We made a bee-line back to NRI where we had a late lunch. Later in the evening, we went to Lotus. Lotus is a local restaurant with exceptional food at very low prices. Arsen, Dasaradh, our driver, and myself all ate for under $20 US.
Monday June 10th:
Today Arsen and I returned to CHIPS to finish some of our analytical work in the morning. We completed HPLC and also worked with the UV Spectrophotometer for a bit.
During the afternoon, we were reassigned to the pharmacology department. In this department they do animal experiments to determine the efficacy of drugs. I didn't take any pictures because I was somewhat uncomfortable during the encounter. Let's face it. CHIPS isn't on the cutting edge of drug development. The effects of diuretics, antidepressants, sedatives, and other drugs they were using are well known. I didn't see any merit in subjecting a poor animal to needle sticks to see how Lasix administration made them pee more.
This may have been our last visit to CHIPS. Sometimes with the language barrier it is hard to tell what our preceptor has planned for us.
Tuesday June 11th:
This morning we met with Dr. Raju Mantena. Dr. Mantena is the secretary for NRI and spent 30 years practicing medicine in St. Louis, MO. He looked over our itinerary and suggested some modifications. He also did a much better job of explaining the differences in pharmacy between the US and India to our preceptor without the language barrier that Arsen and I often face. We are hoping that some more clinical opportunities come out of our short meeting.
After departing Dr. Mantena's office, we headed back to the Main Pharmacy at the ground level. I swear you need ADHD to function in this setting. There are 6 dot-matrix printers that make a sound so old it's almost foreign to me, 6 pharmacists acting as tellers (making the bills, checking the work of those who retrieve medications from the shelves, etc), another 4 or 5 pharmacists retrieving medications, and a phone that rings incessantly. It is nearly impossible to focus on what Mr. Nayak is saying. But we soldiered on, and eventually were given the opportunity to complete the task of creating bills for transactions. The drug stock is far too extensive for Arsen and I to have mastered yet (all the different brand names, etc) so we were not asked to retrieve medications to prepare orders.
Before lunch, Mr. Nayak took Arsen and I to a small room on the ground floor where bulk IV fluids are kept. I noted some of the IV fluids are supposed to be stored below 30 Celsius (which the room wasn't). This is kind of a trend here with the warm weather, so I often wonder about drug stability in this hospital.
In the afternoon Arsen and I continued to shadow pharmacy staff and were showed how to generate a few more reports through the software system. The pharmacists decided to start teaching us Telegu (the native language in Andhra Pradesh) so our first word is Bonara (sp) which means "How are you?" When we got back to our room, Dasaradh decided to jump in and help and assigned us "Bonchesear" (sp) which means "Lunch".
Wednesday June 12th
Today was rather uneventful. We spent more time at the NRI Main Pharmacy which is open 24/7 and serves both inpatient and outpatient visitors.
Mr. Nayak showed us a prep book used by Indian pharmacists in advance of their license exam. We went through a few sections and refreshed ourselves on the latin abbreviations used in pharmacy. We also did a brief and unfocused pharmacology review. Mr. Nayak was impressed with our level of pharmacology knowledge. Between Arsen and myself, we may have only missed one mechanism of action in the list of drugs we spoke about.
At night, Dasaradh took us to the roof of the NRI hospital building. I wish my iphone picked up the lighting better, because the view was spectacular. Under the veil of dark, the poverty of the country disappears and you can see how truly beautiful this part of India is and the potential it has if it can emerge from the 3rd world.
I'm having some trouble today synching my photos from my phone to my macbook. Once I get that sorted out, I will edit this post to include some.
Que Dieu veille sur vous et vous aide à mener à bien votre travail. Elv
ReplyDeleteThank you! :)
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