Volunteering at NRI Hospital in Vijayawada, India

Dr. Keith Williams is a board-certified internal medicine physician, who is currently in a general surgery residency program at Baylor University Medical Center in Dallas. Dr. Williams has been volunteering for Project HOPE in various countries – primarily in Africa – since August 2012.  He spent one month providing medical training at NRI Medical College and General Hospital in Vijayawada, India in early 2013.  Dr. Williams was named Project HOPE’s Volunteer of the Month in November 2012.

The hospital is relatively new and quite large with an open ward design that was common in the United States at one time.Each of the medical services is organized under the direction of a senior faculty member and two junior faculty physicians.The hospital has male and female wards as well as patients within the intensive care unit.

During the later morning, junior faculty members typically present a clinical lecture to all of the medical students and afterwards conduct bedside teaching sessions with smaller groups assigned to each individual medical service; I was fortunate to have been given the opportunity to teach several times in both capacities.

Patients often present with diseases typically not seen very often or at all in the United States, such as malaria, dengue fever and filariasis.  Rheumatic heart disease, once common but increasingly rare in the United States, continues to be an issue in India.  Due to a relative lack of access to health care for a variety of both economic and noneconomic reasons, patients often present late in the course of their diseases at advanced stages not frequently seen in the United States.  Although illicit drug use is rare, alcoholism is not uncommon, often presenting with associated medical complications.

Not surprisingly, as the wealth of the population has increased, diseases of affluence such as diabetes and coronary artery disease are becoming more common.Interestingly, obesity also is becoming a major public health issue.Dr. Manisegaran, a general surgeon, told me that the hospital will soon be performing bariatric procedures.

As I had expected prior to my arrival, Indian physicians are extremely well trained with clinical skills that rival any clinician trained in the West.  I was fortunate to have worked with Dr. G. Raghava Rao, the senior faculty physician, and Dr. Amit Kumar, one of the junior faculty members, who were both assigned to the medical service to which I was attached.  Dr. Rao, a friendly gentleman in his mid-sixties, is a superb clinician and teacher with a wealth of clinical experience.  Dr. Kumar, although much younger, is also a very skilled clinician and teacher.

Dr. Kumar often provided me with opportunities to shadow him in medical settings outside the hospital including a rural clinic he staffs every Sunday morning.  He was also a very gracious host, often taking me to eat and shop in the city while providing me with insight into Indian culture and life.  All of this made my experience in India very personal and meaningful.