"Homecare" is where the heart is...

Sr. Ruby & new patient Sathyanarayana
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Community Nursing...........this has got to be the complete devotion to the nursing profession, showing true humanity & humility. The nurses (Sister Ruby & Bindu) comprise the 2 Homecare Teams, who go out into the community with an auto rickshaw & a driver and cover the whole of the city of Bangalore between them!

Their work is incrdibly challenging as they travel long distances to visit patients in their homes, which are often in the slums. This can be a major problem as the patients are difficult to find in the maze of 'houses'. I had the opportunity to experience this myself & had the most incredibly sad, humbling, yet rewarding days of my life.

Sr. Ruby giving injection to patient
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The first day I went out with Sr. Ruby (a nun from the ? convent). We visited 3 patients, the first being a new patient; a 63 yr old man with Ca prostate & bone metastases. He lived with his wife & son in a tiny house & only the son was working & bringing in the money. They were so grateful & offered us a drink & food, even though you could plainly see that they probably didn't even have enough for themselves, so we declined graciously.

The second pt. was also a case of Ca prostate, who was not doing so well. He lived in a house with his wife, son, daughter-in-law & their 4 month old baby. The family were slightly better off and the house bigger, yet they were just as in need of our sevices & were just as grateful.

Homecare patient
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The third pt. was a 12 yr old girl that lived in the slums in the district of Legeri in the NW of the city. This was a truly heart wrenching case of Ca lymphoma. The little girl (very underweight for her age) was very sweet & bright-eyed and had been diagnosed a year before, yet the family (Just her mother & brother) had no money for treatment. The family lived in a 'stone shack' within a labyrinth of narrow lanes which had open drains running down the middle of them. It was certainly an eye opener & it almost made me cry when the pts mother ran off to find me a plastic chair to sit on....instead of on the stone floor. The little girl showed me some of her drawings that she had done (the paper & materials having been donated by Karunashraya) & then she began to count out her tablets. She was a very sweet girl & obviously very much 'in charge' of her illness as she told Sr. Ruby how many more extra tablets she needed !

Sr. Ruby with Yasmin (12 yrs old)
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When we had finished the visits, we parked up in a leafy suburb and ate our lunch. The area was in a 'nice' part of Bangalore & it made me reflect on how some peoples lives are so taotally different and how some are full of sadness & hardship.

The following day, I went out with Bindu, the community nurse that has been working for Karunashraya for nearly 10 years (since it started). She is a caring & lovely person.... a true humanitarian, who shows so much empathy towards  her patients. We were covering the south of the city along with Babu, our auto rickshaw driver. These guys definitely deserve a mention too as they battle through the most horrendous traffic with such skill & dexterity. Some of the manoevours almost gave me a heart attack, yet Bindu seemed very casual & relaxed about it all ! The drivers also help out with shifting pts & doing dressing if needed so are a vital part of the team.

Sr. Ruby & Yasmin showing her drawings
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Our first pt of the day was a 78 yr old lady who lived just round the corner from Karunashraya but was housebound. She had squamous sarcolemma & had an ulcerous foot that had developed after an operation in which 2 of her toes were amputated. The wound was cleaned with hydrogen peroxide & betadine solution then dressed usind 'aseptic techniques'...well as much as any homecare visit is sterile ! The dressing pack was a large canvas roll that contained instruments & dressing materials that had been autoclaved, so in actual fact it wasn't so different to back home in the Uk, except that we use a whole lot more plastic !

Yasmin & her mother
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Also very similar to UK community nursing, out next patient wasn't at home when we visited ! She had in fact been admitted to the hospice but the family had 'forgotten' to inform us ! however the next patient was at home...if you could call it that. He was a 45 yr old man with penile cancer and yet again a very sad case. He lived with his wife in this thiny brick 'box' & was not a well man at all. His wound was awful & even though his wife had been doing her best in looking after him, he really needed to go to the hospice for proper care & pain control. Bindu spoke to his family (wife, brother  & extended members) and they said they would think about it, although he hasn't been admitted yet.

The slums of Legeri
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Another patient was a 48 yr old male with Ca buccal mucosa and he lived in the slums. Again in a myriad of lanes and small 'shacks' with a family of 5 living in about 15 square meters! A family memeber ahd been to the doctors who had prescribed IV fluids (he was unable to eat) and various pills for pain relief, however, the family could afford no more. Bindu spoke to them & told them to bring him straight to the hospice. He was admitted later that day.

To end the day on a slightly cheerier note, we visited a 20 yr old who had had his left leg amputated a year ago. Once again he had been living in abject poverty, but donations from kind friends & neighbours had allowed him to have the operation. After recovering he was also able to buy a small 'shop' (kiosk ) from which he sells snacks, sweets & cigarettes. He at least was smiling even though we were there to give him some tramadol for his pain.

A typical 'street' in the slums
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These past couple of days have been a real eye opener as to the poverty & hardship that some people have to face everyday of their lives. It showed me the awful conditions in which some people have to live.....yet they were the ones that were still smiling. These people truly are survivors.