Written By Andrew Gilmour, Trainee Clinical Vascular Scientist. HCPC Registered Podiatrist. GCU CAHPR Scotland – GCU ReaCH Fellow 2024-2025 with link to Safeguarding Health through Infection Prevention (SHIP).
I have just spent the last few weeks in Delhi with my esteemed colleague immersing ourselves in a unique and rewarding experience, working alongside a dedicated team of healthcare workers and nursing students to provide wound care services to the local population who suffer from Hansen’s Disease (Leprosy). Our base for work was a bustling little village in Tahirpur just on the outskirts of east Delhi. Here patients are seen with an array of lower and upper limb ailments ranging from ulcerations, infections, deformities and nerve damage.
Hansen’s Disease: A persistent stigma
Hansen’s Disease remains a significant health concern in India, despite developments with treatment and screening. While the disease is curable, there is still a profound stigma attached to it and can influence patients’ access to appropriate healthcare and social inclusion for those affected.
Misconceptions: Many people still believe that this disease is highly contagious which can lead to fear and ostracism.
Social Exclusion: Many people with this condition will frequently face discrimination, they may be denied access to employment, housing, social interaction which can lead to mental health issues. This can lead to a delay in seeking medical attention, resulting in late diagnosis and complications.
Beyond bandages: While the bandaging unit is essential for immediate care, we quickly realise that long term health inequalities require more than just treatment. Education is key to empowering patients to manage their condition and to help prevent further complications. Education to the healthcare staff also played an important aspect of our time in the village, we conducted several workshops whilst there, covering essential topics such as hygiene, infection control, foot screening and patient centred care.
There is a critical need for infection prevention control education in developing countries as healthcare acquired infections pose a significant threat to patient safety and can lead to increased mortality, hospitalisation and higher costs. If there are inadequate infection prevention and control (IPC) practices amongst healthcare staff, then this can be a major contributor to the spread of Healthcare Acquired Infections (HAIs). By simply equipping the staff and students with the knowledge and skills to implement IPC measures, we can help reduce the burden of HAI which can lead to improved patient outcomes. It is important that countries invest in Safeguarding for Health Infection and Prevention to ensure that everyone has access to the information and resources they need to help prevent infection.
The response we had was positive, patients were eager to learn and take advice from us and see new ways of doing things to proactively help in the management and treatment of their conditions. The staff and students also gained transferable skills and a new basis of knowledge to better serve the community. It is a huge reminder of the transformative power of education, not just in the medical field but in all aspects of life.
A snapshot of my time in Delhi
- Hazardous air pollution: We landed when Delhi was experiencing ‘severe plus’ levels of air pollution with the Air Quality Index (AQI) reaching over 1300. The air was toxic and had a knock-on effect to travel and disrupted many services. The air quality improved over the duration, but it was still evident in the air.
- The bandaging unit: Our workplace was a hive of bustling activity, different from the usual clinical settings, we utilise what we have, we see many patients, the unit sees upwards of 60 patients per day. There is a nice atmosphere to the unit, it is warm and everyone is in good spirits.
- A Day in the life: The days are filled with a mix of clinical work, teaching, outreach to the local community hospital. It is also a chance to get to know some of the patients who come regularly and help with their management and well being.
- Cultural Immersion: Beyond work, I had the chance to explore some of the city, visiting historical sites and landmarks and sample the local food and delicacies.
- Colourful chaos: Delhi is a vibrant and chaotic city, quite a sensory overload for any newcomer. The crowded streets, bustling markets to the amazing food, cultural heritage to green space there was always something new to discover.
In conclusion, my time in Delhi has been a whirlwind of activity, learning and cultural exchange. I leave with a deep sense of appreciation for the resilience and spirit of people we have met along the way. I have a renewed commitment to the importance of education and outreach within healthcare and safeguarding for health through infection and prevention. Looking at access to healthcare and provision I have a new appreciation for the things that we take for granted within our own health service in the UK.
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