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Aust. J. Rural Health (2012) 20, 167

From the Journal Associates Holistic health care in rural India
In January 2012, staff and students from the Canberra campus of the Australian Catholic University visited the Holy Family Hansenorium, a rural health-care facility in Tamil Nadu, southern India, during a one-week immersion experience. The group, from the schools of nursing and social work, saw holistic care provided by health-care professionals and assistants to people whose lives had been changed by debilitating illnesses – in most cases Hansen’s disease (leprosy), HIV/AIDS or tuberculosis. The experience was both confronting and inspiring. Social work student Linda Norris reflected that she was confronted by the challenges patients faced with accessing adequate medical care when basic needs, such as food and employment, were a priority. The group observed primary health care, community care, acute and long-term care, and rehabilitation services. Health promotion activities targeted disease prevention, especially of sexually transmitted diseases. Community services, provided by nurses, included administering oral medications to villagers from outlying areas and to the orphans who lived at the Hansenorium. The group also witnessed villagers attending the hospital for medical and nursing assessment and care, pathology and ultrasound services, minor procedures and medications. Heidi, a second-year nursing student, was particularly surprised to see that natural and herbal remedies were the first-line treatment for conditions such as eczema, migraines and allergic reactions. Hospital inpatient care included palliative care and a program for the treatment of alcohol dependence. The obstetric clinic and witnessing the birth of a baby by caesarean section were particularly interesting. Ashley, a third-year nursing student, commented that she felt privileged to be included in an intimate moment in the mother’s life. Heidi shared the sentiment but was also mindful that the staff were working under a constant threat of power outages. Every morning, the group observed the routine of long-term patients soaking major skin lesions resulting
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from Hansen’s disease (usually on the feet) in salty water, after which the lesions were debrided, cleaned and swabbed. Both nurse academics recalled using the clinic’s basic supplies – sodium bicarbonate, mercurochrome, gentian violet, eusol and sitz baths – in their training in the 1970s. Ashley reflected on the strong sense of community, which was greater than she had experienced or observed in Western cultures and which demonstrated the holistic care provided by the Hansenorium. Some of those who attend to dressings and help out in the clinic are themselves people with Hansen’s disease. After their recovery, some patients remain there because their disfigurements are accepted, rather than return to their villages. Long-term residents tend the Hansenorium’s rice fields and dairy cattle to provide food and milk to patients, staff and guests. The chief boot maker, who has a below-knee amputation, makes special footwear designed to avoid pressure on healing wounds. Women spin cotton and hand-weave beautiful fabrics to raise funds for the community. The group’s time at the Hansenorium was an amazing, enlightening and unforgettable immersion experience. The authors would like to acknowledge the National Rural Health Alliance for its donation of a large number of 2012 calendars, which now decorate many walls in rural Tamil Nadu. Margaret McLeod, RN, RM, Cert MidMan, BA (SocWel), GradDip (MH), MA (HSM), PhD1 Margaret Boyes, RN, RM, BA Soc Sci(Hons), M(Bioethics), Cert IV (T&L),1 Linda Norris,2 Ashley Maher3 and Heidi Welsh3 1 School of Nursing, Midwifery and Paramedicine (Signadou Campus), 2 Bachelor of Social Work student, 3 Bachelor of Nursing student, Australian Catholic University, ACT, Australia E-mail: margaret.mcleod@acu.edu.au

© 2012 The Authors Australian Journal of Rural Health © National Rural Health Alliance Inc.

doi: 10.1111/j.1440-1584.2012.01278.x