My time is drawing to an end

Today we had a brilliant staff meeting about the elderly care program. It has been running now for nearly 2 weeks and there is a core group of 20 members who are regularly coming for meals. We went to see them again yesterday, taking some Australian Social Workers from a RUHSA appreciation society back in Australia, people who have been to RUHSA in the past, working on various projects over the years. They were very interested in the program. Several of them had done projects involving the elderly, some of which we used as references, and so they knew very well what sort of problems they face.

What is very interesting to observe is how the elderly are being empowered by the program. It seems that even the fact that someone is paying attention to them and asking their opinion has given them strength and an identity in the village once again.

Today everyone met for a discussion about the future of the program. I have been anxious that my plans for the future in term of expansion and development weren’t matched by the other team members; that people were so pleased to see the feeding program successfully starting that they would place less importance on the further development of other services etc. I was worried that people would concentrate on the feeding program and ensure that it all ran smoothly that they would forget that spending £3000 on feeding 20 elderly people for a year cannot really be classed as a success, anyone can do that, given that amount of money; for the program to be a success it has to be developed further and involve the wider community, including other vulnerable groups.

However, my fears were foundless. We had a fantastic meeting. Everyone is so keen to move the project forward and develop it according to exactly how we envisaged, there is very little bullying and cajoling needed to be done by me now. Everything that I have been hoping would happen is being planned for and everyone is in accordance with the ideology of how it will develop further in the future. It really was an amazingly fantastic meeting. The only sadness for me is that my time here is drawing to it’s natural conclusion. It is clear that there is enough momentum to keep everything moving forward without further input needed from me. Obviously, this is exactly the plan as intended but it’s still sad to know that this is ultimately neither my project or my responsibility, I have just been a guest – and a troublesome, difficult, noisy, bossy one at that! It was quite sad to listen to them planning how they were going to manage things in the future, knowing that I couldn’t be included in the plans as I was not going to be around for much longer.

All that is left for me to do now is to finish the medicals and do full nutritional assessments on everyone attending the program, some of whom slipped through the net before it started, as part of the evaluation and monitoring process.

There is one other thing that I would like to do before I leave and that is hold a focus group in the village to discuss their perceptions of what local health services can, do and should provide. I was discussing this with Dr Rita today, who is developing expansion of the mobile nurse and medical clinics and she was excited at the idea. CMC outpatients departments are overrun by people “inappropriately” attending for things which could be dealt with in primary care. There are primary care centres (of sorts), RUHSA has a weekly clinic in the village and there are various private doctors in the area. With such a smorgasbord of medical care theoretically available, it is important to find out how these services are being used. This will help us understand were the service gaps are and where health education is needed to ensure that services are used optimally. It will also help us to understand why people don’t use medical services, even though it’s clear they should. I think this will be a phenomenally useful piece of research and will help in developing the primary care facilities more efficiently.

So, my plan is to spend a few more weeks here and then leave in March, which is a little earlier than I was planning before Christmas. I definitely do not want to be hanging around, not doing very much except being an “executive” at the meetings, I need to be remembering that first and foremost I am a GP and I need, at some stage, to be planning getting back into work at home. Also, I had an exciting email from a previous teaching colleague, who said that the University of Liverpool was enquiring about my return, hopefully because there is another opening doing GP teaching next academic year, which is tres exciting.

Mum and Dad are coming out to India in mid February, and apart from having to negotiate renewing my visa, which runs out in about 10 days time, I anticipate being at RUHSA until about the end of March. I may or may not then go travelling, I haven’t decided. Depends, I think on how frivolous I think I’ve been and how much responsibility I feel for me to return to a proper job!

The downside to all this is that I’ve got to start thinking about packing. Oh my God. Why am I not surprised at the amount of stuff I have accumulated. Maybe they will let me leave stuff in the attic. I have left stuff in attics wherever I have been; one day I’ll go back to my first year room at Oxford, climb into the roof space and see what I left behind 16 years ago! I can’t remember at all what it was, but I’m sure I would be delighted to be reunited with it again after all these years.