Major Dr Ashlesha Tawde-Kelkar - Army Medicine and Rural Practice in India

Major Dr Ashlesha Tawde-Kelkar is a rural doctor and army veteran from India.  During her uniformed service she was stationed between India and Pakistan and looked after the troops, as well as the rural and tribal populations in the area.  She currently provides care to tribal communities in the Western ghats of Maharashtra.   Episode Summary:  01.15  Working as an army doctor on the India-Pakistan border  05.15  Who makes up the army healthcare team? 12.15  How many people did the team look after? 16.20  What does a typical week/month look like for an army doctor? 28.00  How much time is spent on clinical work, how much on admin and training? 34.15  How does the conflict situation affect the local communities? 43.00  Working as a rural doctor with tribal communities in Maharashtra 45.15  Traditional medicine 50.00  Building trust with the community 55.10  What have been the biggest challenges in working in rural health? 1:01.00   How did she change her practice when she left the army? 1:06.00  What has she most enjoyed about rural practice? 1:08.40  Top tips for a rural health career 1:11.20  Projects that she is working on  Key messages: As armed forces, the area may be our workplace but that area is the community's home. Receive support and cooperation, but also give back to the community. Health is at the core - provide medical care and screening for the local communities. Within the battalion the medical officer is a direct advisor to the commanding officer.  The team consists of nurses/nursing assistants, posted with every company.  They act as eyes, ears and hands.  The medical officer provides training to the wider medical team. Battlefield nursing assistants - trained soldiers, given basic first aid training.   Ambulance assistants - trained soldiers who help with transport and evacuation of injured soldiers. There are field hospitals and military hospitals which are a higher level center above the battalion medical officer.  In a conflict situation the injured need to be effectively triaged and directed and evacuated to the correct facilities.  A battalion consists of 2000-3000 soldiers, during certain training exercises there may be up to 7000 troops.  Usually there will be only one doctor looking after these troops.  They will also be looking after an additional few thousand people living in the local area.  Female medical officers have a slightly different role - they are posted in the field hospital and relieve the regimental medical officer for up to 3 months.  This also means that they spend time with different battalions. Regimental medical officers live with the troops and are usually male. The main role of the army doctor is to keep the troops well and avoid illness.  Keeping soldiers fit and well, mentally and physically.  Looking after sanitation, food hygiene, devising strategies based on terrain and weather.  Indigenous communities live in hamlets with traditional housing.  One of the villages is called "the medicine village" - healers traditionally came from that village.  Now no longer practicing traditional medicine practice, sometimes still seen during child delivery.   Less COVID19 cases in indigenous communities as they are closed communities with limited movement.  Speaking the local dialect helped to build relationships with the local community combined with experience in working with different communities during her time with the armed forces. Go into the community with an open and receiving mindset.  Accept what the community has to offer to you, learn from them. When you practice rural health it is easy to counter existing practices and beliefs of the community, we should not forget why we are there.  We are there to improve the quality of life for the community.   Thank you for listening to the Rural Road to Health - [email protected] Support the podcast by buying a Ko-fi