Each week this month, we’re bringing you fresh perspectives on ASRI’s work from some of the people who know it best: our volunteers.
Dr. Ruchit Shah is a third-year medical resident in the Yale/Stanford Johnson & Johnson Global Health Scholars Program who volunteered six weeks at ASRI. He sat down with Kari (Director of International Volunteer Programs) and Trina (Development and Administration Associate) on his second to last day to talk about the ASRI experience.
Trina Jones: Hi Dr. Ruchit, thank you for talking with us today. Let’s start with how you heard about ASRI and why you chose to come here.
Dr. Ruchit: I first heard about ASRI back when I was first interviewing for my internal medicine program. The Yale J&J Global Health Scholars Program allows you six weeks to go abroad and has six or seven sites total to choose from. ASRI was the only one not in Africa, and I had heard it is a different experience from other people who had gone before. Finally, I think it is the only site that is more hands-on. It feels more intimate with the team. Other places seem to involve mostly shadowing.
TJ:What were your expectations coming in?
RS: I knew the climate would be different than what we get back home, and there would be lots of bugs, but I came in open to the experience. Not everyone is suited for this environment, but if you are open, there is plenty to enjoy here.
TJ: What did you enjoy here?
RS: Definitely the staff! I enjoyed the staff – they have been super helpful, and they and the patients have been so welcoming. The medicine was great, but also challenging. You definitely see a breadth of pathologies here. It also makes you humble. You know the next course of action back home, but here it is more difficult. The patients are so grateful, even if you can’t help as much as you want.
Kari Malen: You said the medicine can be challenging, what is challenging about practicing medicine here?
RS: For example, last night we had a heart attack patient. In other places, we could send him somewhere else for more advanced treatment, but we had to stabilize him here and hope he will do well with limited treatment.
KM: So resource-based challenges?
RS: Yes, definitely. Another challenge is that people often go to shamans first, so care gets delayed. We saw a kid with left-side paralysis. He went to a shaman two to three months before he came here. He got some function back, but had he come to us earlier, who knows what we could have done.
KM: Was it challenging to be a vegan here?
RS: I can’t say enough about Ma Engel [Ma Engel cooks and keeps house for one of the staff and volunteer homes ASRI rents in Sukadana]. I have had no shortage of delicious food!
KM: What is different about practicing medicine here than in the United States?
RS: Back home they also emphasize the physical exam and patient history to make decisions with diagnostic tools secondary, but the stress is really on the history and physical exam here, because we don’t have the diagnostic resources. Everybody should go through this for getting comfortable with physical exams.
KM: So with the limited resources, how do you feel about the quality of care here?
RS: The quality of care is excellent for what we have. From what I hear, patients prefer to come here, so I think we are doing a great job. I hear at other facilities they focus on a high turn around rate. The way the staff conducts themselves, makes connections, and ensures patients understand their diagnosis and treatment, I think that makes people prefer to come here.
KM: In addition to working in the clinic, what other experiences have you had at ASRI?
RS: I went to ASRI Kids one afternoon with Etty, to an organic farm meeting and on a mobile clinic.
TJ: Will you tell us more about your experience on the mobile clinic?
RS: It was a four to five hour ride on pretty rough roads. The village was very small – you could walk around it in two minutes. We stayed with the village head, who was very gracious with sharing his space and food. We had even less resources than at the clinic, but we saw about 20 patients. You do what you can, but then ask if they can come to the clinic. However, this time, we were able to treat everyone without referring them to the clinic. The trouble is follow-up. We don’t know exactly when we will be here again, so we can’t tell them when to come back. It was a great experience that you don’t get to do back home.
TJ: What has it been like to work with the doctors: Nomi, Nur, Ronald?
RS: It has been quite fun. We joke around, they teach me lots of medicine, and hopefully I teach them some of my medical knowledge. I don’t think it is a unilateral relationship – it is definitely bilateral. They have taught me so much, and I hope they have learned from me too.
KM: What was your low point and high point?
RS: Low point was stepping on a sea urchin! But the high point was seeing patients here that at home would be in the ICU, and they can get better here and go home.
KM: What has changed about the way you will practice medicine in the United States?
RS: I am definitely more comfortable relying on a physical exam, but otherwise, care is totally different in the United States. I have a great deal of respect for the doctors here. What they do is amazing. I mean, Dr. Nur, he is amazing! He could practice anywhere in the world. If you ever get sick in Indonesia, I would trust him.
KM: What is next for you?
RS: In July, I start a fellowship in cardiology in Georgia for three years. I will probably specialize after that, which will be an extra year or two somewhere else. Hopefully someday I will come back here and see the hospital!
TJ: What would you say to future volunteers?
RS: If you want to disconnect from all your devices, and be in the present and enjoy the present, this is a great place to be. And we laugh a lot. Every day.
KM: Thank you Ruchit for everything you have done here, we would happily have you back at the hospital!