Upon arriving at the rural clinic, I immediately encountered difficulties. For one, my ability to speak the Tamil language was poor as I struggled to explain my health monitoring objectives to the clinic staff. I then regretted not having learnt my mother tongue as a child, much to my grandparent’s displeasure.  

 

Despite being logistically well prepared, I realized that I had overlooked a major factor in any foreign healthcare initiative. I failed to involve the clinic staff and the rural community beforehand to ask what their specific healthcare needs were. I ignorantly assumed that my initiative would be accepted and sustained. The absence of computerized data management at the clinic and lack of record keeping practices by villagers defeated the purpose of my project, rendering it useless.

 

A low point of the trip was when a local resident asked me if I had come to solve all of the community’s health problems. Despite my poor grasp of the language, I detected her sarcasm. I was unprepared for her comment and could not respond. I came with good intentions but the woman made me feel small. My family encouraged me to carry on, and I diligently collected vitals of two-hundred patients.

 

Another frustrating challenge I faced was when the clinic staff were adamant that the heart defibrillator my family had donated be locked in a closet. When I explained the necessity of such devices being immediately available in an emergency, the staff maintained their fear and belief that it would be stolen if made accessible. This clearly showed a different mindset relating to healthcare practice and procedure.

 

I began feeling guilty on the plane ride home, acknowledging that I had wasted my family’s time and money in bringing me to India. My health monitoring initiative had little effect on the community, but on reflection, it had a significant effect on me. I learnt the importance of engaging the rural communities and creating a dialog beforehand so programs can be sustained by the local community. I am better with this first-hand knowledge I gained, and conscious of my failure to include a strategy for sustainability. The challenges I faced helped confirm my desire to pursue public health, as I wasn’t bothered by the travel, dilapidated facilities or the poor-hygiene I encountered.    ​

 

It’s interesting how a fascination with a 1950’s Hollywood movie star influenced my career path, and serendipitously exposed me to my heritage and ancestral home. During my downtime at the clinic, I was fascinated by Pillayarpatti’s architecture as I walked the temple corridors, and marveled at the daily procession conducted by the priests. Many knew my grandparents, and my attendance felt strangely like a homecoming. The indescribable kinship I felt with those I encountered at Pillayarpatti has left a lasting impact on me, and helps me better understand my Indian-American identity.