Life History, Varying Outcomes, and Support Systems of MDR-TB Patients in District Kangra, Himachal Pradesh
“Do not fear going out of your comfort zone!” admonishes Senior Olivia Harris. Do the thing you never thought you would do- that once-in-a-lifetime opportunity that has been persistently on your mind. At Vanderbilt, students are provided the resources and the support to think big, push beyond their prior limits, and take their ideas to a global stage. Taking her own advice, Olivia thought big and journeyed to India for a 15-week intensive study of Public Health and Policy Advocacy.
As a Public Health major whose second professional love is public policy, Olivia always knew that she would study abroad, researching global policies that would inform her future thoughts about domestic policies. SIT programs, accessible through Vanderbilt’s Global Education Office, offer programs of study that immerse students in the international location of their choice. Students take intensive language and learning courses, participate in a homestay with local families, and conduct in-depth research into a large swath of topics. In India, Olivia turned her attention to the tuberculosis (TB) epidemic, specifically focusing on the different styles of healthcare and perspectives among places in India and also in comparison to the United States.
The program Olivia selected gave her “a chance to do something unique that make a large impact.” She partnered with a local hospital that connected her to doctors and practitioners who manage the treatment and care of patients with TB. The treatment plan for TB patients can last up to two years, requiring daily treatments administered by a healthcare or community health worker. Patients can potentially lose their ability to walk at the onset of treatment, and the intensive regimen tends to interfere with normal life activities. While in treatment, people cannot work while contagious, their relationships suffer, and society rejects them out of fear. Reintegration is not easy and recurrence of the disease commonly occurs. Through her immersion with the SIT program, Olivia traveled to several states within India and noted a great diversity of cultures. In some regions, it was not uncommon for patients to wait outside of hospitals and clinics due to a shortage in healthcare providers. In the Northern region, there resides a prominent Tibetan population, and in every geographic location she visited, a different language was spoken. One reliable commonality, Olivia realized, was the desire and the need to be heard.
Olivia chose to perform interview-style research. She spoke with the treatment program manager, doctors working in the hospitals, and several TB patients. Her empathy and attention drew conversation from the patients when she spoke with them and they were relieved, finally, to tell their stories. Olivia realized that the healthcare providers were treating the disease, but not the humans. Upon completion of her four week research project, Olivia’s recommendations were to treat the patients for TB as well as the collateral effects of the disease: depression and anxiety caused by social isolation and/or adverse reaction to the TB medication. While the cost of medicine is covered through the National TB Program, travel costs and ancillary expenses are not. Olivia also reported to the TB treatment program that more research is needed on the beneficial effects of patients who stay in the hospital during treatment instead of being treated as outpatients. To avoid disability and to promote efficiency of care, patients may experience better outcomes if they stay at the hospital during critical points in their care. Further, notes Olivia, mental and emotional treatment can be given when patients can be observed for longer periods of time.
As for Olivia, she has personally experienced a host of benefits from her study abroad in India. Among those are greater knowledge about field research and healthcare that she can share with others, a higher comfort level participating in professional and academic conversations, and the attention of several employers. On a personal level, Olivia has been encouraged to be more involved. Bursting out of her comfort zone taught her to have no fears and no regrets. She plans to always look for ways to help and find solutions that benefit others, making the world a better place for everyone.