From the Journal Associates

Holistic health care in rural Indiaajr_1278 167

In January 2012, staff and students from the Canberracampus of the Australian Catholic University visited theHoly Family Hansenorium, a rural health-care facilityin Tamil Nadu, southern India, during a one-weekimmersion experience. The group, from the schools ofnursing and social work, saw holistic care provided byhealth-care professionals and assistants to people whoselives had been changed by debilitating illnesses – inmost cases Hansen’s disease (leprosy), HIV/AIDS ortuberculosis.

The experience was both confronting and inspiring.Social work student Linda Norris reflected that she wasconfronted by the challenges patients faced with access-ing adequate medical care when basic needs, such asfood and employment, were a priority.

The group observed primary health care, communitycare, acute and long-term care, and rehabilitation ser-vices. Health promotion activities targeted disease pre-vention, especially of sexually transmitted diseases.Community services, provided by nurses, includedadministering oral medications to villagers fromoutlying areas and to the orphans who lived at theHansenorium.

The group also witnessed villagers attending the hos-pital for medical and nursing assessment and care,pathology and ultrasound services, minor proceduresand medications. Heidi, a second-year nursing student,was particularly surprised to see that natural and herbalremedies were the first-line treatment for conditionssuch as eczema, migraines and allergic reactions.

Hospital inpatient care included palliative care and aprogram for the treatment of alcohol dependence. Theobstetric clinic and witnessing the birth of a baby bycaesarean section were particularly interesting. Ashley, athird-year nursing student, commented that she feltprivileged to be included in an intimate moment in themother’s life. Heidi shared the sentiment but was alsomindful that the staff were working under a constantthreat of power outages.

Every morning, the group observed the routine oflong-term patients soaking major skin lesions resulting

from Hansen’s disease (usually on the feet) in saltywater, after which the lesions were debrided, cleanedand swabbed. Both nurse academics recalled using theclinic’s basic supplies – sodium bicarbonate, mercuro-chrome, gentian violet, eusol and sitz baths – in theirtraining in the 1970s.

Ashley reflected on the strong sense of community,which was greater than she had experienced or observedin Western cultures and which demonstrated the holisticcare provided by the Hansenorium. Some of thosewho attend to dressings and help out in the clinic arethemselves people with Hansen’s disease. After theirrecovery, some patients remain there because their dis-figurements are accepted, rather than return to theirvillages. Long-term residents tend the Hansenorium’srice fields and dairy cattle to provide food and milk topatients, staff and guests. The chief boot maker, who hasa below-knee amputation, makes special footweardesigned to avoid pressure on healing wounds. Womenspin cotton and hand-weave beautiful fabrics to raisefunds for the community.

The group’s time at the Hansenorium was anamazing, enlightening and unforgettable immersionexperience.

The authors would like to acknowledge the NationalRural Health Alliance for its donation of a large numberof 2012 calendars, which now decorate many walls inrural Tamil Nadu.

Margaret McLeod, RN, RM, Cert MidMan, BA(SocWel), GradDip (MH), MA (HSM), PhD1

Margaret Boyes, RN, RM, BA Soc Sci(Hons),M(Bioethics), Cert IV (T&L),1 Linda Norris,2

Ashley Maher3 and Heidi Welsh3

1School of Nursing, Midwifery and Paramedicine(Signadou Campus),

2Bachelor of Social Work student,3Bachelor of Nursing student, Australian Catholic

University, ACT, AustraliaE-mail: margaret.mcleod@acu.edu.au

Aust. J. Rural Health (2012) 20, 167

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© 2012 The AuthorsAustralian Journal of Rural Health © National Rural Health Alliance Inc. doi: 10.1111/j.1440-1584.2012.01278.x