The end of an amazing experience...

Following an exciting and interesting first week at the hospital, the group looked forward to a weekend of leisure in Vinh Long. The Saturday saw the group take a tour along the Mekong Delta to the floating markets. We stopped at several sites to see the local people making traditional rice paper, snake wine and performed theatrical Vietnamese songs. The group disembarked onto smaller wooden row boats with a single woman paddling standing up. We sat in groups of four and travelled seamlessly through smaller channels. We saw beautiful greenery and witnessed local Mekong Delta residents going about their usual day. The Sunday was a time of relaxation and immersion into the local Vinh Long atmosphere.

Our final week at the hospital went past quickly. Our Vietnamese language skills had developed and basic communication with the local women and families was possible; even if they did find our pronunciation hilarious. The professional relationships between the staff and students further grew. This allowed for open transfer of practices, culture and knowledge. We gained valuable insight into the Vietnamese way, particularly their great family involvement from pregnancy to the postnatal period. We provided information on Australian obstetric practices which that staff found very interesting.

As the week neared the end, our group was humbled to be invited to share meals with the local staff. A generous invitation for a few of us to attend an Anniversary of Death at a doctor’s home was humbling and beyond expected. On attendance a lush spread of local food was presented before us. This had obviously taken several days to prepare and tasted divine. Another generous invitation to attend a local restaurant for pancakes arrived from another doctor. On our final day at the hospital, we dined together with several doctors and midwives and enjoyed the Vietnamese pancakes. We returned to the hospital and said our goodbyes. It was a bittersweet moment to part with the wonderful staff and families as we began our trip home to our own families. 

We travelled back to Ho Chi Minh City on the final Friday, ready to depart for Adelaide on the Saturday evening. We were fortunate enough to have some more leisure time. On the Friday evening we enjoyed a delicious farewell dinner and saw the views from the highest building in Ho Chi Minh City on the 52 nd floor. On Saturday morning most of the group went to the Cu Chi tunnels to learn of the Vietnamese War and its impact. Finally, we scattered to quickly buy gifts and bargains from the local markets before departure. 

Now back in Australia to our creature comforts, I reflect on the most amazing experience I have had as a student midwife. Words cannot describe these experiences well enough, especially those shared with the women, families, local practitioners and as a group. We thank Antipodeans for arranging this placement and extend a special thank you to Michelle, Chi and Tam.

Our Exciting First Week of midwifery in Vietnam!

After check in and a team photo we were finally boarding. The long, overnight haul had finally begun after weeks of planning, preparation and excitement. Two stopovers and rough nights' ‘sleep’ saw us to Ho Chi Minh City where we had the afternoon to settle in, a welcome dinner of local cuisine, and an early night. Monday morning was here, time to pack up, board the bus and move onto Vinh Long. 

We dumped our bags at the hotel, were fed an enormous lunch that could quite easily have fed us for days and made our way to the hospital for a tour. Waiting at the steps of hospital were the beaming smiles of staff and translators. As we made our way through the corridors, locals stared, waved, giggled and followed us. It was clear we were going to be welcomed, it was also clear this was not a place that foreigners frequented.

The staff proudly walked us through their hospital and sat us down in the meeting room for an official welcoming. If you’re a health professional student you know this kind of welcoming doesn’t happen at home (well it certainly doesn’t in Australia). We felt like royalty and were all thrilled to finally be here.

We later left the hospital and made our way through the local supermarket collecting some basic supplies. Once again the locals looked on intrigued that white Aussies were wandering through their supermarket. Tuesday was here, day 1 of placement! It was very different to home, there was no patient hand over, we had no idea of the daily routine and yet we all drifted off into our own areas and began to immerse ourselves in the women, babies and families. It was difficult, we looked at babies, smiled and felt unsure exactly where to begin. This didn’t last long... as we were collected and off on ward rounds, showering babies, hands deeps in welcoming new arrivals or practicing our ultrasound skills. 

Ward rounds were not like home, for one patient’s don’t get privacy like we are used to. Woman sharing birth rooms, or being examined surrounded by others was something we were just not used to but here in Vietnam it was completely the norm, they know no other way, and it was time we got used to it. The other thing we had to get used to was working through interpreters or communicating without one if they were busy in other room. I think we all left our first day feeling relieved, exhausted and excited for day 2 of placement. As the week went on we moved throughout the various areas of the maternity/obstetrics unit. We all faced different challenges and were given new opportunities that we know we wouldn’t get at home. 

 We had all collected donations of new and pre loved baby goodies to which we made into packs for the women. Their faces were often blank when we handed these out. In shock that they were given something and unsure of exactly what was inside. If you walked back to the room a half an hour later the baby was often dressed in your clothes and snuggly wrapped in the blanket you had gifted. A warm smile was exchanged and it was clear they were appreciative. After all these women were not used to receiving things from the hospital in fact it’s quite the opposite. The women themselves provide everything they need to birth at the hospital from disposable mess mats to food, so they hardly expect to be handed a collection of brightly coloured baby goods. 

As the week draws to a close I think we can all proudly say we all survived week one! Mainly because we all came with no expectations, embraced opportunities and, importantly, supported each other through challenges big and small, personal and professional. I feel like next week with be filled with new challenges as some have been overcome and new ones arise. We are all craving a home cooked meal (or at the very least vegemite on toast) and missing loved ones (both two and four legged)!

Namaste in India, thanks

No one can believe the trip is over already. We've had the most amazing experience - from meeting new people at the different placement sites to teaching others and learning so much ourselves and weekend getaways that don't always go to plan. All the things we've learnt along the way will undoubtedly help us in our future physio careers and in our lives. So I thought I'd finish off this blog by telling you some Do's and Don'ts we've learnt in India

Don't say yes to being in a photo with one Indian. This one Indian will soon become 100 Indians and instead of the Taj Mahal being the attraction, it will be you. We're still not quite sure what they do with all the photos of us but everyone seems to need one with the tallest whitest, blondest haired people in the group - special thanks to Swedish Giants Jack and Elise for taking the bullet most times on this front.

Don't get Om tattooed on your foot. The foot is a negative place and you'll end up offending your yoga teacher and have to be pulled aside from the class to have a "talking to." This chat will also cause you to be late to the only meat meal of the week.

Don't always believe your trekking tour guide's weather forecast. Although they dress and act like they're "one with the earth" and have done this hike over 1000 times, even if they say it won't rain, it might definitely rain... And hail... And be windy as anything. Your tent might collapse and they might not get out of their cosy tent to help you fix it or cook you a warm dinner. You might have to wait out a 7-hour storm while propping up your tent with your head. So yeah, just trust me, don't always trust them!

Don't try to understand the Indian head nod. It might mean yes, it might mean no, it might mean that they have no idea of what you've just said and it's the Indian equivalent of smiling politely because that usually suffices as an appropriate response to any question. Either way we never could quite work it out and generally assumed it was whichever response we wanted it to be!



Now on the flip side

Do take up the offer to visit a 150 year old tea plantation. We were lucky enough that our host dad's family owned a 100-hectare tea plantation just a 15-minute walk from our house. His father, the most passionate tea maker I've ever met, showed us around the expansive property full of bright green tea hedges while explaining the difference between the techniques of preparing green and black tea. We learnt about the sorting, packaging and exporting of this tea to many countries around the world. It was such a beautiful place to spend an afternoon.

Do try extreme sports. The views while paragliding were incredible and we can now all say we've paraglided in the same spot the world championships were held. We also tried our hand at white water rafting, arguably the best activity we did on the weekends. We set off from Manali in two rubber rafts and followed each other down the Rapids. Our guides were excellent and ensured our safety while sending us straight for waves ensuring we were soaked with the biggest smiles on our faces by the end of the 14km trip. All for only $12!

Do try paneer. And any other meal you're served for that matter. We ate predominantly vegetarian the whole trip with the exception of chicken on a couple of meals we ate out and chicken or lamb once a week at the house. Our wonderful chef never disappointed, to the point some of us (previously "carnivores") weren't even craving meat.. For the first week anyway! Paneer is the most delicious cottage cheese often in a tomatoey sauce with peas or spinach sauce. We also had a mixture of Dahl, chickpeas in curry and beans in curry accompanied by a variety of breads; chapati, kulcha and naan.

Finally,
Do take up the opportunity to visit India! Whether it be for study, work or a holiday, it's a beautiful place to visit and the people aim to look after you, on the most part, and show you all that India has to offer. We've seen and learnt so much of the culture, their physiotherapy treatments and the attractions to see and unless someone is keeping really quiet about it, none of us regret coming here for our advanced physiotherapy practice placement. We're so thankful for the experience and now it's onto further travels around the world or home to rest, relax and enjoy our mid-year holiday!!

Dust, hail and sweat with some physiotherapy in between

We carried on this week at our respective placement sites in the morning and completing tutorials and case studies with our teacher, Julie, in the afternoons. One of Heidi's patients, a paraplegic post-surgery complication, is becoming more independent and we've ordered her a wheelchair that will fit her so she is able to get around more easily. One of Ryan's patients has progressed from not being able to sit for 10 minutes to now sitting for more than 6 hours with ease, which enables them to make the necessary travel requirements to see their family and friends.

Luci enabled one of her patients to get out of bed independently using a rope attached to his bed so his wife now won't have to drag him out of bed using her strength. Alexa, Alice and Elise continue to improve the motor skills of the children at the Rotary school so they are able to socialise with other children in the playground. The other students at the private practices continue to minimise the negative impact of the various injuries they've been presented with.

Dust and sweat 
Two weekends ago we travelled as a group to Amritsar, in the nearby state of Punjab. As the hours crept up on the bus ride so did the Celsius outside. 6 hours later we arrived at our hotel in 44-degree heat. It was a struggle to leave the comfort of our big fluffy beds and aircon to head out and drive to the India/Pakistan border. Our driver got us as close as he could then we were on our own. Outside and covered head to toe for cultural purposes, we squished in between the crowds of thousands who lined up to get through the first gate towards the border. Two gates further on, lots of sweat, plenty of selfies and we were sat down in the special "foreigners" section awaiting the spectacle. It was an hour wait in the sun once we had our seats but, definitely worth the wait!

Each country had an MC whose job was to hype up the crowd and dance along to the loud music blaring from the speakers. Then the guards from each side appeared and essentially had a dance off! Swinging guns around, jumping up and down and carrying out high kicks better than a cheerleading competition. The ceremony lasted for about 45 minutes with a confusing combination of the guards shaking hands to show friendship and threatening each other to show who's boss.

We followed the swarms out of the ceremony to meet our driver to head back to Amritsar and visit the beautiful golden temple. This Temple is open 24/7 and serves food for free but don't forget to walk through the water on your way in or you'll be smacked by the security guards with a stick, Alice learnt the hard way!

Hailstorms for hours
I'll start by saying we're all safe and alive! Just last weekend we set out for a blissful hike up the beautiful Himalayas to a well-known camping spot called Triund. We were prepared for spectacular views during the day and cool weather at night but that's not exactly what we got. The hike up was magnificent, with the view getting better and better at every turn. We shared the hiking path with donkeys and were greeted by thousands of cows and goats when we reached the campsite after the 9km trek.

We found our tents and the storm set in. Strong winds, hail and thunder had one tent collapsed within minutes and 12 of us bunking into 3 tents suitable for 7. We had a few laughs and made the most of the situation until even stronger winds, more hail and a broken zipper meant the second tent collapsed and 12 of us squished into 2 tents for the remaining few hours of the storm (7 in a 4-man tent and 5 in a 2-man tent). We held up the remaining 2 tents until the first storm passed. We ran to the closest market for snacks and drinks and feared worst. The second storm hit and we were bunked down in our overpacked tents once again!

We missed dinner and packed like sardines to attempt sleep and waited out the storm which ended up lasting from 3pm to 10pm. Wet and cold we exited the tents at 5am for sunrise and trekked back down the 9km path. A quick look at the markets, some lunch and a visit to the Dalai Llamas monastery and we were on the bus for the drive back home. It's safe to say we all enjoyed warm showers and sleeping in beds with fans more than ever before!

Helping Hands

COUNTRY: India
PROGRAM: Faculty Placement
PROJECT: Physiotherapy
WRITTEN BY: Ali Thomas

Karan hospital
Amanda and Ryan have been completing placement at Karan hospital physiotherapy clinic. In the morning, they look forward to a refreshing fruit box on arrival and greeting their Indian physiotherapy educator who is "Indian Fonz" says Ryan. There is no strict appointment schedule like we're used to in Australia and gradually, the waiting rooms fill up with patients. "Indian Fonz" does the translating and asks the patients what their main problems are (ranging from lower back pain to old fractures, paraplegia and tennis elbow) then Amanda and Ryan are able to practice manual techniques they've learnt at home to treat pain, stiffness or weakness. The techniques we use at home are quite different to India where they tend to use a lot of electro therapies. Amanda and Ryan have found it interesting to teach the Indian physiotherapist a few of the manual techniques we use in Australia and educate him about the evidence of their effect.

Goenka private physiotherapy clinic Heidi and Jack have been at Goenka physiotherapy clinic from the start of the placement and Kath and I have joined for the last 2 weeks. It has been an interesting experience with only a handful of the patients speaking English and no Indian physiotherapists around all the time to translate. One Indian physiotherapist wanders between the rooms to check in on patients and treatment techniques. The experience here is quite similar to the other private practice with the Indian physiotherapy course focusing on electro therapies and minimal manual techniques. Each patient receives their electrical modality from the Indian physiotherapists and then they are seen by the students from UniSA for manual therapies. At this private practice, there isn't an appointment schedule either and we filter through the patients throughout the morning. At both private practices, the students are able to practice their clinical reasoning for different patient presentations and practice a variety of manual techniques.

Rotary children's school Kath, Luci, Jacquie and I attended the Rotary school for the first half of placement and now Alice, Elise and Alexa are attending the school for the second half. The school has 20 boarding students and 20 who arrive by bus each morning. All the students are mentally and/or physically disabled, with the most common presentations being cerebral palsy and Down's syndrome. The morning is spent with select students who need a physiotherapy focus to improve their ball skills, fine motor skills and general function of everyday activities so they can interact more easily with other children. The children have already made so much progress in the first half and we all can't wait to see their overall progress at the end of placement. The last half an hour is spent dancing with all 40 of the students to traditional music. The children are so sweet and the pure joy on their faces while they jump around together is one of the most rewarding images. A photo of the girls with some of their students they've been working with can be seen above. 
Home visits Elise, Alice and Alexa attended the home visits for the first half of placement and now Jacquie and Luci are carrying on with the same patients for the second half. They attend three homes of patients who would find it too difficult to leave and make their way to a physiotherapy clinic. This placement site takes on a rehabilitation focus for patients who have had strokes, leg fractures and other long term physical issues. The families are all so lovely and welcome the girls into their homes with traditional tea, juice and snacks throughout each of the treatment sessions. The patients in these sessions have already made such great progress as well with one in particular being able to get down stairs for first time in 3 months and almost ready to return to work. A photo of the girls with some of their clients and families on home visits can be seen below.

All the sites have shown a completely different side of physiotherapy to each of the students and seeing something so varied to the hospitals and sites in Australia has been an experience we've all learnt so much from.

Temples, Take-Away and The 'Things We Take for Granted' List

COUNTRY: India
PROGRAM: UniBreak
PROJECT: Physiotherapy, University of South Australia
WRITTEN BY: Suzannah Michell

Week three in Palampur started with a bang! Our weekend was spent in Amritsar where we were lucky enough to visit the Pakistan border and the Golden Temple. Fun fact: the Golden Temple has more visitors annually than the Taj Mahal!

Whilst our trip to the Golden Temple was vastly different to our experience at the Taj, there seemed to be some common themes: it was hot. Like, really hot. 45+ degrees hot. We planned the day to visit the border and the changing of the guards in the afternoon, and then see the temple on Saturday night to cope a little better with the sauna-like conditions. Our little bus spluttered it's way triumphantly the 5 hours to Amritsar and then the further 2 to the border between India and Pakistan WITH air-conditioning (for most of the time).

The border first: this bewildered author had no clue of Pakistan and India's long term and ongoing wars, violence and feuds prior to the spectacle that occurred at changing of the guards. Imagine two soccer games going on side by side - cheering and all - separated by two metal gates. But the soccer players specialize only in high kicks and yelling. And they're wearing peacock-esque hats and military uniforms, sometimes holding guns. Yeah, well that happened for a good hour. Pakistan and India performed similar displays of gymnastics, strongman posing, screaming and marching whilst separated by the border's elaborate gates. All the while, the extremely large crowds gathered on either side of the border cheered and yelled and danced to the music of their country, trying to outdo each other.

The closing ceremony featured the opening of the gates and quick synchronized lowering of the flags. The finale: a really high, high kick and a scream. Really, I'm not lying - it was strange. Bobby, one of the main organizers here, said that the kicking was to show the opposing side the sole of their shoe as a sign of strength. Whilst Julie mused that it really seemed like a show of good faith to each other to keep the peace. One thing is for sure, it was kind of fantastic, and the vibe was electric and intriguing. If that wasn't enough to round out our trip to the border, we were also patted down and searched 4 times on entry to the event, and it was by far the most number of photos we've been asked for. We were even asked to hold people's babies.

Note: 45 degrees + large crowd + 7 hours by bus + multiple photos with people's children and families = slightly disgruntled travellers. Enough said.

So the Golden Temple next: so nice we visited here twice! Once by night, and then again in full sun. Holy moly batman, that's a nice temple. You have to remove your shoes and place them in lockers on entry then walk through water to cleanse your feet, but the shoelessness was worth it. (Thanks Julie for teaching us all about parasites that can enter your feet by burrowing through your skin that live in water). At night it was like this shining beacon surrounded by water hovering in the darkness. By day it was an immense feature of light surrounded by the vivid colours of India. The first night we stumbled into the temple we may or may not have exited out of a different gate than the one we entered. After some shoeless strolls through the overpopulated city, our shoes were recovered! Whilst dirty, we were thankful that night of India's obsession with burning all roadside rubbish and the lack of glass or suspect liquids in our path.

One more important note from our weekend trip: if you thought we fought over chicken bones, you should've seen the lengths we went to acquiring McDonalds and KFC. The latter was more difficult due to Amritsar's, the holy city’s, pure vegetarianism. But after some crafty Google searches and an excessively long tuk-tuk ride we all had some Kentucky fried solid food to consume. McDonalds was actually located very close to our hotel though! And McPaneer ain't so bad! The McFlurry was arguably better though. Ice cream solves all problems in 45 degrees, let's be honest.

My goodness and that was only the weekend!

This week we started at new placements - rotating around to gain a better spread of experience. Everyday we arrive back at the house for lunch after placement and share stories of confusion or success from our days, revel in the contrasts of Indian physiotherapy, or boast about what delicious treats we were offered on home visits.

In general we decided this week was a bit of a "things we take for granted week" though. So here's the short list:
- Running drinking water
- Air conditioning
- Electricity
- Medicare and private health insurance
- Opening your mouth in the shower
- Fresh and safe meat and poultry
- The ability to safely cool and store meat...
- Currency with less 0's
- Relative social equality between men and women
- Automated washing machines
- Long-handled brooms
- Solid foods
- Australian Heath literacy
- Knives
- Napisan oxidation plus
- Less hand sanitation requirements
- Access to basic groceries
- Beer
- Road rules
- Less need to give way to livestock
- Indicators
- Quiet streets
- Animal welfare league and the RSPCA
- Beaches
- Alan keys (you can't fix a wheelchair without one!)
- Blending in
- Understanding conversation
- Rabies shots

A special thank you to Bobby's dad who also hosted a private tour of his tea plantation this week! His resemblance to the monopoly man was uncanny, and his touring skills were unparalleled!

Golden quotes for the week:

"Things like this just wouldn't happen if I had a knife and fork!" Luke

"Laurence, you should put henna on your face. It will come off straight away" Leah

"I've given up! I'm boycotting pants!" Alex

"I'll bring my Alan key tomorrow!" Undisclosed

"If you can dodge traffic, you can dodge a ball" Laurence

"That's 133 beeps! In only 3kms. A new record." Tobi

This weekend we're going for a 9km 'moderate' walk through the foothills of the Himalayas. I'm forecasting it as a bad episode of survivor... "12 people begin the journey and only the strongest will survive..."

Suzannah, on behalf of Tobi, Luke, Leah, Viv, Maddie, Tina, Alex, Laurence, Teagan, Nadia and Julie

Cricket, Curry and Clinics - Week 2 for Physios in Palampur

COUNTRY: India
PROGRAM: UniBreak
PROJECT: Physiotherapy, University of South Australia
WRITTEN BY: Suzannah Michell

Another week in Palampur has flown by, and I'm sure all the parents will be relieved to know that we mean that figuratively. Paragliding was a no go! Fun fact: apparently the Indian government have banned tandem paragliding! And since none of us had the courage to jump off a cliff alone, we ventured to the markets for the weekend. And boy, oh, boy do we stand out at the markets! To keep it short, we've had a dramatic effect on the Palampur economy - flooding it with Australian money in exchange for scarves, hats, tailored clothes and exotic sweets. And chocolate.

Our lunches and dinners here always come with rice, chapati (flat bread), sliced cucumber, red onion, tomato and a lentil dish. In addition there is usually another delicious vegetarian dish and once a week it's chicken! Bones, liver and all! You've never seen students fight over chicken bones like this before. And despite our cook's amazing, authentic and delicious meals, we just can't bear to give up the dairy milk chocolate stash in the fridge; in fact, it is constantly replenished! What a trap 40c Cadbury chocolate can be.

On the weekends we aren't provided with lunch, so we found Palampur's best restaurant. Rookie error on the first visit: just because the curry is cheap does not mean you need one each. On our second visit our table looked less like a medieval-Indian feast with one curry between two instead.

But fear less mum, we aren't too fat just yet. There's really no snacking outside of the three meals and we've been doing regular exercise this week too! Shock, horror. Our once a week yoga sessions have progressed well. This week we sat cross eyed, poked out our tongues and roared in unison. True story. Edit: we laughed in unison... Mothers Meeting United may as well be sponsoring our 6:15am walks through the hills too. No brave boys have joined the girls for their chats and hour-long walks, but we'll let you know how the next week continues. Many thanks to Bobby, one of the group organisers, who showed us the walk route. Although Suzannah in particular thought she might be dying on the first loop as they walked over a bridge without railing along the train tracks 20m high above a meandering stream. Unsure of when the train would actually be coming...

Placement has had its ups and downs, but distinctively more ups than downs! And all downs have been resolved diplomatically and promptly. Furthermore, a few students have begun at the school for disabled children in the area. It has been best described as chaotic, full of energy and a lot of fun. Nadia, Luke and Tina have each been assigned a child to set goals for and work towards them, such as catching a ball in two hands or counting to 10.

Alex and Tobi finished at Amit's private physiotherapy clinic, with an extensive knowledge of EPAs and Indian physiotherapy.

Leah and Viv at a local physiotherapy clinic started doing home visits this week too and had a great time applying their physiotherapy skills in a more rehab-environment. Although their favourite part was probably the pasta that one family cooked, served and made them eat on one visit in particular.

Suzannah, Teagan and Maddie have all had a lot of success with their paraplegic patients on home visits. Laurence played tag team and helped the girls this week in prep for handover. He chose a good week to do so too! Friday was their last day with the patients and their families before handing over to the other students on Monday. There were a lot of family photos taken and tea given that day! Our kitchen might as well be a tea factory with the three large plastic bags of tealeaves next to our kettle!

For a comparison, we visited the Palampur tea factory this weekend. Wow, that was a good Segway! It's like I planned it or something?! Crazy. Shout out to our Indian homeboy, Viv, who can speak enough Hindi to not only organise the tour on a Sunday, but also translate the entire tea drying and fermenting process! (We think?)

Other highlights include consistent cricket matches with the local Indian boys in the field next to our house, catching dragonflies in the kitchen and doing the dishes feat. Kanye West and, naturally, dance competitions next to the sink.

One challenge we struggled to overcome this week was the consistent inconsistency of power and Internet available. We'll probably never forget trying to access Uni emails like this... It was a solid hour out of our lives, after all. Nor the Tute sessions we had by headtorch. Not only did we take in a great deal about clinical reasoning, but some bugs were also ingested when they flew dangerously close to our illuminated faces.

However, with power we have been able to do physiotherapy tutes we wouldn't have otherwise been able to do. Such as Julie's headache tute at 9pm on Tuesday when Tobi asked her about headaches referring from his neck.

In all, we are thoroughly enjoying ourselves, even when slightly out of our comfort zones! We've had a few gastro issues, but everyone is fit, healthy and happy on the closing of week 2!

This weekend we have planned to visit the Golden Temple and the Pakistan boarder! So back into the bus we go for a "6 hour" journey. Will keep you posted on that one!

Suzannah, on behalf of Tobi, Laurence, Teagan, Maddie, Alex, Luke, Leah, Tina, Nadia, Viv and Julie.

Sweat, Tears And Physio Placements in Palampur, India.

COUNTRY: India
PROGRAM: UniBreak
PROJECT: Physiotherapy, University of South Australia
WRITTEN BY: Suzannah Michell

The first week in India has come and gone already! Like the heat in Delhi, we just can't believe it. With 11 students and 1 professor, Julie, on our trip and several hours in a plane and car, we finally reached the halfway-student house in Delhi at 9pm to rest and recuperate.

On the second day, we stumbled into the 44 degrees and tried to scrape our jaws off the ground at the Taj Mahal's Royal Gate entrance. There were tears, there was sweat. There was a lot of sweat. Okay, the tears may have been sweat, we're not really sure. What we are sure of is this - the Taj Mahal is one of the most beautiful buildings in the world. Period.



We then embarked on our "8 hour" bus trip from Delhi to Palampur. And by 8 hours, we really mean 13. Which was both a beautiful painting of India's vast and contrasting scenery and a terrifying, thrilling submersion into Indian culture.

It must be noted, just like a horror film, it was the pretty blonde who was most willing to try new things who was struck down first. By food poisoning. But what a comeback she had! And we were back on the road! Until we got a flat tyre.

Things we learnt in India this week:

- Road rules are more of a guide and an actual rule in India.
- The car horn can also double as an indicator. Or to tell someone you're coming around a blind corner. Or to say “hello”. Or “goodbye”. Or “I'm passing you”. Or "Stop, I'm cutting you off". Or "Get out of my way". Or "I'm braking now".
- One hour can mean one hour in Indian time. But sometimes it means an hour and a half. Or two hours!
- The food may look the same as yesterday, but may taste drastically different. But it's always devastatingly delicious and you'll want to lick your plate.
- Cricket transcends all languages. But Viv finds talking to local Indian children in an Indian accent a necessity of communication.
- Do not stand near Tobi when he bats
- You will need to buy the local Indian children a new ball if you hit it over the river.
- "Internet" doesn't necessarily mean you'll be able to access the World Wide Web. Although, if standing on one leg and facing due east, there is a sweet spot on the roof for 2G data downloads.
- Just because the currency is in thousands, doesn't mean you are spending very much.
- A 4 person badminton kit can be acquired for $4 AUD at the Palampur market.
- Anything can be acquired at the Palampur market.
- The roof isn't necessarily the best place to play badminton. But it has the best views and you're out if you hit too close to the edge. And you're definitely out if you fall off the edge...
- When playing badminton, innuendo and puns are a must.
- Common toilet etiquette is that you do not flush the toilet paper down the toilet.
- Palampur will always have a more beautiful view than you do. They have the Himalayas. You just can't compete! Sorry.
- Tobi hates geese.
- If you're blonde, you're a celebrity. People will want photos with you and their children and their cousins and their distant relatives too. Brunettes just don't cut it.
- Rooftop yoga is the best, regardless of hamstring length.
- Livestock can live on a farm, but it's much more likely that they will sleep on the road.

Golden quotes for the week:
- "I'm not blonde enough, though!" Nadia
- "I'm at a point where I just can't trust my farts, you know?" Tobi

But, okay, placement!

As a group of 11 we are split across 4 different placement sites - physiotherapy hospitals and clinics, and home visits.

Physiotherapy in India is very different from both Australian physiotherapy and what we expected. They use a lot of electrical therapy tools, such as ultrasound, transcutaneous electrical nerve stimulation, short and long wave diathermy. Parents: Google them. And they use much less conservative prescriptions of the electrical stimulation (e-stimm) than we would. There have been studies about the therapeutic effect of e-stimm, and they all point to "more is better" but in Australia, we shy away from using such parameters because of the increased risk of injury with them. It has been very interesting to see the way they use these machines.

In this first week of clinic we've done a lot observation. We've tried to gauge our patients' health literacy, conditions and treatment so far through Pictionary and stunted English-Hindi. Or else had Physios translate for us. Or if we were especially lucky, we had patients who spoke full English.

The patients are warm and welcoming - there have been offers to stay at their houses, eat their food and constant offers of (crazy-delicious) tea on home visits. I believe one student has already been proposed to!

The home visits are to 3 paraplegic men in the nearby towns who couldn't otherwise afford regular Physio at home. They all live in beautiful parts of Palampur. At first, they found our Physio-rehab strange and unfamiliar. However they have, thus far, been incredibly enthusiastic, willing to engage and to try things in a different way.

The other clinics are roughly the same, and are as the description above. Some extra details though:
- One centre is a naturopathy-yoga-hospital-Physio clinic, which is highly esteemed in the area.
- One of the physiotherapy clinics is owned by one of the main organizers of our trip, Amit who is one of the most highly revered Physios in the state.
- The physiotherapy hospital has a much more neurological-rehab focus than the others, but deals with musculoskeletal conditions as well.

This weekend we plan to visit tea plantations and jump off cliffs. That is, we are going paragliding!

From the group: sorry about any lack of communication, our Internet and phone coverage has been in and out. We all received Indian SIMs the other day and hope to be in touch with families more regularly in the coming days!