7/20 - DMH Hospital (Day 1)

First day at Deenanath Mangeshkar Hospital (AKA DMH Hospital).

This was the first government-run hospital that we shadowed over the course of our trip.

The inside of the main building.

A few general observations:

• Befitting that of a governmental clinic, the hospital is absolutely huge. Almost all medical services are available here. 
• Recently, DMH now is comprised of two buildings: the original hospital and the newly-constructed Super Specialty Hospital (ex. OB-GYN). 
• Available medical technology is state of the art. The majority of all work and patient information is processed electronically. 
• Protocols for sanitation and patient confidentiality are extremely tight here. ID tags were issued to all of us for additional security. 

The entrance to the new building.

For our first day, the three of us shadowed in the Neonatal Intensive Care Unit (NICU), a place where newborns that severely require medical attention are treated.

All the babies seen in the NICU were premature ones, usually in the 30-32 week range of gestational age. There are multiple factors that can contribute to a premature birth, including but not limited to:

• The presence of multiple babies in the womb (i.e. twins)
• Stress 
• A shortened or weaker cervix

As one may expect, a premature birth can be host to a plethora of complications for the newborn. Infants are generally at a greater risk when it comes to visual and auditory problems. In addition, developmental delays become far more common. These risks only become more severe the earlier the child is born. In order to keep the newborn as safe as possible, in the NICU they are usually kept in specialized warmers to monitor their oxygen levels, feeds (nutrients), blood pressure, and temperature. 

Laryngomalacia - Literally meaning a softening of the larynx, it is an extremely common issue in newborns where the weakness of the epiglottis folding in on itself causes airway obstruction. The characteristic sound produced by this is known as stridor. Although surgery is rarely needed for treatment (usually the larynx develops after a while to its sturdier state as the newborn ages), cutting said epiglottis folds can allow for restoration of airflow.

As a final note for this post, NICU services are quite expensive. Warmers cost ~20000 rupees a day (roughly $322 USD). Hospice care is available, but they are currently extremely few and far in between.