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After completing my MBBS degree, I have spent majority of my time working in rural and remote communities of Punjab, India. My real love for rural and remote general practice began in the year 2006, when I got my first government rural physician posting in a small rural village of approximately 1200 population. Since then, my attachment with rural general practice has intensified manifold.
After 2006 beginnings, I have served in many rural and remote villages of Punjab, India as a rural family physician. I served as a replacement physician for a few months at remote village known as Bambiha in Punjab, India. Here I realized how much health-related work can be done by a rural family physician with minimum financial support by the government. While serving at various rural health centers, I was fascinated by the innocence, ever uplifted morale and helping nature of rural people as well as by the sheer beauty of rural landscape and nature.
Since my first day of rural practice I have always felt the warmness of underserviced rural communities. I still remember my first day at rural health center in 2006, when the village council chief came to my clinic to thank me for opting to serve at that rural community. I have numerous such experiences while being posted at rural health centers in Dhurkot Kalan, Dhudike, Bambiha, Thathi Bhai, Sukhladhi, Bathinda, Sangat and Pakka kalan etc. which ignited my passion to serve as a general practitioner in underserviced communities. So, I do not have any doubt that I want my further training in family medicine. I enjoyed tremendous respect amongst my rural patients.
Sometimes, when the stock of government-funded medicines was dwindling, rural communities came forward to purchase medicines for rural health center by pooling in common village resources. It really moved my conscience and inspired me to do more for the rural communities beyond my normal duty hours. Sometimes, old and debilitated patients could not come to the rural health center, and then I used to visit patients at their homes. This voluntary gesture was well appreciated by the villagers.
At Dhurkot Kalan village, my health center shared premises with the local church known as Gurdwara. The villagers felt proud to invite me to their monthly religious congregations at the church. Many a times when villagers came to pay their obeisance at the place of worship, they used to visit my clinic for various ailments or even to discuss career options of their children or just to say Hello to me. It helped me integrate their physical, mental, social and spiritual health into a holistic approach. I was treating not only organ or system specific ailments, but also individuals as a whole.
At Dhurkot Kalan and other health centers, we worked very effectively in a team of rural family physician, multipurpose health worker (MPHW), pharmacist and a helper. This rural health team is co-ordinated and engaged well with the village council to tackle various barriers to better health. I lead the rural health teams in implementing various national health programs as well as delivering the primary care, with active guidance and assistance from senior health officials at the district level. During pulse polio campaigns, sometimes it was difficult to bring the under 5 children to polio vaccination booth at rural health center as rural parents feared that polio vaccine can cause polio. So in order to address this unfounded fear, I formed small health teams in the village, which will go door-to door to convince the rural population that the benefits of polio vaccine far outweigh its side effects, if any. And, I used to request the village church priest to announce the benefits of polio vaccination on church loudspeaker and request the rural parents to bring under 5 years kids to polio vaccination booths. Due to the effective co-ordination between rural health center, polio vaccination teams and the village communities, this pulse polio vaccination was a huge success and not even a single polio case was reported from villages falling under the jurisdiction of my health centers. There was a high prevalence of infectious diseases, diabetes mellitus, hypertension, mental health issues and other common conditions. With compassionate patient education, we were able to make behavioral changes in the communities for disease prevention and health promotion.
While practicing as a rural general practitioner, I saw a wide spectrum of diseases covering Pediatrics, Obstetrics and gynecology, Psychiatry, Social and Preventive Medicine, Surgery, General Medicine etc. in all age groups varying from a neonate to the elderly will in their 80s.This opportunity to see a wide variety of patient and disease categories further attracted me to general practice. In May/June 2018, I attended to Manitoba fires evacuees from Little Grand Rapids/Pauingassi, Manitoba First Nations while working as an emergency response team member with Canadian Red Cross. I felt immediately connected to these rural folks based on my previous vast rural general practice experience from India. It was my first direct major interaction with First Nations people of Manitoba. While counseling these evacuees, I got some glimpses of their routine rural life including the inadequate primary health care they are getting currently. Some elders told me that they do not have a regular family physician in their First Nation. So, naturally I was moved by their plight and contemplated on helping these communities by serving as a rural family physician after completing my MLPIMG enhanced residency training.
When I serve the homeless or poor underprivileged Indigenous or other people at Siloam Mission in Winnipeg, my mind echoes similar feelings of serving these underserviced people in whatever capacity I can, most likely as a general physician. Here I meet people of different cultural and social backgrounds. While serving these people with meals and clothes, they usually have an inclination to tell me their stories. I am always happy to lend them an affectionate listening ear.
At Siloam Mission, I realized that disturbed social factors can badly impact all spheres of an individual’s life-including physical and mental health. I am deeply moved by seeing poverty-stricken mothers with young children, differently-abled young people, homeless elderly waiting for food and clothes at this mission. And there is no better way to help such people in the near future than to become a compassionate family physician looking after them as capable individuals and not as poverty-stricken or homeless cases. Friendliness of the people, pristine nature, good life-work balance in rural Manitoba appeals me. There is no better chance to serve these under-serviced people than to take MLPIMG residency training and serve in these communities. These factors also influence my decision to go for MLPIMG family medicine training.
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