Himalayan Health Exchange

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Himalayan Health Exchange
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Mission Statement
To provide medical and dental care to the
underserved people living in remote regions of
the Indian and Nepal Himalayas and to uplift two
orphanages located in the North Indian state of
Himachal Pradesh
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Under 5 Child Mortality India 1980-2004
www.who.int/countries/ind/en/
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Under-5 deaths from specific causes preventable
through listed interventions as percent of
total deaths (2000)
India
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Life Expectancy
67.5 70 yrs
http//en.wikipedia.org/wiki/FileLife_Expectancy_
2007_Estimates_CIA_World_Factbook.PNG
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Extreme Poverty
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1.6 billion live on less than 1/day
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Disease Statistics

• Tuberculosis
• 1,932,852 people, (estimated incidence 2006)
• HIV/AIDS
• 2,300,000 people, (living with disease 2007)
• Malaria
• 1,781,336 of standardized reported malaria
  cases
• Leprosy
• Eliminated

www.globalhealthreport.org
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Water Sanation

• Indicator
  
  Value (year)
• Access to improved drinking water sources rural
  86 (2006)
• Access to improved drinking water sources urban
  96 (2006)
• Access to improved sanitation rural
  18 (2006)
• Access to improved sanitation urban
  52 (2006)

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Acclimatizationin Manali

• Max altitude 13,050 feet
• Clinic sites 9,500 feet

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Dead Mans Pass
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Lahaul Valley

• One of the most sparsely populated regions on
  Earth
• Population Density
• 2 persons/km2

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The Price of Beautiful Scenery
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About the Clinics

• Rotations through
• various stations
• -Triage
• -Medicine
• -Peds
• -OB/GYN
• -Dental
• -Pharmacy
• 6 MS1s to each
• physician
• HPI, ROS, PE, assessment/plan
• all on our own!

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1,600 patients in 3 weeks
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Who we treat and why we love it.
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Clinic at Sissu
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Case 1
CC/HPI 48 year old female presents with dry
eyes, light sensitivity, and visual acuity
deficits over the last 5 yrs which is worse in
left eye. Left eye also has large brown
spot. Hx Beyond MSK pains associated with
lifestyle she denies any other problems Exam
CV, GI, Neurological, Respiratory all normal Eye
exam was marked for slight lens opacities, dry
irritated conjunctiva, and large dark spot on
sclera.
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Ocular Melanoma?
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Case 2
CC/HPI 64 year old male complains of severe
epigastric pain for the last year that gets worse
after eating or sleeping. He has not noticed the
presence of worms, mucus, or bloody stools. Hx
treated previously for worms Exam HEENT, CV,
Resp., Neuro, all normal GI normal bowel sounds
on auscultation with upper quadrant pain on
palpatation Diff Intestinal worms, H. Pylori
(Peptic Ulcer Dz), GERD Dx GERD Treatment
Prilosec
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Clinic near Kyelang
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Case 3
CC/HPI 2 year old female presents with cough,
wheezing, and labored breathing. Hx Mother
reports that the cough has gotten progressively
worse over the past 2 weeks. Exam Localized
dullness to percussion and crackles on
auscultation
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Pneumonia
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Case 4
CC/HPI 5 year old female presents with red
patches on the surface of the tongue bordered by
grayish white areas. No pain Hx Mother
reports that the patches disappear and reappear
and change shape and size. Exam HEENT, CV,
Resp., Neuro, all normal Tongue no TTP, no
bleeding, no exudate.
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Geographic Tongue
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Dental
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Dental Block
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Leprosy
www.searo.who.int
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Leprosy

• Recently India announced it had eliminated
  leprosy, but according to a target set by the
  WHO, elimination is simply fewer than 1 case in
  every 10,000.
• With Indias vast population there are more than
  150,000 new cases each year.

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Leprosy (Hansens Disease)

• a chronic disease caused by the
• bacteria Mycobacterium leprae

• Leprosy is primarily a granulomatous
• disease of the peripheral nerves and
• mucosa of the upper respiratory tract
• skin lesions are the primary external symptom.
• Contrary to popular belief, leprosy does not
  actually cause body parts to simply fall off.

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• For purposes of treatment, leprosy is divided
  into two types
• Pauci-bacillary(PB) leprosy 1-5 skin lesions
• -Rifampicin and Dapsone for 6 months
• Multi-bacillary(MB) leprosy 5 skin
• lesions
• -Rifampicin, Clofazimine and Dapsone
• for 12 months

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Some time for leisure, too.
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Buddhist Monasteries
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Zorbing
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Yak Skiing
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Camping
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Questions?