Village Clinic

In the western world, medicine is giving disease a run for its money. In the East, disease is still laps and laps ahead.

India's Madras Province has 60 million people and the population is still growing. The number of doctors in Madras is dwindling: they die off faster than its four medical schools can replace them. All but 200 of the province's 8,500 doctors are in cities, where they can make a living; in the villages, peasants are lucky to earn 10-c- a day.

Conscience & Cow Dung. Only 17 miles from the city of Madras (pop. 1,000,000) is the village of Alamadi (pop. 1,500); until this year, Alamadi had no medical service at all. Then some students of Stanley Medical College picked Alamadi as a place to set up a Sunday clinic. Said one: "We thought it quixotic that there should be so much cutthroat competition among city doctors, while a few miles away peasants died of tetanus because they thought cow dung would cure an abscess."

Every Sunday now, rain or shine, a blue bus jounces into Alamadi. Children swarm into the street, shouting: "The doctors have come." The bus brings 16 medical students, a dozen doctors, two nurses, and boxes of medicines and ointments, hypodermics and surgical instruments.

Alamadi's untouchables are treated first, caste Hindus second. Last Sunday, a 35-year-old mason named Sriramulu showed a foul-looking ulcer on his ankle, explained: "First there was an abscess. When it became very painful, I cut it with a penknife. This did not cure it. The village barber told me to apply lime and tobacco. It got worse and I tried a local remedy, covering up the sore with mud. That did not do any good, either." The student put on a sulfa dressing, told Sriramulu he was lucky not to have developed tetanus.

Quick, the Needle! Said a village elder: "Before these doctors came, we depended on three brothers belonging to the barber caste. For all types of intestinal and stomach ailments, they prescribed a strong decoction of black pepper. Cholera victims were given opium. Sometimes they recovered, more often they died. The wives of the barbers acted as midwives. To keep out evil spirits, we sealed all the windows where a woman was confined, plugged her ears with cotton and locked the door. Now the blue bus doctors say there should be maximum ventilation. We follow them because we find their methods work. Not a single woman has died in childbirth in the last six months."

At first, villagers were afraid of the needle; some fainted when they got an injection. Now, injections are a source of pride. Two patients, given a bottle of medicine last Sunday, asked disappointedly: "No needle for me?"

The doctors can cure hookworm anemia, suppress malaria and relieve leprosy. But most of the sick in Alamadi need food more than medicine. It would take much more than a weekly bus to cure that.

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