Today our program coordinator, Sanjay, looked more tired than usual. Yes, it is a Monday, but he seemed drained. While standing next to him on the metro for our morning commute I found out he worked all weekend. Speaking with him more about his work schedules (because of course he has more than one job), I found out working on the weekends is common for him. He also brought up that he has not been able to take a vacation with his family in almost six years.
And it isn’t just Sanjay who I have noticed is working hard. Almost every person we have met works just as hard to provide for their families. From our program director to the preceptors we met with on rotations to our friends we visited with this weekend, it seems everyone is always working in some capacity. Lucky for us we had the weekend off to recharge.
Our first rotation this week took place at the Sharan Drop-in Center. We met with David, who runs one of the smaller clinics in Delhi, and he gave us the run down on when/ why Sharan clinics came to be. Sharan clinic is an NGO that was started in 1979 and focused on educating and providing care to poor and migrant populations, focusing on TB. In the 90s they started reaching out to IV drug users due to the HIV epidemic. Sharan facilities used to receive funding from the government as well as donations from outside of the country, although recently their funding has become sparse. Without proper funding a lot of their programs had to be cut, including their detox center and cooking/ computer education classes. Today though we learned about their two initiatives that are still being funded and supported.
The Sharan drop in center aims for harm reduction for the IV drug using populations they serve. David spoke with us about their two initiatives, a needle exchange program as well as opioid replacement therapy (ORT) and how similar programs helped him turn his life around and go from addict to peer educator to program director. Dr. Gill, the medical director, also spoke with us about ORT, growing population, and female IV drug users. Dr. Gill helped us gain a clearer picture of the differences between drug use and outreach programs in the US versus India. The main things I took away is that India uses buprenorphine and does not use Methadone (due to potential OD and difficulty regulating), naloxone is not available unless at the hospital, and only 2% of people using Sharan services are women, even though women likely make up a larger percentage of drug users in Delhi. Overall, I learned a lot during our time at the Sharan clinic and I am amazed at all of the good work done by Dr. Gill, who also has a job as an internist in a hospital and a gynecologist. David does great work with his clinic as well which he took us to for lunch. He told me he is too old to have more than one job (although he is the same age as Sanjay, so I think it may be due to the fact he is Nepali and not Indian…).
-Megan