After 31 years practicing medicine in Denmark, this October I returned to India, to actually practice medicine again. It felt like a homecoming!
I have a full-time practice in Denmark, which means I can only visit India for short periods at a time while my Danish staff enjoy their vacations. Since Dr Kusum and I established our little Kendra (MPSAK) in July 2024 at my parents’ old bungalow near Belati village, I have been eagerly waiting to interact with the women of the village and offer my services.
At the Kendra, we are advocating for preventive and minimally invasive treatments for rural women and trying to empower them with all the necessary health related information to improve their lives. Our little team of Dr. Kusum, Poonam, our nurse , Meena our secretary and Devi our helper , had been spreading the word in the villages that I was coming for four days and would be providing free gynaecological and ultrasound examinations, so there was quite a crowd waiting.
The difference in the types of issues I see in Denmark and in India were striking. Our rural women are young and hard working, most of them get married at around 16-18 years of age and within the first three decades of their life, they have already had 2-4 pregnancies. Even though, we do not advocate for such an early age for marriage, finishing their reproductive needs before the age of 35 is still a very healthy trend, practically unseen in developed countries like Denmark. In Denmark (on average), women start their “baby making” project at around 30 years of age and up till then they would have had approximately 1-3 intended abortions and multiple partners.
Even though my impressions are based on a very short visit , I could see our rural women were healthier with respect to these gynecological issues, what was disturbing was that most of them complained of general body ache and weakness, heartburn and epigastric discomfort. That made me more inquisitive of their general lifestyle, their eating habits and diet, the work they did daily etc. It’s here I found some answers to why our women suffer compared to most of the women I see in my practice in Denmark.
Our rural women work in the fields about 8-9 hours a day and eat a very standard diet of bhakri (Indian bread made usually out of millet) and dal (lentil soup) 2-3 times a day. The inclusion of vegetables in their meals is about 2-3 times a week but they rarely eat fruit. Basic sources of calcium like milk, ghee, etc are not part of their diet, and oil is the major ingredient in cooking their food.
Furthermore, the physical posture they work for these long hours are almost always monotonous like bending, de-weeding, lifting heavy objects in the fields. They are unaware of basic stretching exercises or simple yoga postures that could help relieve their muscular pain at the end of a hard day’s labour.
So though I had come with all the intentions to provide my gynaecological expertise, I found our rural women were actually healthier than those I see in my practice in Denmark. However, they lacked the knowledge of proper nutrition and basic physical exercise to reduce their muscular pain and discomfort. This has also been the observation Dr. Kusum has made in the several months of her outreach and camps during the last year.
It is though reassuring that this is an issue that is preventable and with focused efforts, we can hope to improve their wellbeing. So our next focus will precisely be centred around providing them simple tools to tackle these issues.
