My visit to Landour Community Hospital was my first true “aha” moment here. Perched on a hillside overlooking the town of Mussoorie, the hospital is small. If you placed it next to a facility like UPMC, the difference would be startling, not just in size but how it operates. With only two doctors managing nearly all aspects of care, it is very different to the hospitals I’m used to back home where each floor has a specialized department. As a pre-med student who has spent countless hours volunteering in various different US hospitals, I was stunned to walk into an emergency room with just two beds and an ICU with three. Another shocking moment was everything being manual. Handwritten patient records, treatment plans, vitals, prescriptions. There were virtually no computers. While it felt like they were stuck in the 90s I realized while resources are limited, medicine here relies heavily on clinical knowledge and community trust.
On nearly every wall were signs stating that the “disclosure and selection of a fetus’s sex is prohibited under the law”. Walking down a hallway with eight of these posters, I was confused why this was such a big deal. Until I asked and found out the reality of female feticide. In India, there has always been a cultural preference for sons for various odd reasons including inheritance and superiority of the male gender. Daughters are considered a financial burden related to dowry and marriage expenses. These preferences have led to increased female fetus abortions. Learning more about this issue taught me that medicine cannot be separated from the culture it exists within. These things matter and affect the way healthcare is practiced.
However, the greatest shock I faced was the cost of care. Here, seeing a doctor typically costs around 70 rupees. That is 7 cents in US dollars. Insulin costs 150 rupees or about $1.54. When I heard these numbers, I paused trying to process the reality that healthcare here costs less than a cup of coffee back home. If you’re reading this and you’re shocked, you should be. In the US, insulin costs hundreds of dollars per vial, adding up to thousands per year for patients who need it to survive. Why is something so vital treated as an economic privilege? Why must so many Americans ration their insulin or skip appointments when here despite limited expertise and infrastructure, people can still afford the basics they need to live? In my public health classes, we have spent hours learning about the inefficiencies and inequities of American healthcare, but this realization forced me to confront how broken our healthcare system really is.
This visit was incredibly insightful and was my first time entering a hospital outside of the US. It challenged my assumptions and beliefs of medicine. I had grew up believing that American healthcare was superior by knowledge, access and equipment. But standing in that small hospital, I realized that while the US may lead in technology and specialization, it fails at the most basic measure of care. Affordability. The true strength of medicine and healthcare is how high and far it can serve its people. And at the end of the day, medicine should always meet people where they are.
