I went to Lady Willington Hospital in Manali, India during my third year of residency for 4 weeks. Manali is a rural hill station (small town) in the state of Himachal Pradesh in north central India. The Lady Willingdon Hospital is a Christian mission hospital that has been serving the local community since 1935. The catchment area is extremely broad, serving patients up to 10 hour drive on poor quality mountainous dirt roads since there is minimal medical infrastructure in the this area (Himalayan Mountains).

I stayed on the hospital campus (they have small rooms available for rotating trainees) and there were several students from the UK also doing an elective rotation. In the morning we did hospital rounds on infants and children, patients hospitalized for medical conditions, and post-surgical patients. In the late morning and through the afternoon we did outpatient clinic, which was essentially an acute care clinic. There is very little chronic disease management or focus on health prevention. Basic laboratory testing and X Rays were available when absolutely indicated. There is also a labor and delivery room (which I did not participate much in, given that I was an Internal Medicine trainee) and an 24-hour Emergency Department.

I saw a wide variety of illnesses, including TB, Scrub Typhus, Entamoeba histolytica, dysentery, a variety of worm infections, and typical bacterial pathogens. There was a high number of accident-related injuries, primarily from MVA’s and unsafe work conditions. Older people presented with respiratory symptoms, probably from some form of obstructive lung disease from smoke exposure from cooking fires and inhaled dust/dirt from hard labor.

Throughout my elective, I was impressed that the staff at Lady Willingdon Hospital were able to provide excellent care with minimal resources by our standards. I did experience a degree of ‘culture shock,’ but overall it was a very valuable experience and I am thankful for the opportunity to travel to India during residency. I felt safe throughout my time in Manali, the scenery was amazing, and I had the opportunity to meet many wonderful people.