Planning your elective - Calcutta

Jayati Das-Munshi looks beyond poverty and pollution, and discovers a rich and varied culture

Calcutta is a sprawling metropolis in the northeastern corner of India, near the Bangladeshi border.

For most travellers to India, Calcutta still conjures up images of grim urban poverty and city congestion, with pollution far worse than elsewhere in the country. As I found out, the experience is an altogether different one if you have a chance to live and work here.

History and people

Calcutta has a reputation for being something of a cultural Mecca. There was a prolific Bengali renaissance movement in the arts here during the 19th century, and a Nobel prize winning writer, Rabindranath Tagore, as well as a renowned film maker, Satyajit Ray, both come from Calcutta. During my stay here I attended several concerts where Indian classical music was performed, theatrical productions and gallery exhibitions. West Bengal is also known throughout the rest of India as being a friendly and welcoming place. I definitely felt this during my one month placement here.

Health care

There are several university and government hospitals providing health care to all. Wealthier people tend to go private as the conditions in these hospitals can be terrible. There are also many private practitioners in the city who can admit patients to these hospitals as well as see patients in their own chambers.

For poor people, primary and preventive health care is increasingly being provided by the growing number of non-governmental organisations in Calcutta. These are independent charitable organisations that are able to provide community oriented health care specifically designed for the people they hope to serve, and without much intervention from the government. This means that they can often operate in otherwise taboo areas such as sexual health.

Another interesting aspect of health care in India is the widespread use of treatments that would be considered "alternative" in Britain. Medical students in some Indian schools must complete short units on homo-eopathy, and leading research and teaching institutes in India are promoting evidence based yoga and a yogic lifestyle in the management of heart disease and diabetes.

Some practical advice

If you plan to do your elective at one of the teaching hospitals you should apply well in advance. Allow plenty of time as the medical school must then approach several bodies, including the Medical Council of India, in order to gain approval.

My elective with the Indian Institute of Mother and Child was initially arranged through the internet, as described overleaf.

General risks

Immunisation against tetanus, typhoid, poliomyelitis, and hepatitis A is recommended regardless of your location on the Indian subcontinent, as is malaria prophylaxis. All water should be regared as potentially contaminated and should be boiled or sterilised. Eat only well cooked meat and fish, preferably served hot, if you want to avoid India's most common travel complaint, traveller's diarrhoea. Pork, salad, mayonnaise, and ice cream tend to carry an increased risk. It might be a good idea to travel prepared with antidiarrhoeal drugs and rehydration sachets, just in case.

Cholera is a serious risk in India, and precautions are essential. Up to date advice should be sought before deciding whether these precautions should include vaccination as medical opinion is divided over its effectiveness, although a vaccination certificate is not a condition of entry into India. Some general practitioners strongly advise vaccination against yellow fever, although this may not be essential if you have not travelled from a region where yellow fever is endemic. Try to avoid sandfly bites--they may lead to sandfly fever, which is on the increase in India. Those intending to stay for a long time should consider immunisation against diphtheria, meningitis, and hepatitis B, and check their BCG status.

Visas

A three month visa for India costs £13 and can be obtained on the day of request if a medic is travelling to one of the Indian High Commission's designated hospitals. If the hospital that you have chosen for your elective is not on the approved list, you may have to wait for a week to three months for a visa. The telephone number of the Indian High Commission is 020 7836 3677. To find out whether your hospital is on the approved list, ring 020 7836 8484, ext 287.