Sun Life Financial Osler Global Health Team Blog

Day 15: Homeward Bound


Well, it is here. Our last day on the 2017 Global Health Tour.

As the reality hit, a sense of melancholy went through our team, which has grown incredibly close over the past 17 days. Working, travelling and basically living in close quarters in a foreign country makes for quick and lasting friendships. We learned more about each other in this short period than most colleagues do over a span of many years.
Read more
The drive to the Karachi airport was slow, as we hit Friday night traffic. Our usually rambunctious and loud team remained silent; a few people slept, a few were lost in their thoughts about what we had seen, smelled, shared and experienced over the past two weeks.

If you have attended one of the Global Health Tour events, you have heard from earlier teams that this incredible experience is ‘life-changing’. The 2017 team would wholeheartedly agree. The learning is incredible. The experience in better understanding how care is delivered is extraordinary, and meeting health care leaders who deliver great care with so little is eye-opening. This year’s exploratory tour into the slums of Karachi – a place tourists would not venture - has made an imprint in our memories which will stay a lifetime.

We have so much to be thankful for here at Osler, and so much that we can offer, give and learn from health care providers in India and Pakistan.

As we reflect on the last few weeks, consider recommendations about new and existing partnerships and plan for the year ahead, we are excited by the opportunities for the 2018 Global Health Tour team.

In the meantime, team member Parul Giare discovered this video made by another visitor. The team agreed that this gives a flavour of our experiences in India:

The 2017 Global Health Team will be sharing our experiences at lunch and learns on May 3 (Brampton Civic) and May 10 (Etobicoke General).

The 2017 Global Health Team returned home on Saturday, April 8, 2017.

Day 14: the home stretch


Today, we are visiting Childlife Foundation’s Paediatric Emergency Departments.  It's also our last official day of exploratory meetings in Karachi. And, we all realize, almost our last day on the Global Health Tour!
Read more
Childlife Foundation is a not-for-profit organization that operates free emergency departments at three Karachi hospitals: Civil Hospital, National Institute for Child Health and the Sindh Government Hospital (slated to open later this month). This is done along with its sister organization, SINA Trust which operates 17 Primary Care Clinics (including the Momin Adamjee Centre, which we profiled yesterday).  They also run a preventative health program. Together, these organizations have created a framework for health care delivery in a country where the health care “system” is virtually non-existent for the poor or disadvantaged.

Childlife was established five years ago and, along with SINA, treats more than 1 million patients every year, with three emergency rooms caring for 1,230 patients each day.

It is a very professional organization focused on delivery of quality care with standardized practices and protocols, and best practice treatment plans for the most common patient populations that present at the emergency room. It provides critical care to more than 500,000 patients a year.

Our first stop was the emergency room at the Civil Hospital. We toured the facilities and were surprised to see the organized system at work. From the point of registration to triage and then pharmacy, the patients and families (usually mothers, fathers, and grandmothers) waited patiently to be seen. The organization, the processes and procedures, and the quality have positively impacted the patient access and flow, and helped build trust. There was a camera in the emergency room livestreaming to the head office teleresus room where a physician could view and offer immediate support.

Next we visited the National Institute of Child Health. Walking through the NICU was difficult for many of us, but helped put things into perspective. We saw four babies in one crib as space is always an issue. Resources are limited and they have to do a lot with what they have. There are no ventilators so mothers have to pump air into their child’s lungs (bagging)!

As we left the building we passed through a tiny indoor play area where children played with each other under the watchful eyes of their parents. Parul Giare, our Acute Mental Health nurse had brought a large bag of candy, and the entire team handed it out to the children.

We then visited the head office to see the teleresus room and saw firsthand how the process worked to improve efficiency and quality of services. The Childlife team had a short presentation and we saw the before and after pictures of the departments we had visited. We were impressed by the change they have been able to create for the underserviced community of Karachi.

A brief visit of the Aga Khan University Hospital later in the afternoon showcased the ‘tale of two cities’ aspect of Karachi. The site, established in 1985, is a private, not-for-profit institution that serves as the primary teaching site of the Aga Khan University’s Faculty of Health Sciences and offers a broad range of secondary and tertiary care for a fee. The quality of services and facilities was top notch.

We ended our last official tour day with a formal dinner and discussion of potential partnership opportunities with the Chairman and board of Directors of Childlife Foundation at the beautiful Sindh Club.

Tonight we pack and prepare to head home tomorrow!

Day 13: Exploring possibilities with SINA


Today we began the exploratory leg of our Global Health Tour – meeting with two NGOs in Karachi.

Our early morning drive from the hotel to SINA’s Momin Adamjee Centre was beautiful – a mix of ancient and modern architecture, lots of greenery and parks, and surprisingly a fairly quiet drive – no horns honking to indicate traffic. It was surprising for all of us on the team who had never visited Pakistan before, and a direct contrast to what we see in the news in Ontario. It was also reflective of a middle and upper middle class section of a city with 22 million spread over a huge geographic footprint.
Read more
As we travelled into the less prosperous areas, the landscape shifted and we saw more people on the streets, more street vendors, bicycles and horse - and donkey - pulled carts. We eventually made our way to one of Karachi’s poorest slum areas – the Shirin Jinnah Colony - where we visited the Momin Adamjee Centre’s Jinnah Clinic. Operated by SINA Trust, this is the largest privately-funded not-for-profit primary healthcare system in Pakistan.

Home to about 400,000 people, the vast majority in the Shirin Jinnah Colony live below the poverty line in Pakistan. Families of five or six are supported by a single male who works in manual labour or at Clifton Beach, a local beach nearby catering to tourists. They usually earn between $2-3 per day.

The primary/community care clinic is located in the heart of the colony, and the building is a stark contrast to the surrounding buildings.

The chaos, noise and busy-ness of the street transforms to calm and order once you step inside the clinic. Patients are triaged and wait patiently for their number to be called. SINA Trust operates 17 clinics in the poorest areas of Karachi, and only in places where more than 70% of the catchment area live below the poverty line. About 80% of the patients served are women and children.

SINA Trust focuses on delivery of primary and preventative care. They emphasize access to care, quality of care and standardizing processes to ensure best outcomes. We were also surprised to learn they measure patient satisfaction both via text and phone surveys. While they are hoping to collect significant data via text, the high level of illiteracy makes it difficult, and phone contact receives a higher completion level.

These are impressive health care operations with a homegrown electronic medical record, which provides real-time patient information throughout the clinic. More specifically, health information follows patients as they move from registration to triage to physician assessment and treatment to pharmacy. This new system was implemented just a few months ago and provides tremendous opportunity for research and health population data collection.

We visited Clifton Beach on our way back to the hotel and got to see how some of the people living in the colony made their living. There were camel drivers, horse drivers, and young guys on ATV’s offering their services. Off in the distance, we saw fishermen traversing the rough waters of the Arabian Sea in search of their next catch.

Our day ended with a formal dinner with the Board of Directors of SINA Trust at the Karachi Boat Club where we discussed the possibilities of partnership.

Tomorrow is our last official day of the Tour as we visit Childlife.

Day 12: Up and down, and up, up, up!


After our incredibly amazing and exhaustive day in Agra yesterday, we got ready for another full day of travel. Today we say goodbye to India and continue our journey to Karachi, Pakistan.

Chiranji has greeted us every (early!) morning with a huge smile and a cheerful ‘hello’ and has been just as cheerful dropping us off at the hotel every night. He drove us to the airport in the trusted tempo.

Read more
We reminisced about our overwhelming experiences, learnings, and the wonderful people we met in the packed flight from Delhi to Abu Dhabi. We had time to get a quick snack, get some work done, and check-in with loved ones during the stopover in Abu Dhabi.

Although it is only a 90-minute direct flight from Delhi to Karachi they only operate a few days a week, and we flew on an off day. This meant we went from Delhi to Abu Dhabi, and Abu Dhabi to Karachi – 4.5 hour flight and with a two hour stop over – making about a 9 hour day of travel from the time we left the hotel in Delhi to arriving at the hotel in Karachi.

We landed in Pakistan and were greeted by Dr. Naveed Mohammad. He was so happy to welcome us to his hometown. On the drive to the hotel he pointed out landmarks and briefed us on the work that he and Ron Heslegrave had done.

It was a long day of travel, but we are excited to begin our work tomorrow.

Day 11: The majestic Taj Mahal


While seven members went to visit the Taj Mahal today, Dr. Amlan Das headed home to care for patients, and Dr. Mohammad and Ron headed to Karachi, Pakistan. It was sad. Our team of eight had become very close after spending the last eleven 18-hour days together.

One of the privileges of being on the Global Health team is the opportunity to visit Agra and one of Seven Wonders of the Modern World.
Read more
Like all tourists, we were amazed by the size and grandeur of the Taj Mahal even as we made the journey in 42C temperatures.

Sitting on the banks of the holy Yamuna River, the Taj Mahal was commissioned in 1632 by Mughal emperor Shah Jahan as a tomb for his favourite wife, Mumtaz Mahal,and was completed in 1643. Beautiful marble (some of it coming from as far away as Italy) and inlay stones of jade, jasper, and lapis lazuli from around the world (Afghanistan, India, and Persia) decorate the interior, interspersed with verses from Shah Jahan’s favourite Surah (chapter) of the Qu’ran.

We arrived back at the hotel at 8 p.m. – a mere 14 hours after leaving Delhi.

Next we are off to Pakistan to visit Childlife. Stay tuned!!

Day 10: The team takes a breather on the way back to Delhi


After two days of Medical Camps in Sarabha village it was time to leave Ludhiana and travel back to Delhi. With at least a five hour drive ahead (totally traffic and livestock dependent), the team was up at 5 a.m. with the Tempo on the highway by 6 a.m.

The ride started quiet with a few of us still exhausted from triaging, assessing and dispensing medications to as many as 500 patients over the last two days. Some of us were suffering with upset stomachs, and some were just reflecting on our time at Dayanand Medical College and Shaheed Kartar Singh Sarabha College of Nursing in Sarabha.
Read more
The drive was relatively quiet with only one herd of oxen and one seeminglyly abandoned overturned transport slowing us down along the way. None of us even blinked an eye at the myriad of traffic with bicycles, Tuk Tuks, motorcycles, scooters, cars, buses and trucks of all sorts (from three-wheeled to the lorries) filling the roadway and moving in a state of chaotic order.

We arrived in Delhi mid-afternoon where Dr. Naveed Mohammad, VP Medical Affairs and Sun Life Financial Global Health Program co-lead, and Ron Heselgrave, Director of Research were waiting for us after attending the Canada India Health Care Summit 2017. You can see Dr. Mohammad's presentation below!

After a brief stop at the hotel, we grabbed a meal, and did a quick driving tour of parts of Delhi, including India Gate and The Red Fort. Then duty called as we had a few meetings. But before heading back to the hotel, we drove through Old Delhi to see the outside of the Jama Masjid.

Old Delhi is hard to describe – it is a mix of vibrant street life full of food vendors, street merchants, pedestrians, and all types of vehicles filling the streets. It is also a stark reminder of India’s socioeconomic extremes, with luxury vehicles driving only inches away from men, women and families living and sleeping on the sidewalk on mats, cardboard or the dirty bare cement. It was heart-wrenching, and yet a reality in a country which is a contradiction of high tech businesses and a backbone of manual labour.

For the team, it was a moment to pause and reflect on the value of the Sun Life Financial Osler Global Health Program and Osler’s Vision: Patient-Inspired Health Care without Boundaries.

Day 9: SKSS diabetes and education camp shows no signs of slowing down

As our second day at SKSS wrapped up, we ended up seeing about 500 patients over two days!  Today, we saw 267 diabetes patients and handed out 68 glucometers.  Our days were focused on helping a community with treatment and education for long-term self management.  This will make sure that change is sustainable with our patients!

Also, a shout out to our new partners, Sun Life Financial who helped fund this camp.

Our vlog today is a little special - we went around to all of our team members so they could each say a piece. This is the first time you'll be hearing most of their voices! Plus, bonus messages from the people we've been working side by side with over the last two days.

Day 8: A hectic first day at the SKSS medical camp


We mentioned in our last blog that when the previous team visited the SKSS medical camp, they saw 500 patients over two days, so we were bracing ourselves. Day One for us didn't disappoint, with 225 patients seen. We figured instead of writing about it, we'd take you through the entire process a patient would go through to experience the journey first hand. Watch our video blog below, with pictures after the jump!

Read more

Day 7: Sharing knowledge with nursing students


After a stressful morning trying to make photocopies at the hotel Business Centre and leaving late, our honorary 2017 Tour team member Chiranji, with our trusted Tempo Traveller, used his navigation and back route superpowers to get us the SKSS with five minutes to spare!
Read more
The team started its day the same as the rest of the students - in the Gurdwara from 9 to 9:30 a.m. with prayers and singing hymns.

A formal welcoming of the 2017 Osler Global Health team included singing the school song, formal remarks by Madame Principal Mahal and the College Chairman, followed by the presentation of a bouquet of roses to each team member. The team then joined with the college dignitaries in a Diya (lamp) Lighting Ceremony.

Then the Team got to work lecturing on topics like mental health and addictions, suicide prevention, community outreach and diabetes, hospital electronic and referral systems, and even nomophobia, which is the fear of not having access to your mobile phone or social or digital media.

To enhance student understanding and awareness, team members presented in a mix of Punjabi, Hindi and English. It was refreshing for the team members to present in front of a room of students who were engaged, focused and truly interested in hearing what we had to say.

It was another amazing day! IWe learned from the Madame Principal Mahal that SKSS has been marketing the Medical and Diabetes camps for a few months and they are expecting a good turnout of patients during our visit.

The day ended with an upbeat dance performance by four Year 3 and 4 nursing students, which left us all energized for the day ahead.

Knowing that the 2016 Global Health Team served more than 500 patients in two days at the camps last year, the entire team is somewhat anxious of what we will see over the next two days. For the first time since the trip began, everyone is going to bed early to ensure we are physically and emotionally prepared for the village camps.

Good night!

Day 6: Farewell to DMCH for now; Hello SKSS!


Wednesday was a transition day. In the morning we provided our observations, recommendations and collaboration ideas to the Medical Advisory Committee (which is a committee of key leaders including medical and nursing leaders) at Daynand Medical College & Hospital (DMCH).

After two and half days of spending valuable time with our medical and nursing partners at DMCH, the quality of those conversations – the frankness, the sense of inquiry, the debate and collaboration – was evident in the alignment of the DMCH and Osler presentations. It was clear early in the two hour closing meeting that the emergency medicine, psychiatry and nursing leaders at DMCH and the Osler Global Health team were completely aligned in identifying the focus of our continuing partnership.
Read more
This year, we also agreed to have regular progress reporting on the initiatives we have committed to. For DMCH, this represents a mix of operational and academic pursuits; for Osler, it means implementation of some of our service quality commitments such as a Family Presence Policy.

Along with the important new relationships we have forged, our shared commitment to research projects and finding ways to implement evidence-based quality improvements is a key priority for both organizations. We also have made strides in working together to serve our shared patients by agreeing to move forward on Care Beyond Borders. This is where patients needing ongoing regular care can be referred to either organization (depending on which country they are visiting). In all cases, patients will be notified that they will need to have insurance in order to access care within the other country.

The team was also thrilled to hear that the DMCH Psychiatry Department would be sending two residents to support our Medical Camp on March 31, 2017, which focuses on mental health and addictions.

Osler and DMCH have also agreed to have monthly/bi-monthly meetings to ensure we build upon the momentum from the past few years, reignited over the last few days.

Farewell DMCH; Hello Sarabha

Chiranji and the trusted Tempo Traveller whisked us from Ludhiana to Shaheed Kartar Singh Sarabha College of nursing (SKSS) in Sarabha. During the 30 minute drive we saw lush green wheat fields, small villages and road side stalls that lined the way. Beautiful.

We started our Sarabha visit meeting with the Madame Principal Mahal and former Chairman Mr. Avtar Singh Grewal. If we haven’t mentioned it yet - each time we meet a partner, sit to discuss an issue, or just take a two minute break in the midst of what are incredibly jammed pack days – we have tea! Sweet, milky, hot and delicious and something sweet. As it is an important sign of respect and friendship it is not appropriate to decline, which means that some days we are having anywhere from five or more tea breaks!

SKSS, a charitable hospital built in 2001, serves upwards of 100 outpatients a day from the surrounding villages. It offers surgery, nursing and dental, ayurvedic medicine, gynaecology and regular paediatric services. The nursing college, which opened in 2006, has 150 students per year enrolled in the BSc, MSc, and GNM programs.

The Village

Following our visit at the SKSS, we toured the village with some of the professors. We started by visiting the local Gurdwara to show our respect, toured the home of Shaheed Kartar Singh Sarabha, and then had a meeting with the Sarabha village Panchayat and one of the members of the Council of Five. Meeting with the Panchayat, like drinking tea, is also customary in a culture where formal structures and demonstrating respect are critical to developing relations.


Finally, shopping!

For all of us members of the Global Health Team, it is hard to believe we have not ventured out to the local areas to shop in the first six days of our tour. While it was reinforced during the information sessions and pre-tour briefings that the days would be long (7 a.m. briefings, and late evening 8-9 p.m. post-day briefings) followed by blogging, videos and answering work emails – it is hard to believe until you are actually involved on the ground in Punjab. So, to be able to spend a night out seeing the real India was amazing.

Accompanied by two young, enthusiastic and super-shopper teachers from SKSS, we went to a market called Ghumar Mandi. It was a vibrant busy street in Ludhiana where a sea of colourful fabrics, appetizing street foods and the sights and sounds of the non-tourist areas amazed and delighted us – especially those team members who have never visited Punjab before.

After visiting various shops, being offered tea, water and other refreshments and viewing hundreds of different options, all tour members found something perfect for themselves or their loved ones! Success!

Now for a good night’s sleep. All tour members are spending Day 7 lecturing to the nursing students at SKSS!

See you tomorrow!

Day 5: Lots of learning and some familiar faces


While Susan, Amarjit, Dr. Haider, and Dr. Pede were observing their counterparts in the emergency department, the Mental Health team of Dr. Das, Parul, and Carrie, along with yours truly, were with DMCH’s Psychiatry team.

We were excited to see the team of nurses and medical residents, led by Psychiatrist Dr. Ranjiv Mahanjan, to continue our collaborative work.

We shadowed the team and observed their processes and procedures, and joined Dr. Mahajan on his rounds. We were struck by the integration of the family in the provision of care. There is one family attendant for every patient, at all times!
Read more
Parul and Carrie spoke with some residents and nursing staff to gauge not only the scope of practice but to understand what they hoped to gain from our visit. The nursing team was interested in implementing some of the processes, especially group counselling and activities for the patients.

After the rounds we joined Dr. Mahajan for his outpatient sessions and we had the chance to observe ten patient interviews.

We even met someone from back home in Brampton! When he heard that our team was from Osler, he broke out into a huge smile. We know that many of our patients spend the winter months in Punjab and then head back home for the summer. It highlights the need for collaboration and partnerships like ours, and seeing him really drove home the point of the Global Health tour for all of us. We share similar goals and a similar (sometimes even the same!) patient population!

Dr. Mahajan is a passionate champion for mental health. He spoke to us about the opportunities for growth in psychiatry in India and the implications of the proposed Mental Health Act in the years to come.

In fact, the following day the Mental Healthcare Bill passed in Indian parliament! The Mental Health Act decriminalizes suicide in India and gives the right to access mental health care and treatment from government-funded health services.

Dr. Das highlighted the practical implications and opportunities of the Mental Health act in his presentation to the DMCH medical residents.

Carrie continued her work with the residents. Parul’s demonstration of the Pinel restraints we brought from Osler was well-received by mental health team at DMCH.

Meanwhile the emergency team felt right at home in busy the Emergency Department, and then toured the Labour and Delivery Unit and the ICU floor. DMCH has an entire Intensive Care Units floor that incorporates all the critical areas.

We had a very busy day of observing and learning. The opportunities for knowledge exchange have been invaluable. We are looking forward to our presentations tomorrow!

Day 4: Focusing on Emergency Medicine and Mental Health and Addictions at DMCH


Today the Global Health Tour team visited Dayanand Medical College & Hospital (DMCH) in Ludhiana, India. We split into two groups to focus on our clinical areas – emergency medicine and mental health and addictions. Each group toured with our clinical partners, observed patient interactions and learned about patient triage, assessment and care planning.

DMCH is a 1,300 bed tertiary teaching hospital in the centre of Ludhiana with clinical specialties in cardiology, oncology, internal medicine, neurology, general surgery and urology among others; emergency medicine is an emerging program that the hospital is working on developing as a specialty. It is known as among the top medical teaching centres in Punjab, and one of the top 10 within India with 4,000 employees and more than 200 physicians.

Today our blog focuses on the experience of the Emergency Medicine team.
Read more
Emergency Medicine
Our day started with observation and program assessment in the Emergency Department where we learned that DMCH is in the process of beginning to move from paper-based to electronic medical records. Most patients are brought to the ED by their family; veryfew arrive by ambulance. Whether brought by ambulance or family, patients are immediately triaged by a physician – the files we reviewed had the Physician Initial Assessment (PIA) time listed as about 5 minutes. While the physician (called consultant here) does the triage, medical residents conduct and document the medical history. Organized into different areas (cardiac, surgical, medicine, paediatrics), the open-style emergency room is also staffed by physician specialists (called ‘super specialists’) who assess and assume care for the patient immediately upon entry to the emergency department.

Some of the things we can learn from DMCH include:
  1. The model of physician triage on the stretcher in the ED: this alleviates patient and family concerns and ensures care begins immediately;
  2. Timely access to specialist care in the ED and the subsequent diversion of patients, where medically appropriate, from the ED to an ambulatory outpatient clinic: and
  3. Benefit of further development of a robust medical training program to facilitate flow within the hospital.

 Intensive Care Units

With 120 ICU inpatient beds, DMCH is the largest provider of ICU care in the Punjab. Specialised ICUs include stroke, pulmonary, neurology, surgical, paediatric, burn units within the hospital. Units are staffed by nurses and residents with the nurse to patient ratio similar to Osler’s with one nurse for every two patients. A family member is also present at the bedside 24-hours a day to support the patient. Each unit has one computer on the nursing station in the middle of the open unit, with documentation being manual and completed mostly by residents.

The ease of transfer between the specialized ICU units facilitated patient flow throughout the organization.

As you can see it was a busy day! And the work – and opportunities for collaboration -- is just beginning.

Tomorrow we will share the Mental Health and Addictions team’s experience at DMCH, so stay tuned!

Day 3: Our first day at DMCH and finding a bit of home away from home


Today we left Amritsar and headed to Ludhiana.

Ludhiana is the larger of the two cities, and combined, they are home to more than 2 million people! The distance between them is a mostly rural area, or what my dad calls “the real Punjab”. It reminded us of home actually. While we don’t have the same numbers, our own region is similar in this way.
Read more
At home, we have Brampton, Etobicoke and Dufferin County -- a catchment area that cares for a large rural and urban population base with many Punjabi families.

In Ludhiana we met with our partners at Dayanand Medical College & Hospital (DMCH). DMCH is a tertiary centre and a Medical College. With 1300 beds it is the largest private, not-for-profit hospital in Punjab with 14 superspecialites, including, cardiology, plastics, urology, neurology, nephrology, cardio, GI, endocrinology and emergency medicine.

We had already ‘met’ during our early morning Skype meetings during the preparation phase, but this was our first official face-to-face meeting. After the meeting with the senior leaders, we were given a tour of the Mental Health facility and the emergency department.

Tomorrow we will be observing and shadowing our Indian colleagues. We will be breaking off into two teams – one team for the Mental Health area and one team in the emergency department.

If you followed last year's Global Health team you've got some idea what to expect. If this is your first time following, it's a blog you won't want to miss as we get down to work with our partners -- and now friends -- to identify ways to help improve the patient experience here and back home. We're looking forward to the chance to keep learning from each other as we continue our journey here.

Day 2: Moving "beyond borders" in Amritsar, Punjab


After a stop-over in Delhi on Day 1, we arrived in Amritsar, a city with a population more than 1.2 million people, and part of a bigger district area topping out at more than 2.5 million people.

The city core is bustling with every mode of transportation imaginable -- trucks, cars, taxis, rickshaws, motorcycles, bicycles, horse-drawn carts and, of course, people on foot. Along with pedal-powered rickshaws there are also motorized rickshaws which transport locals and visitors throughout the city.
Read more
Our plan for Day 2 was to visit the Golden Temple, Sikhism's holiest shrine and symbol of brotherhood and equality. Everyone, of any religion, can seek spiritual solace and religious fulfilment at the Gurdwaras and seat of Sikhism by washing in the clear, cool, blue waters at the temple.

Like any well-laid plan, it didn’t go quite as expected. Chiranji and our trusted Tempo Traveller picked us up at the airport and whisked us to the hotel to check in and then we were off again immediately for the Golden Temple. Being Saturday, the roads were clogged. Despite dedication and determination, we had to park the Traveller – leaving Chirinji behind -- and take a motorized rickshaw to make our way to the site. For those of us who have never been to India it was a once-in-a-lifetime experience. Complete traffic chaos, traffic jams, and a few heated tempers. Team member Dr. Leili Pede describes the journey.

As a Global Health Team, we visited the sacred Golden Temple to demonstrate our respect to our partners in the Punjab, a deeply moving experience for us all. The Temple is more than 400 years old, and it is estimated that during its busiest time more than 100,000 people visit daily.

Finally, we went to the Wagah India-Pakistan Border Ceremony, the nightly ceremonial closing of the border between India and Pakistan. The day we went there must have been easily 10,000 people on the India side of the ceremony, and while we were not able to see the other side completely, there were almost as many on the Pakistani side.

The border closing ceremony was a magnificent feast for the eyes, ears and senses as the guards from both India and Pakistan put on an amazing show, even if at the end of the show both sides return “triumphantly" to their own sites.

It was a fabulous Day 2! We can’t wait to see what Day 3 has to offer as we travel to Ludhiana to meet with our partners at Dayanand Medical College and Hospital.

Day 1: Arrival in India and greetings from the team


The Global Health Team has landed in India!

We are tired, but even after a cumulative twenty hours of travel our level of excitement for the Global Health tour has increased exponentially!

In fact, the long journey from Toronto to Delhi, with a stop-over in Abu Dhabi, gave us a lot of time to share our reasons for joining the Global Health Tour.
Read more
We bonded through sharing stories (and the occasional armrest space!), interpreting for each other, and making sure everyone was accounted for at every leg of the journey. It has strengthened us as a unit.

This year’s team includes:
  • Susan deRyk, Senior Team Lead role
  • Dr. Kamil Haider, Emergency Medicine Physician role
  • Amarjit Dhillon, Emergency Medicine Services Nurse role
  • Dr. Amlan Das, Mental Health & Addictions Physician role
  • Parul Giare, Mental Health & Addictions Nurse role
  • Carrie Woodcock, Mental Health & Addictions Social Worker role
  • Dr. Leili Pede, Family and Emergency Medicine Physician, clinician role
  • And me, Sundeep Hans, the Tour Coordinator this year

I also want to introduce a very important member of our team, Mr. Chiranji, seen here throwing up a peace sign! He has been our driver and our on the ground support since the very first Global Health tour. He has been helping us as we prepared for the trip by sharing pictures and interesting facts.

We’ve had an extremely long day one, but we are geared and ready for day two!

Resource Center

Helpful links to the most useful lists and forms for health professionals.

Connect with Osler