A Patch Adams prescription

A pioneering project to view medical treatment and education through the lens of gender is underway in Maharashtra.

Aurangabad-based Dr. Sonali Deshpande comes across as unusually candid when she says that until recently she, like many other doctors, wouldn’t venture beyond obvious clinical concerns when she saw patients. So, if a woman with a bandage wrapped around her hand consulted her for a headache and nausea, she would only inquire about that, and ignore the bandage. In the last six months, however, much has changed. “Earlier, I wouldn’t pay attention to the vague complaints some women made. But I can now sense domestic violence,” she says.

Dr. Deshpande, associate professor at the Department of Obstetrics and Gynaecology, Government Medical College (GMC), Aurangabad, completed her MD in 1999, but was introduced to the concept of gender only recently when a project was rolled out in a bunch of medical colleges in Maharashtra and educators were told, for the first time, to see women’s health through the lens of gender.

Through the gender prism

Faculty from six government and one private medical college were trained and a pilot project is currently underway in the government medical colleges of Aurangabad, Miraj and Ambajogai where third-year MBBS students are being taught to consider how societal norms often weigh heavily on women’s health.

In practice, it is turning out to be a Patch Adams approach with a gender twist. “I would often chide women seeking an abortion more than once and ask them why they didn’t use contraceptives,” says Dr. Shrinivas Gadappa, professor of obstetrics and gynaecology at GMC, Aurangabad. “I had no idea about gender, apart from the male and female. At the gender training sessions, we were told that repeated abortions are possibly indicative of sexual violence,” he says.

In February this year, when the Centre for Enquiry into Health and Allied Themes (CEHAT) launched its pilot project on Gender in Medical Education programme along with the Directorate of Medical Education and Research (DMER), Maharashtra University of Health Sciences (MUHS) and the United Nations Population Fund, it was the first practical attempt ever made at adding the gender perspective to medical textbooks.

“It was to increase the sensitivity of doctors when dealing with women patients,” says Padma Bhate-Deosthali, coordinator, CEHAT, adding that they have built on the work done by the Sri Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, which had assigned senior people to review medical textbooks in 2005.

Importance of being humane At the end of the pilot project in July, a report will be submitted to the MUHS, and if approved, the gender perspective will be woven into Maharashtra’s MBBS curriculum.

“This will remove gender bias from syllabus of medical colleges,” says Dr. Pravin Shingare, director, DMER, adding that certain sentences in medical textbooks need to be completely reframed. “Poor nourishment of a baby is blamed on women not preferring to breastfeed,” he cites as a case in point.

“Women are often scolded if they miss an immunisation dose for their child. But we try to factor in how difficult it is for the mother to come,” says Dr. Priya Prabhu, associate professor, community medicine, Government Medical College, Miraj, Sangli.

But given the workload of doctors in the public health-care system, how possible is it to be sensitive to each patient? “It is not about the workload,” says Dr. Prabhu, adding, “a humane approach doesn’t need time, only instinct.” She suggests an empathy test for medical school aspirants. A Patch Adams prescription?

roli.srivastava@thehindu.co.in