Sonesh Surana
PhD Researcher
University of California at Berkeley

We interviewed this patient at the Ambasam Vision Center. He used to work as a contract painter regularly before his eye problems set in. At the time of this interview, it had been only 29 days since surgery [he was referred from Ambasam]. The doctors said it would take about 60 days for him to fully recover sight. Among other things, he mentions that during follow-up visits at Ambasam, it was nice to talk, via video, to the same doctor who had performed surgery on him. He also talks about the expenses involved in going to Theni.

I: Grandpa, tell us your name.

P: My name is Krishna Ramanujam, T. R. Krishna Ramanujam.

I: How old are you?

P: 69.

I: How many people are there at home?

P: At home two girls and two boys and then my wife.

I: Are your daughters married?

P: Yes, all of them except one son are married. Only one son is left.

I: So how many of you stay at home?

P: Just two of us.

I: Two of you. You and your wife?

P: I and my eldest son.

I: Just you and your eldest son?

P: All of the others have left for work. They are all married. Only this son is not married.

I: How many kids?

P: Two and two.

I: Who are you staying with?

P: My son and I. Just the two of us. And my wife.

I: Do you go to work?

P: I used to go to work. Nowadays I dont. I used to go

I: Please talk louder grandpa

P: I used to go to work. But now I dont go.

I: Okay, so you are not working now?

P: Yes, I havent gone to work after my eye operation

I: You stopped going after your eye operation?

P: Yes, I used to work as a painter.

I: When was your operation done?

P: It has been 29 days now. The operation was on a Thursday

I: So you used to work before the operation?

P: No, I havent gone since the operation.

I: But you worked before?

P: Yes, I did. Even 10 days before the operation I was working.

I: How many days in a week did you normally work?

P: Only 5 or 6 days a week.

I: 5 or 6 days?

P: Yes.

I: From Monday to Friday you work? Daily?

P: Yes if there is work.

I: So it depends on work availability?

P: Yes, if I get work I would go. Otherwise I would stay at home. We would go to Theni for work; if we get work here, we would work here.

I: Okay. Where is your house grandpa?

P: What?

I: Where is your house?

P: Next street, it is in the next street. Second street from here, the house is the second house on that street

I: Second street from here. So it is nearby?

P: [Unclear] This lady stays in that house. Next house is ours.

I: Alright. Do you have your own vehicle?

P: What?

I: A vehicle like a moped or a bike?

P: I dont own a vehicle. My eldest son has one. My younger son is in Madras.

I: Okay

P: Yes, he works there. He works with the government on something to do with the eye.

I: Really?

P: Yes, he works in the hospital there. [He names the hospital, but I cannot understand it]

I: Okay.

P: One daughter works as a teacher. In Nagallapuram.

I: Nagallapuram?

P: Yes, in Nagallapuram. The other daughter is at Mayiladdumpparai. She is at home only. They have [some kind of trees, but I cant figure out what tree or crop he is talking about]. My son-in-law is back now. He was in Dubai.

I: Okay. This eye center here how did you come to know about this?

P: Yes, the video is very clear. I could see people clearly and hear them talking [Strange answer - perhaps, he overheard us asking the vision center nurse if we could interview some patients about the quality of video-conferencing theyve been experiencing].

I: Okay, so how did you come to know about this eye center?

P: This center is very convenient. It also looks very nice.

I: It is very nice.

P: Yes, very convenient for people to come by bus.

I: So you have known about this center from the time this started?

P: Yes, I live here. I knew about this. After my operation, I sit here for a long time daily and then only go home.

I: When was the first time you came here?

P: I came here 40 days ago. Before that once in a while, we would come here to get an eye check-up. We have been coming here since this center started.

I: So you have been coming here since 2004? 2 years ago?

P: Yes. I even tell people from the neighboring town to come get their eye check-up here.

I: So why do you come here? You could go to Theni maybe?

P: Theni is not so near. If we go all the way to Theni, we will have to spend more. Here, it is nearby.

I: You come here because it is near?

P: Yes, the expenses come down as it is nearby.

I: Okay.

P: If we go there, we might end up eating there and then there will be other expenses, we would have to spend some 20 30 rupees. Now all that money is saved. The facilities are also good here. I will go to Theni once I get the receipt. I will go there tomorrow. They have given me a referral there. So I will get the receipt and go.

I: So you cannot come here once you start going to work?

P: Yes, if I work, I cannot come here.

I: So what will you do once you start going to work?

P: We will come the day we are off. Our rest day, we will come here then.

I: Have you ever missed work to come here?

P: I come here after work. I have come here after work.

I: But have you ever missed work to come here?

P: I come after work.

I: Have you ever taken a loss because you had to come here?

P: No, no. No loss in coming here. We have only gained.

I: But your work.

P: No, there is no loss in coming here.

I: So you come here alone?

P: Yes. To Theni also, I go alone. No one comes with me. For my operation, I went alone. No one came with me.

I: So do you think this is convenient or going to Theni is convenient?

P: For important things, we go to Theni. For the operation, we go to Theni. Otherwise we will see the doctor here.

I: What is difficult about going to Theni?

P: We have to take a bus and go there no? It is tiring. If referred, we will go there. If it is something very important and cannot be done here, then we will go there. If it can be done here, we will get it done here.

I: What other issues do you have in going to Theni?

P: I go there to get eye checked, sometimes for glasses and when it is important, we go there. Otherwise we can talk to the doctor from here through video.

I: Yes, if you have to go there, there is bus charge and other expenses

P: Yes, if we come here, that is not there. [Says that he goes to Theni when referred]

I: Suppose this vision center is not there, what would you have done?

P: If this is not there, we have to go to Theni. Yes, we would have to go to Theni then. I have gone to Madurai for checkups before, to Theni also. If I go to there, I have to stay there one day and then come back.

I: How far is Theni from here?

P: Theni hospital is 7 kms from here. Theni is 6kms [to the bus stand] and then 1 km to the hospital [Its actually 11kms].

I: So you have to go 8 kms? [Interviewer seems to have added 1 km!]

P: Yes, 8 kms [and the patient agrees!].

I: 8 kms there and 8 kms back?

P: Yes. It takes 12 rupees to go there and come back.

I: 12 rupees ticket charge? So it is 6 rupees from here to there one-way?

P: Yes, 4 rupees to the bus stand and the 2 more to the hospital. So it is 6 rupees to there and another 6 for the return journey, it will be 12 rupees.

I: It will be 12 rupees. So you can just pay 10 rupees here and get a check-up done?

P: Yes. We give 10 rupees and get our check-up here.

I: You can also see the doctor?

P: Yes. If we go to Theni, there we have to pay 40 rupees to get check-up. If we go to Madurai, there also we pay 40 -50 rupees. I have diabetes, I also get that checked-up. For that, I pay 25 rupees for the check-up. In Theni and Madurai also, I pay 25 rupees.

I: So

P: I havent been going to work since the onset of diabetes. Not regularly. I will go for 10 days and then not regularly. If I get work I will go, otherwise I wont.

I: How long have you had diabetes?

P: It has been three years now. And 5 years since my eye problems started. Before that, I used to work all the time. After that, I only go if someone calls.

I: You havent been able to work because of your eye problem?

P: Yes, I have pressure in my eye and I havent been able to work.

I: So thats why you havent been working?

P: Yes, I will feel like fainting if I go. I used to work in 10 15 houses in Theni before the eye pressure and diabetes. But after that, I started to faint.

I: Before you came here, did you know that there is a doctor here?

P: Before I came here.

I: Yes, did you know whether there was a doctor here? Before you came here for the very first time?

P: Yes, [he mentions that someone else] used to come here [he talks about Mugam - I cannot make out what it is. He says that he used to go for that. He says they used to refer patients for operation in Theni or Madurai].

I: So you did not know before coming here that could speak to the doctor through the TV?

P: No, I did not know. I knew only after I started coming here.

I: So if you could not speak to the doctor, would you have come here?

P: There is the computer and I have been coming here [he probably didnt understand the question fully].

I: So when you first came here, what was the eye problem you had?

P: I have pressure

I: But what was the problem that made you come here?

P: Pressure. If I cannot see properly and I have pressure, I come here. For spectacles, we come here.

I: Okay.

P: We would have to wear spectacles. And we might have to change it sometimes. I go to Theni and come back and get my spectacles here.

I: Before you came here, how long have you been having this problem?

P: Pressure? 2, 3 5 years. For 5 years, I have been having this problem.

I: Before you came here?

P: 5 years. I used to go to Madurai and get medicine for the eyes.

I: From 2002 then?

P: 2004

I: That is when this was started. But you problem was there since 2002?

P: 1980from 1987 I have been having problems with my eye.

I: From 1987 you have been having this problem?

P: Yes. The pressure came in 1987. My vision became dim then. I went to Theni and they asked me to go to Madurai. I used to go to Madurai and once Mugam started I go there.

I: Okay, once you started coming here, what change have you noticed? What did they do?

P: It is better. I come here regularly.

I: What happens here?

P: They run tests, we talk to doctor. The doctor prescribes medicine. And we use that medicine.

I: So you speak to the doctor? How do you feel speaking to the doctor?

P: It is nice. We can see the doctor clearly now. Before, it used to be dim, now it is clear. Before we also could not hear properly but now it is very clear.

I: Now you can speak to the doctor about all your issues?

P: Yes.

I: So the doctor listens to you?

P: Yes

I: Is there a change in your eyes after you have started coming here?

P: Yes, it is better now.

I: What change exactly?

P: I got an operation done. If I didnt come here, I wouldnt have known. The doctor said I needed an operation.

I: So the operation is over?

P: Yes, it has been 29 days now. I can see more clearly and I have been asked to come tomorrow

I: Did you come to this center after your operation?

P: Yes, yes.

I: So how does your eye feel now?

P: It is better now. I can see better. I: So what problem did you have before?

P: It is better now. It is not very clear but it will get better. It will take 60 days.

I: Do the medicines they give here make you feel better?

P: Yes, the doctor will prescribe medicine and I feel better when I use the drops. First they gave me a medicine which wasnt so good but the one they give me now is very good.

I: Okay

P: They tested my eyes today. After one week, they will test again and give me glasses

I: Are you able to communicate well with the doctor through the computer?

P: Yes

I: Can you see the picture clearly?

P: Yes. The same doctor who did the operation talked to me. It was nice.

I: You just spoke to the doctor right? What did he tell you?

P: He said in some days, it will be alright

I: Did he prescribe any medicine?

P: Yes, three times a day I have to use the drops.

I: How long has it been since the operation?

P: 29 days. First I had to use the medicine 8 times a day. Now it is 3 times. Tomorrow I will find out more.

I: So your eyes are feeling better now?

P: Yes

I: Do you think talking to the doctor through the computer is better or do you prefer seeing him in person?

[The interviewer repeats in a couple of times. The patient talks about how he doesnt get to talk to the doctor for more than a couple of minutes anyway. But he seems happy with talking to him through the computer. He also says that it is better than going to Theni]

I: Do you wish to say anything else grandpa? Can you see the image well through the computer?

P: Yes, I can.

I: Thank you very much grandpa.