NTSP Special Interviews (India 2026): Brendan & Sarah Full Conversation (Parts 1, 2 & 3)

The team were in India in February 2026 and had the privelege to meet patients, families and staff who were working to improve tracheostomy care. This special interview is a conversation between Prof Brendan McGrath and Prof Sarah Wallace from the NTSP, reflecting on their time in India. The team visited the Tata Memorial Hospital Mumbai, and attended the National Tracheostomy Conference hosted by TMH, the Christian Medical Centre in Vellore, and St John's Hospital in Bengaluru. Brendan & Sarah discuss some of the community work, innovation and patient contact that they were invovled in during their trip.

The UK National Tracheostomy Safety Project (NTSP) is committed to providing education, information and resources to improve patient safety and the patient experience for those with tracheostomies and laryngectomies. All of our resources are housed on our website www.tracheostomy.org.uk, accessed by over 30,000 visitors each month from around the world.

This is the only podcast to bring you literature reviews, hot topic discussions and interviews with healthcare staff, patients and families.

Our goal is to improve the safety and quality of care for patients with tracheostomies and laryngectomies through education. We work closely with patients, families and healthcare professionals to develop new resources to improve care. We’ve collaborated with key stakeholders in tracheostomy care since 2009, and developed freely accessible resources, supported by online learning developed with the UK Department of Health. We’ve worked with the Global Tracheostomy Collaborative since 2012 to improve care for patients and their families everywhere.

We are funded by grants, donations and in partnership with medical device companies through unrestricted awards. This podcast series is supported by unrestricted education funding from the Atos Learning Institute. The funding supports the professional production of the podcasts and videos, and the medical device companies that support us do not have any creative influence over the content that we record. All of our work is undertaken by volunteer healthcare staff, patients and their families. 

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Transcript

SPEAKER_00 0:08

Hello and welcome to this special episode of Krafty Talk. We're here in Bengaluru in the south part of India and I'm joined by Professor Sarah Willis, OBE, who is a legendary speech and language pathologist that I'm sure many of you know. We're currently in the Holiday Inn near the race course in Bengaluru and we're very grateful to the staff for finding us this nice quiet space. We've got a bit of time to kill before we have to head home, so we thought it'd be a really good idea to spend a bit of time just reflecting on what we have observed and learnt and some of the people that we've met and some of the things that we've seen in India. So I hope you find that useful. We've been to quite a few different centres, haven't we?

SPEAKER_01 0:59

Yes, we've done a fair bit of travelling.

SPEAKER_00 1:01

Yeah, so we were hosted initially by the Tata Memorial Hospital in Mumbai. We were working with the speech and language therapists and the head and neck oncology team primarily, and we participated in a two-day conference by the National Cancer Grid, which had 250 delegates from all over India, and some people had travelled days to get there, which was quite amazing and quite humbling. And then we travelled to Chennai and moved from there to Valour, where we spent some time at the Christian Medical Centre or CMC, as it's more widely known. And then we moved across to Bengalulu, where we spent some time at St John's Hospital, which is just in the south of the city, and at Art Park, which is the AI and Robotics Institute here in Bengaluru, seeing the sort of innovation pipeline for ideas, particularly focused on healthcare, which was absolutely fascinating. We've seen a lot of things. We've obviously tried to contrast the differences between the way we practice in the UK and what we've seen in India. I mean, from a speech and language therapy perspective, tell us your thoughts on what you've seen in India.

SPEAKER_01 2:13

I mean, it's hard to process, isn't it? How much we've seen, and we've talked to so many wonderful people, and we've been able to visit wards as well as obviously having meetings with people. But I spent the most time, I suppose, with the Tata Memorial Hospital speech and language therapy team, who are all wonderful. And I think one of the things that really has struck me is just the volume of patients that all the clinicians across the board have. And I mean it's sort of quite mind-boggling, isn't it? How when we observed this when we were walking around the hospital, it's just the numbers of patients, partly as they explained to us, that just the sheer population of India, but also the fact that their cancer rates are incredibly high, and so they have a lot of oral cancer and head and neck cancer as one of the main you know diseases in India. So, you know, they're talking about seeing 10,000 patients a day in an outpatient clinic. And when I met with the team, we had a really lovely exchange of ideas, and everything that I said, they sort of tripled in terms of numbers of case on their caseload and numbers that they do in fees and video phrascopy, and they have got access to instrumental assessments, but a lot of people that we talk to during the conference don't have access to that. Um, they are very reliant on bedside assessments, they also, because of that, are using things like blue dye testing, which we've been able to sort of move away from in the UK, but because we have instrumental tools, but they they're probably seeing the triple the numbers of patients that we see, and I just can't can't conceive of how they do it and and how little time they have. They work very, very long days, and um they rely a lot on their fellowship students. They have um a lot of close links with the the ENT team and the surgeons, and everybody says, don't they? I wish we had more staff so they could do more, but a lot of the work they're doing is outpatient-based. And um it's very difficult for them to find any time to see the inpatients. And a sort of strong theme, I think, across all of the people that we've met in all of the hospitals is this sort of inability to see patients while they're still in ICU. Certainly, nobody's really seeing patients on ICU, they're seeing them either on the ward or just before they go home. Yeah, and you know, they're travelling incredibly long distances, the patients, aren't they, to visit the hospitals. So, especially at a tertiary centre like Tartan Memorial, the same patients would spend three or four days just by train trying to get to the hospital for one outpatient appointment, and then you've got you know just an hour or so to see the patient, and then they're gone. Yeah, so that whole idea of you know having the the luxury of time to follow patients up isn't really there, so you've got to kind of give very kind of rapid input and then cover everything because the patient's going and they're not going to be there anymore.

SPEAKER_00 5:29

I mean, I think you and I have busy days at work and they just another level, isn't it?

SPEAKER_01 5:35

Yeah, it really is another level, and they you know they're lacking things like um you know availability of trache tubes, aren't they? So things like subglottic suction tubes are really difficult to come by. Everybody gets speaking valves, you know, virtually non-existent. There were a couple of people at at the conference who are uh had come from an other parts of India who were saying, Oh, yes, we can get speaking valves, but they're getting the erata valve, which is which can't be used on ventilated patients. So, so speaking valves they're all super interested and really want to use, but the cost for patients is really high, and finding a supplier in India is a problem. And there were some sort of uh I suppose in discussions we found some differences in how people manage cuff inflation and deflation, weren't there? Yeah, what you thought about that, but yeah, no, it was interesting.

SPEAKER_00 6:32

I mean, it's probably worth just going back and just talking about the the different hospitals because the the care you got is is slightly dependent on the model of the hospital that you're in, and you know that the guys in every hospital were doing their absolute best. It was stunning that the quality of care that people were giving in such difficult circumstances. But they we were visited when all the hospitals uh had different tiers of um patient care, I guess, and then there was that sort of fully private, semi-private where you made a contribution towards your care, and then in in Tata Memorial Hospital, in particular, that they they basically would see anyone, and they had a unique funding where they were funded partly by the uh Tata Group, which is a big international group, uh but also the government, yeah, so it's a government-funded hospital, and so and and philanthropists, I think. Yeah, and and it was amazing, but so that their philosophy was that if someone turned up on the doorstep, they would see them, and as you said, Sarah, people were travelling. You know, we we were in a clinic, and remember the first guy I saw was a farmer from West Bengal, and that's miles away. I mean it's a huge clinic. Yeah, it's like a three-day trek to get there with nasty established oral cancer, and and just some of those sort of challenges, like you say, about you know, you see that person, you can offer them some treatment, and patients were having to then go and find somewhere to live in Mumbai for a couple of days, maybe a couple of weeks, then have major surgery, then have to find somewhere to recuperate.

SPEAKER_01 8:00

They did have hostile accommodation for some of the patients, didn't you? And they subsidise a lot of things for patients who who can't afford to do that. But yeah, yeah, the scale of it was quite um yeah, really impressive. So impressive, and I think we we attended a multidisciplinary team clinic where they they I think they tried to arrange for tracheostomised patients to come. And you know, I think the the cancers in these patients were really quite far advanced, so they're having to consider doing you know really large surgery, and I think it must be terrifying, you know, and a lot of when you consider as well that there's 750 languages in India and communicating this information to patients who've traveled from other district, you know, the states in India and and the language barrier is a huge problem, isn't it? And yeah, it it's the the I thought the passion that the clinicians, the surgeons, everybody we met was incredible, the dedication, um, the hours that they work is is so uh I think we're both so impressed, aren't we?

SPEAKER_00 9:08

I mean the the the outpatient clinic that we went to in uh at at Tata in in Mumbai, the the hall was full of football clinics. It was just insane. People sitting on the stairs waiting for their outpatients, people sleeping, people eating there.

SPEAKER_01 9:24

It was just it wasn't a single space on the floor, was there? And people very patiently taking a ticket.

SPEAKER_00 9:29

Yeah, people were super patient, and and they were, you know, the and the the the teams were just working until they'd seen everyone. It was so amazing. Um I guess we started off this segue with with your question about cuffs, and I think we we did realise that it depended a little bit on on sometimes how much money you had. So for the if you could afford it, um then you could have you know, you could follow up on those recommendations, perhaps moving from a cuff to an uncuffed tube. If it was a sort of philanthropic or a publicly funded patient, then you know, generally what patients needed they got, but it was uh you know, you had to justify everything, and and I think it made me realise how sort of privileged we are in in our NHS that you know, generally by and large, in in critical care, if you need something, you you get it, and you know, the guys are working really hard to make sure their patients got the right sort of care.

SPEAKER_01 10:21

And they were sort of using corking or capping, but literally a cork, wasn't it? Because the whole um problem with trying to wean patients without I mean I mean it was just so difficult for them because they didn't have that time where they could consistently go back and review patients, did they? It was sort of like right, what are we gonna do? And the idea that we've got an energy to remove and a trackie to remove and we need to kind of sort these two things out, and and and I think without that again, that time for the uh full sort of multidisciplinary team approach because everybody's running around like headless chickens, is you know, meant that some of those decisions would uh seem to be taking longer than they they were comfortable with, and patients were very often going home with a tracheostomy, weren't they? And then coming back, you know, six months later, and then they you know have another conversation about whether it could be removed. So they were very concerned when we talked to um Dr. Guri and the ENT team and the speech therapist that they wanted to be able to decannulate patients sooner, and they've got all these constraints that make it very hard.

SPEAKER_00 11:31

Yeah. So I mean it was great to be able to share some of the work that we've been able to do in collaboration with other sites in the UK and around the world about some of the strategies that we've worked out over the years that that that might be able to help patients get decannulated more quickly, which you know nearly everyone we spoke to was was really interested in, because as you say, if the the the best way to reduce tracheostomy problems is to try and get the tracheostomy out, and and what struck me about the the care that they were delivering often you know because patients particularly were paying for it, or there was such pressure on their beds that patients got their care, and as you say, a lot of patients were being discharged of tracheostomy, and maybe in a week or two, if they were under the nose of the teams, they could have got decannulated, but the patients were then travelling back home. And there was often that the TATA group, for example, um, and CMC as well, had had a network of hospitals around the country, yeah, and so they were able to try and signpost patients to to other hospitals where they may go if they had either problems or or if they needed a review. But as you said, quite often patients are coming back to Tata.

SPEAKER_01 12:38

And there's a cost burden to that for patients as well, isn't there? So but each yeah, each particularly CMC uh has and Tartan Memorial have this vast network of um hospitals where they have and CMC are training you know thousands of nurses who now work all over India and often also in the UK and USA as well, but who are taking those skills with them. But that community care is incredibly challenging, isn't it?

SPEAKER_00 13:08

Yeah, absolutely. Um it was something that I mean we went, well, you went to a clinic, I was feeling a bit rough that the community clinic. Tell us a bit about what well this is outreach from uh CMC, wasn't it? Yeah. So tell us a bit about that, Sarah.

SPEAKER_01 13:24

Well, so what was really interesting was that at CMC College, where there is a big hospital, very big hospital, I mean 3,000 beds. The new bit, and then have all these other old bits, older buildings as well, and and and a training college, and they have made it sort of mandatory that nurses who teach in the degree programs and postgraduate courses all still have responsibility for wards and for community outreach, and everybody has to do uh community outreach as well. So they've got this network of um village clinics where which are uh nurse-led, and um, the nurses will go to you and use you know, either to visit patients in their houses or use um a very small kind of community space um and set up sort of clinics for children for the elderly, and they'll do a bit of exercise. We joined in with the exercise class, and all of the um elderly women this was for were were just absolutely killing themselves laughing at my attempts to um do a little bit of uh you know physio.

SPEAKER_00 14:34

And if I can persuade Sarah to put our pictures on social media, I will.

SPEAKER_01 14:38

Oh, why not? Uh it it it did kind of I think we bonded over it. Um but they also get health checks. Um, there's a lot of diabetes in India, and that's something that they are managing people with you know long-term conditions in the community, and it can and it it's it's just fantastic. So, you know, no one has to pay unless they can pay, they get their prescriptions for free, um, they give them a you know a bit of food and and and drink as well, and it's a social aspect as well, because somebody told us how um the elderly in India in the urban areas now, because of the way that people work long hours in their jobs and and move away from families, they've got the same problem we have in the west, which is the elderly people are isolated. So having these sort of centres where they can socialise as well, they're really placing a um a great uh sort of service there. Um, in the villages, it's it's still a lot more sort of you stay with the family, and the family then have to do all of the care. So the family have to learn how to look after a tracheostomy.

SPEAKER_00 15:47

Yeah, which is quite a big deal, isn't it? I mean, we've just literally met one of the managers at the Holy Inn as we were just coming up here, they were finding us this lovely space, and she said, Oh, tracheostomy is my my father had a tracheostomy, and she was describing how exactly as we've said, you know, there was an inpatient period, and then her father was discharged to the family, and there was a little bit of education, but uh not a lot. And she said she remembers sitting with her family looking at YouTube videos, trying to work out how to do the suctioning, and you know, she's describing all the things that that we do on a daily basis. Uh and then yeah, really scary, and that that was something that really came across from our visit here. That that you know, we've got a lot of resources that are very specific to the UK and to sort of our setup, but it was very clear that that we can develop resources in partnership with our colleagues here in India that that may well be relevant to exactly that situation because of that sort of really strong sort of family unit that that they have in India that that are essentially tasked with doing pretty complex care that in our country we'd be having sort of community district nurses going out to to deliver. So it was quite spectacular, really, that that that families can can take that workload on.

SPEAKER_01 17:04

And I think I mean she actually said, didn't she? Well, what was I supposed to do? I had no choice. Of course I'm gonna look after my father, and that you know that's the strength of I think in India what we've been the hospitality has been incredible, hasn't it? And that and that um sort of obviously family is incredibly important, isn't it? And the family networks are obviously really strong, but yeah, I think we've already had some people offer to translate NTSP resources into Hindi, haven't we? So we we've obviously uh when we ran the course at the weekend um on trackicare with uh Dr. Vince Pandian and and my Dr. Michael Brenner um from the States, we we did a lot of shared, you know, sharing of um you know discussions, didn't we? And um yeah, some we said, wouldn't it be great if someone could now follow on from our Portuguese and Spanish versions and and have something in Hindi? Yeah, didn't two people come up to you within five minutes saying.

SPEAKER_00 18:07

And that's what we're hoping to get is it's a collaboration and trying to work out how we can work together going forward to develop sort of India-specific resources, I guess. But then that would be more sort of relevant to this part of the world, sort of taking those uh principles of outstanding care that we've seen and adding in what we've learned.

SPEAKER_01 18:27

We had a lot of conversations with everyone we've met, haven't we, about just not reinventing the wheels and not doing things our way because that's not appropriate for India, the different different challenges, different healthcare uh setup organizations set up differently. But don't reinvent the wheel here, use this as a template, and and we talked a lot about collecting data, and people are really you know how they find time to do that is another thing, but everybody is incredibly keen on producing more um research in India on the in on the um subject of tracheostomy management. I spoke to lots of speech therapists about you know how do you how do you um still primarily work as a clinician but do clin do clinical research as well, and you know that's what I did most of my career until I got protected time, so but I don't have their case lower sizes, but I think they are they know they're so passionate and key. Everyone we met, yeah, I mean it's all I suppose the the it's all about goodwill and compassion and and dedication, isn't it? I've been so impressed. Yeah, and then at um St John's that was a different experience again, wasn't it?

SPEAKER_00 19:45

Yeah, very much so, and and it's again a slightly different funding model again, but the uh you know we were lucky enough to be taken around to the wards, we went to the very impressive attentive care unit, and then we got taken to a brand new sort of purpose-built geriatric unit, which again builds on those sort of Indian values, you know, it was lots of space, space for families to come, uh opportunities for sort of respite care. They had patients. Yeah, yeah, yeah, yeah. Yeah, and they'd had a few patients through with tracheostomies and on that sort of transition from acute hospital care. You know, obviously, the older you are, the more likely it is you're going to take a bit more time to either come to terms with the tracheostomy and learn how to look after it, or to even potentially be decannulated. We were talking about you know getting speech and language therapy involved in in some of those patients because it's likely not all will need a tracheostomy long term.

SPEAKER_01 20:40

Yeah, but I think there's I mean it's such a massive unmet need here because like at St John's Hospital, I think they had four speech therapists for a thousand, three thousand beds. Um, and so they they'd sort of had to one just did sphage and one just did stroke, one just did communication, and you know, of course they haven't got the capacity to get involved early enough. Um but I think that you know there's a and I think there's still they're still at the point where uh there's a bit of a lack of awareness of what we can do for patients and why why we should be seeing them early with tracheostomies not not waiting until they've got you know almost discharged. So there's I think um some really interesting discussions around that, weren't there?

SPEAKER_00 21:29

That probably reflects probably the journey that we've been on the last 10-15 years, isn't it? It is indeed, yeah. And you know, what we'll be trying to do is is is share stuff that we're up to now and and and say, look, you know, we've had exactly these problems, and this is what we've been able to do to get speeches and other people.

SPEAKER_01 21:49

What would be great is if um Indian clinicians can collect their data and and their evidence because you know there are different problems, different clinical problems. Problems and people.

SPEAKER_00 22:00

I was like, is that next part? Sorry, sorry. No, no, no, no. It's it's uh yeah, I mean lots of the research about tracheostomy care and changes and this multidisciplinary, multi-professional approach has come from University Commons, the West, hasn't it? Yeah and and obviously Australia have been strong players in the Global Tracheostomy Collaborative as well. Um, and as you quite rightly say, it it we need some data from this part of the world to reflect the challenges and and and the way that they manage things here.

SPEAKER_01 22:33

And they're different, they have different diseases. Different pathologies, and pathologies, don't they? And you know, they do have heart disease, but it's not a bigger skiller, isn't it? They've got TB, lots of TB here and other diseases that are uh you know pre more prevalent than than us, so different types of tracheosmy covers.

SPEAKER_00 22:51

And that the head net cancers that we saw, as as you said, I mean, that there's a lot of tobacco chewing, yes, which which I I sort of was aware of but not aware of the scale of it. And uh, you know, some of the people who met in the outpatient clinic were presented with pretty significant tumours, they'd sort of been ignoring them, they probably knew what it was, didn't want to see couldn't afford to do it. So very different populations, and uh I mean trying to get some data uh from this part of the world would be amazing, and it was great that all these hospitals that we visited, we talked a lot about the global track has to be collaborative and and and that way of trying to improve care through data. I mean, that that's how you know where you are, that's how you know where you're going, and that's how you know whether you're as good or different to other hospitals, and when you know that you can then ask the other hospital, okay, so what are you doing that I'm not, or the other hospitals say, Well, you're you're doing that really well. Can we take some of that information from you?

SPEAKER_01 23:48

Yeah, and I think I think we talked about the global south, didn't we, and how this it would be amazing if we could have that sort of uh data to show you know what are the what are the future directions that people need to go in, and you know, they're already collaborating and they're already kind of recognising the you know many of the problems that patients with tracheostomies have, but you know, it's it's how do they use things like AI? We went to that amazing art park as well, didn't we? Go on and tell them about that.

SPEAKER_00 24:22

So the art park is a centre for AI and and robotics, and uh it's like an innovation space, lots of work around AI applied to lots of different sectors, and and a relatively small chunk of their work was was in healthcare. But when we say that, when they told us about what they were doing, it was actually huge. Um, a lot of work in COVID, but what they've been able to demonstrate is they can access data sets, they're trying to get standardized data sets for certain things because there's lots of different pockets of data around India, but but there are some commonalities, and they were trying to piece things together and and then I mean it was predictive models we were talking about, in particular about uh dengue fever and sort of predicting outbreaks, things like that. But um we were then we were talking at St John's about they've got a real strong focus on uh AI in their research, and and the GTC database now has 20,000 uh cases in there with patients with tracheostomies, and that it's ripe for applying these sort of artificially intelligent systems too to see if we can start to predict uh some of the some of the outcomes maybe or or predict which patients will benefit from certain things. Uh, but again, like you said, Sarah, having sort of India or global south specific data in there, you know, will really help because you can't apply what we're up to in uh the north of England to what's happening in the south of India. But the you know the principles certainly were there. And I mean what I'll take away from this is you know the next steps is definitely collaboration, um a lot of shared learning, and we were very clear to say to the guys, look, we're not here to tell you what to do, we're here to learn from what you're doing, and we're here to explain what we've picked up from working with and talking to lots of other people around the world, and that shared learning you know was was clearly very strong, and then that focus on you know research in this setting, collecting some data and really trying to understand what's going on now and how we can make some tweaks and see whether we can make any improvements. But I mean I wondered what your reflections were on you know the sort of the next steps perhaps for the for the speech and language therapy teams that you've met here.

SPEAKER_01 26:30

I think it's really exciting because I think um there was so much enthusiasm, wasn't there? Yeah, there's been so much enthusiasm everywhere we've gone for learning and for um pushing quality of care. Lots and lots of conversations about quality of care. But like you say at the moment, I think there's a just uh it's all a little bit of an unknown uh entity, isn't it? Around what is happening to patients, especially after hospital, yeah. Um but even in the hospital, because many of them are not getting seen early enough or at all. Yeah, um, so I feel like um apart from the fact that we've built friendships and collaborations with people, I felt like in at Tata Memorial, that opportunity to get 250 people from all over India in one space, they were networking with each other as well. Yeah, it was really nice to see that that was great to see because especially when so I did two presentations um jointly with I'm gonna give a shout out to Arun um Arun Balaji Balaji, who is um the head of the speech therapy department in Tata, who has helped facilitate this whole thing. Um, and he is he is incredible, but you know, I invited him to do presentations jointly because I can't give the Indian perspective, I can tell you what we you know promote in terms of quality of care and communication and swallow, and he could then say, Um, you know, so this is how we translate this to India, and um and there was a you know a lot of people in the audience who were able to, we had a lot of panel discussions, didn't we? So there was some really what I took away most was the conversations we had in those panel discussions where people shared their setting, their challenges, but also lots of people saying, Oh, you know, I'm I'm working, I don't know, in um another part of India, you know, in Rajasthan or whatever, and you know, I I can I've actually got this, and other people saying, Oh, how did you get it? You know, how did you get that speaking verb or whatever? Because we can't get them, and so that I think it facilitated things to happen within India, I hope. Yeah, and you know, the support of of all of the leadership teams in these organizations has been incredible, and I think they really, really want, I feel like we've we've facilitated hopefully some some changes. Yeah, um, I hope.

SPEAKER_00 28:58

Hopefully empowering teams.

SPEAKER_01 29:00

We want to carry on with me, supporting them as with whatever they want to to do next, you know. I mean, yeah, we'll we'll just keep learning more, won't we? Yeah, absolutely. Yeah, but empowerment, I think, and and I think I can't imagine how how demoralized people would get working in in those settings where they are you know up against it all the time. I I was really struck um by how inspiring people were because they're working up against it and it could be quite demoralizing. You know, you can't get the piece of equipment you want, you know, you haven't got fees, or you want mobile fees, you could you have to do it in a clinic and you're stuck with that, or you've got to see 15 patients in a video phrasy clinic in the morning, and yeah, you know, the the it it's a never-ending barrage of patients, isn't it? And you'd think it would get them down, yeah, but they were so positive, yeah, and so inspired inspiring to me, yeah, but you know, they they just sort of get on with it and um and uh and and are making a difference to people's lives, and it you know, I find I found that inspiring personally.

SPEAKER_00 30:18

Yeah. No, I totally echo that, yeah.

SPEAKER_01 30:21

Yeah.

SPEAKER_00 30:21

So we've been in India for about 10 days, sadly in about half an hour, we're off to the airport to go home, which will be um we've had our last curry. We have had our last curry, the last of probably about 30. Many. What will you take away from this trip, Julie, outside of the hospital stuff? I mean, a lot of the hospital staff have been with us for meals, and then we've been really well looked after, haven't we? But come on, give me some memories of of India.

SPEAKER_01 30:48

Well, this morning was fun, wasn't it? We uh we had um I think this is pretty much today has been our only day off, hasn't it? And uh we decided to go and uh to the market in um in the auto rickshaw. And the traffic of Bangalore is legendary, yeah, is it not?

SPEAKER_00 31:05

Yeah, it is, yeah. Um I mean we thought Mumbai was busy with the roads here, it's like all of Mumbai is on Mangalou's roads, isn't it?

SPEAKER_01 31:12

It's Dodgem's and it's noisy and it's like you yeah, that that that's but to me I I find that fun. Yeah. Um probably wouldn't want to do it every day. But I just think Indian hospitality, yeah, uh of everyone you meet, um, and yeah, I'm just I'm just uh need time to process what we've seen in the hospitals. There's there's the scale of what the scale of the numbers of patients is still hard to grapple with, isn't it? I think. And just when you when I think back to Withenshore and you walk down a corridor and it's you know, there are people, but there's not one, you know, literally no floor space everywhere, and people queuing up out, as you say, overspilling into the stairwells and sitting there and all day waiting for to be seen for 15 minutes. Waiting really patiently, and waiting very patiently and quietly, and you know, it's just incredible, and um the the staff are working so very hard, and their work, yeah, their work ethic is is very admirable. Um, so yeah, I've learned I think we can take uh some lessons from that, can't we? Absolutely, yeah.

SPEAKER_00 32:24

No, I've learned a lot, I've seen a lot. I think uh probably we need to just have a a day or two just chilling at home just to uh transition back from the the pace of what we've seen here, both in the hospitals and the communities, and then just India itself. It's uh it's full on, it's a fascinating place.

SPEAKER_01 32:44

Sensory overload.

SPEAKER_00 32:45

Yeah, it is sensory overload, but in in a good way.

SPEAKER_01 32:47

In an exciting way, yeah. I mean I'm I've kind of I find it I find it exhilarating, but probably not if I did it every day.

SPEAKER_00 32:57

Fantastic. Alright, well, Sarah, always a pleasure to talk to you. Thank you so much for your insights. Yeah, cool. So uh that's it for this episode. Uh as ever, the opinion you just heard are our own opinions, they don't necessarily reflect the opinions of the organisations uh which pay our wages. Uh, you can find out lots more on our website, uh, you can follow us on our social media channels. Um, thanks for listening and see you next time.

SPEAKER_01 33:23

Thank you.