Upon my arrival in Kathmandu I was instantly hit by the sights and sounds of the bustling street life, a characteristic that I have come to love when traveling in Asia. As I navigated around the capital, I quickly got my bearings. My senses were being heightened to the sounds of the traffic, the regular horn-toots; seeing the full spectrum of colour whilst observing Hindu and Buddhist festivals (of which the Nepalese celebrate many) and the brilliance of local dress; and to the rich aromas from the wonderful street food mixed with the notorious dust that covers Kathmandu city.
My time in Nepal was split, at first, volunteering for 6 weeks at Martyrs Memorial Hospital; as the October festivities began with Dashain and later Tihar, the hospitals became quiet. At this time, I leant my hand to activities with the children, for those not fortunate enough to spend their holidays with family; myself and other volunteers planned to make this time fun-filled and enjoyable for them.
As a UK doctor where all patients have a free, at the point of access, health service, my time spent at the local hospital was eye opening. I was in a front-line position, working mainly in the Emergency Room, and whilst there I got to observe first hand how the Nepalese healthcare service functioned.
Inevitably there was a contrast to the environment I am used to working in, notably patients were paying for their diagnostics and treatment—even a simple cotton swab. Certain equipment was outdated—equipment I had previously seen displayed in World War Two films. The doctors and nurses were working resourcefully, trying to make do with simple, limited means.
Coming from a world of high-tech, evolving medical practice, with regularly updated national guidance, and where patients demand the highest of standards and latest medical services—I was far from home. In a country whereby some families struggled to make ends meet, medical practise could be limited by facilities available and often by what the patient could afford. If a patient could not pay for the antibiotics and stitches they needed to clean the open wound from the road accident they suffered whilst driving in the outdoor mayhem... If they could not stretch to pay the extra 3000 NPR (£23, $30) for the CT Scan to investigate their cough, which perhaps wasn't due to the overwhelming dust in the city but possibly due to an underlying cancer.... If they could not pay for the IV access and fluids they needed to rehydrate and improve their kidneys due to the gastritis they were enduring...—they did not get it. They would have to travel to another hospital and wait in another queue, in the hope that some government funding may pay for the treatment they required.
Whilst many of the problems highlighted above might be expected in a developing country like Nepal, I was a little surprised and perhaps disappointed by the attitudes of the medical staff—although I recognize this judgment is based on my very short experience in one hospital. There was a lack of empathy and an element of superiority demonstrated by some staff working in the hospital. I believe this may be accounted by their own personal experiences; they are so accustomed to trauma, to hardship, and to poverty that they appear far less affected by the emotional or psychological needs of patients.
Although I have benefited greatly from my time at Martyr’s Memorial, I unfortunately do not feel I made much of an impact on some of the challenges both healthcare staff and patients face at the hospital. Overall, my invaluable experience includes having gained a better understanding of tropical medicine and infections. I have learnt to become more resourceful when working with limited means and I have developed a greater understanding of the cultural differences and challenges, thanks to my colleagues at Martyrs Memorial Hospital.
During my time in Kathmandu I was invited to speak and teach at the Chelsea Education and Community Center, delivering a health workshop on pregnancy. This was met with such enthusiasm by the women attending the Center for lessons that I have managed to work with Hillary Bernhardt at the Center (with the help of some colleagues at home and previous volunteer Maria Drazek; a medical student from the USA) –we have produced a health curriculum, delivering weekly workshops on simple health problems. I hope to answer some of the many questions the women had during the session I gave. Hopefully we’ll quench some of their thirst for knowledge.
My final two weeks with Volunteer Nepal was spent with the children at Nepal Orphans Home and I couldn't have asked for a better way to spend it. Whilst only a portion of them remained in Kathmandu during the October vacation, I came to learn and adore each of them individually. Michael Hess has set up a wonderful, loving and empowering environment for these children. It has been so enjoyable to play a small fleeting role in their lives. Observing the way the older brothers and sisters care for, help and support the younger children at Nepal Orphans Home is truly wonderful and inspiring.
As I come to a close I would like to thank all staff at Martyrs Memorial Hospital, Volunteer Nepal and Nepal Orphans Home for welcoming me into your world for the last 2 months. Whilst it has only been a short period of time, I'd like to think I helped make a small difference and if I’ve made even a tenth of the impact the experience itself has made on me then that will have been a wonderful success. For now it is not goodbye but see you soon.