Erasmus Universiteit Rotterdam 2014

Medical, Nepal Kathmandu

 

I already knew I wanted to go to Nepal for about eight years. When I found out how easy it was to take some time off for half a year between my bachelor and masters degrees, I decided to go traveling.

I didn’t only want to travel, but also do some kind of medical work. For that medical part I discussed the options with a student counselor at my university. It appeared that Work the World (WTW) had a program in Nepal, which made it perfect to combine traveling with medical work. This is how I eventually linked up with WTW.

After reviewing some more options it became more and more clear that I would join WTW for my medical part of this half-year. I started to get in contact with some of the WTW staff, who kindly helped me in every way I needed. Before departure there is near-perfect assistance from the “MyTrip” site and staff. Everything there is to know can be read on this personalized webpage or alternatively, through a phone call to the UK Head Office team.

Then, upon arrival, a member of the in-country staff is supposed to pick us up from the airport. In my case I arrived earlier in Nepal, which meant I stayed in a hotel prior to the start of my placement. However, I got picked up from the hotel and dropped off by a taxi at the house. After an orientation tour through the house, I got some rest and time to meet the other students. It was a perfect start! The first day of the WTW placement isn’t spent in the hospital, you’ll get a city orientation instead. The in-country program manager will show you around the parts of the city where you’ll spend most of your free time. It is a great introduction to the country.

 the patients, and not to forget the resources, are all on a different level

The second full day will be the start in the hospital. A hospital introduction is given before you actually start your placement. After this introduction the real placement will start. This placement will be totally different from internships back in Europe (or United States, Australia, New Zealand etc). To start with, the treatments, the patients, and not to forget the resources, are all on a different level. The treatment of the patients will be very different from the equivalent back in my country (The Netherlands). I think the words of one of the doctors describe this best. I quote: “we don’t have the time and money per patient as you do back in Holland, we have to make short cuts in order to achieve our goal”. This is definitely seen in the way patients are treated. For instance, the Outpatient Department (OPD) is one room filled with about 5 doctors and 20 patients waiting in line to be seen by the doctor. Per patient there is about 4-5 minutes of consultation, that’s it. Another example (out of countless examples) is the ultrasound.  In Nepal you won’t get a full screening, only a quick look to scan for larger pathology is done.

The second difference is the patients, who are remarkable as well. People wait way longer before they go and visit a doctor. This is mostly because it costs money (which people don’t have), because of logistical reasons (hospital is too far away) and because of cultural differences (seeing a doctor is less self-evident in the culture). The result of waiting longer is more severe pathology. This is something you’ll definitely see in the hospital out here. Some forms of diseases I’ve seen are really rare in Holland because of its severity. Then there is the problem of resources. There just aren’t as much resources in Nepal as there are in Holland. The hospital equipment (if it’s there) is mostly not up to date. Another example, simple hand alcohol, is quite scarce. In the general wards there isn’t any alcohol to be found. I only found hand alcohol in the intensive care unit. When you ask why that is, the answer will just be, “money”.

 

During the stay in Kathmandu, the Work the World students have their own house. It is within walking distance of the hospital. What also added to this feeling is the Work The World staff. Sean, the program manager, makes sure everything is organized as it should be. Apart from that he helps you a lot with everything that you need. For example, he showed us some of the best places in Kathmandu, he helped me plan my trekking afterwards and he always knew where it was best to buy things. Every night (except Saturdays) the cook, Krishna, makes delicious meals. Especially his Nepali food, which is just great. He makes at least 5 different dishes every night. Then there is Lakshmi, she does the housekeeping. You don’t need to worry about making up your bed, cleaning your room or even doing your laundry. This will all be done for you.

 

As part of my placement, I did the Village Health Experience. I think a better term would be the, "in the middle of nowhere experience”, with emphasis on the word experience. The village is just a collection of clay houses built alongside a three-metre wide gravel road. It is probably best that I o not reveal too much and not spoil the surprise of what future healthcare students are in for. What I would say though, is to just do it! It’s a very unique chance, and an experience you’ll probably not get again in your life.

Now, onto the traveling I did. During the placement there is enough time to see some of the country. For example, we went rafting, saw most of Kathmandu and went to Chitwan National Park for elephant riding, jungle walking and jungle canoeing. After my placement I had time to do some trekking (I did the Annapurna circuit, I’d really recommend this track). If you’re in Nepal and you have time before or after your placement, try to do some trekking. Nepal is a trekking country, so it’s a little bit of a shame if you don’t go trekking while you’re there.

In writing this piece, one of the suggestions is to give advice to future students. I will stick to one, most valuable piece of advice, and that is: don’t hesitate, just do it!

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