University of Manchester 2012

Medical, Nepal Pokhara

My trip to Nepal with Work the World has been one of the most fantastic experiences of my life. Pokhara is a beautiful city, full of things to do, and my placement in the hospital was an eye-opening and memorable experience. However, I can say without hesitation that my placement in the rural village of Nalma was the highlight of my trip, so I want to focus on it here.

Three of us set off early from the Work the World house accompanied by our amazing guide (and UNO champion) Rabindra Gurung.

Our adventure began with a strenuous 6 hour trek through the utterly breath-taking mountains of Nepal... taking us along remote trails I couldn’t otherwise have hoped to see in my lifetime.

Thinking ourselves fairly fit we were amused and ashamed to be overtaken multiple times by old people in bare feet carrying enormous bags. I did try to stifle my panting as they passed us but I suspect they notice that we were beetroot coloured and sweating. It did make me wonder why on Earth a health post could be needed if everyone was this healthy?!Our exertion was rewarded upon arrival at our host’s house where we were met with tea and given white scarves - a traditional gift in Nepali culture.

Our hosts for the week were an extremely kind married couple from the village, who provided us with comfortable beds, delicious food and friendly company. One tip I would give for anyone going to the village however, would be to bring some ear plugs because there were chickens and roosters everywhere which woke us up early every day.

Our mornings were spent in the Health Post which, despite its modest size, provides care to a wide area and we saw all sorts of patients and conditions. Many of the people who came had skin infections (which spike during the monsoon) and other common conditions you might expect to see in a GP in the UK such as colds, gout and menopausal symptoms. Anyone who presented with anything serious or which could not be managed in the Health Post faced the 6 hour trek to the hospital in the nearest town.

We soon got settled into a routine of seeing patients with the nurse who permanently worked there and Rabindra, who acted as translator. Among our supplies were: 

  • A limited selection of drugs including some antibiotics, immodium and analgesics 
  • A sphygmomanometer, weighing scales and stethoscopes
  • Iodine, bandages and tape
  • A BNF

I think working in the health post really brought on our clinical abilities – having a limited set of tools our skills in clinical examination and deduction were really tested and they improved greatly. Likewise, our history taking was put to the test as we were faced by a language and cultural barrier – to be able to overcome these challenges is extremely valuable in many parts of the UK where there are large migrant populations and I think our medical careers will have really benefitted from having had this experience on our electives.

Part of our afternoons was spent in the local pre-school which teaches English to about 30 children. We played games and sang songs with the children which allowed them hear different types of accents and to learn some new words. ‘Head, Shoulders Knees and Toes’ went down particularly well and we were also able to do a Nepali version since we’d learned the body parts in preparation for going to Nepal.

Late afternoon Rabindra would take us on walks to the surrounding villages where we saw everything from blacksmiths and bee keepers to baby goats.  On our last full day in the village our host family dressed us all in traditional Nepali clothes and had their photos taken with us. Throughout my whole time in Nepal I was struck by how friendly, humorous and little everyone was and today was no exception. Several of our host’s friends and family came to the house to see us in our clothes and laugh as we couldn’t fit the bangles onto our comparatively massive hands or as my 6’2” colleague tried to put on the shirt he’d been given to wear. It was such a great morning!

Before leaving the health post the nurse staff asked us to write messages in their visitor’s book and out on a small leaving ceremony for us. We were given more white scarves and tikka for our foreheads as they thanked us for our visit and asked us to return again one day. I that hope one day I can. We were made to feel so welcome and comfortable and we learned so much in such a short space of time; I would recommend that anyone planning an elective to Nepal makes the extra trip to Nalma. It was a unique and exceptional experience.

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