University of Birmingham 2020

Physiotherapy, Nepal Kathmandu

Ellie Marok (MAROK22993)I’m a third-year physiotherapy student at the University of Birmingham and I chose to go to Nepal for my elective placement over the summer in between second and third year. 

I had previously been to India whilst I was in sixth form for some physiotherapy work experience and loved that area of the world, so I wanted to travel to Kathmandu for my elective. 

On arrival at Kathmandu, we were greeted by the very friendly and organised Work the World team. Even the journey there was an experience in itself – it took us a while to work out which side of the road the locals were supposed to drive!

As part of the placement, I spent two weeks at a teaching hospital and two weeks at a children’s hospital. 

At the teaching hospital, I was based in the outpatient department where the majority of cases were adult musculoskeletal patients. 

I did also have the opportunity to assist the physiotherapists in some inpatient treatment, for example, stroke patients and patients requiring respiratory physiotherapy. 

One of the main differences was that the five physios in the outpatient department were responsible for all 800 of the inpatients as well, so very few cases were referred for inpatient physiotherapy. 

Ellie Marok (MAROK22993)

I also assisted with ultrasounds for a variety of different conditions, like osteoarthritis and bursitis, and assisted with passive mobilisations of joints following orthopaedic surgery. 

It was interesting how, despite the physios being extremely well-educated and knowledgeable regarding evidence-based practice, there was an increased emphasis on ensuring patient satisfaction, so hands-on treatments were more commonplace than they would be for the same conditions in the UK.

The two weeks I spent at the children’s hospital were very enjoyable as I have had very little paediatric experience before. 

The team here was so friendly and engaging, and asked lots of questions about physiotherapy in the UK, as well as imparting their knowledge about specific paediatric conditions. 

There was a lot more emphasis than I had expected on teaching the parents how best to manage their child’s condition, as in Nepali culture, there is a massive stigma around child disability and very limited, if any, community assistance for parents. 

Again, many patients were outpatients, often suffering from global developmental delay, but one of the highlights for me was going into the neonatal intensive care unit, where physiotherapy involved stimulating the suck reflex in new-born babies to allow the removal of feeding tubes.

Ellie Marok (MAROK22993)

Kathmandu as a city was incredible. It felt really safe and there were loads of places to visit in the vicinity, or a short (and cheap) taxi journey away, like the Monkey Temple, Boudanath Stupa and Patan. 

One weekend, we went to Pokhara where we hiked to the Peace Pagoda, went horse-riding in the mountains, watched the sunset across the city and paraglided off the top of the mountain. 

It was an amazing experience and I would definitely recommend anyone travelling to Kathmandu to go to Pokhara as a weekend trip.

it also helped me to develop my clinical skills with very little equipment

Completing my elective placement abroad not only gave me an appreciation for a culture I knew very little about but it also helped me to develop my clinical skills with very little equipment or a multidisciplinary team around me. 

Ellie Marok (MAROK22993)I definitely had to adapt as very few patients spoke English, and my Nepali was limited to a basic introduction, which stood me in good stead when I went on placement in the UK afterwards and had patients who used interpreters during their care. 

Learning a few words of Nepali (and making the most of the language lessons offered by Work the World) had a massive impact on me building some rapport with the patients and staff and earned respect from them.  

I had an incredible time in Nepal, I felt I had a good balance between experiencing the culture and travelling, whilst also improving my clinical skills and patient interactions. 

I would love to return someday, as the people were so friendly, the food excellent and the scenery unbelievably beautiful!

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