A UK medical students elective in Nepal

Experiences of a UK 4th year medical student on elective in Manma District Hospital, Nepal

“When the hospital was first established by Medecin Sans Frontiér (MSF) during civil unrest in the mid 2000s a few of the current staff lived nearby and remember how it was at that time. Although they were not working at the hospital they were impressed by the resources that the organisation could bring in, mostly via helicopter, to run and manage what would become Kalikot District Hospital, when peace came and the government took over management. Nowadays the X-Ray machine is in dire need of updating, and frequently out of service.  Often the only imaging modality available is an old ultrasound machine. I get the feeling the staff, having known what could be provided by an organisation such as MSF, feel a little resentment at what the government is able to provide them with now.

Many of the cases I’ve seen have highlighted to me how much of a difference the doctors, and the other professional healthcare staff make to an area like Kalikot. Despite the frustrations of outpatient appointments (equivalent to our GP service) with a frequently illiterate population that may not understand or have experienced a Western style of medicine, the professionalism and dedication of the staff is inspiring. This was highlighted to me just yesterday when an emergency appendicectomy case came in at 9pm; the two doctors, scrub nurse (or Sisters as they’re known as they perform midwifery, nursing and operating theatre roles), lab technician and 2 associate health workers, all of whom had worked a full day at the hospital, stayed until 1.30am to see the patient through the operation. The patients appendix had perforated (another highlight of how late cases present) and without the operation more than likely would have died. “image