Since the April 25th earthquake, there has been a surge of interest for well-meaning nurses and doctors from USA who wish to volunteer their services in Nepal. This is as it should be - it is natural to want to help when you have skills that could save lives.
In general, send money instead. Nepal is not an easy "first Asian country" to visit, let alone to work in a hospital. There are many "videshi"(Foreign) medical and surgical teams now operating in Nepal, but these are self-contained teams with specialized skills.
Also, there is ample personnel in the country. CCNEPal(my NGO) trained 1,840 nurses and doctors in Advanced Cardiac Life Support since 2011. 800 of these nurses are doctors were in Kathmandu for the big one, using their skills.
The hospitals in Nepal, and most importantly the ones in Kathmandu, survived mostly intact, which is a blessing. The process of rebuilding will be a long one, and though you may not be able to help right now, there are ways an American nurse or doctor can contribute.
But - things are - different. If you step over the orange line at the Nepal customs desk, below, you will see a little glimpse of exactly how different.....
This is a picture essay, and the pictures come from many different hospitals, taken over the past eight years. please note: I used to take liberal photos of Nepali patients but these days I no longer take pictures of actual patients without their express consent.
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Here is a hospital ward. Some patients pay extra for a "private cabin" but mostly the beds are on a shared ward.
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typically, hospital food is rice and lentils. Often the family is expected to bring in food; it's not part of the room charge. The caste system makes it difficult to supply the same food for all patients.
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ICU in one of the more recently-built hospitals.
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many Nepal hospitals have piped-in oxygen but there is no liquid oxygen capability in the country - so - somewhere in the bowels of the building there will be a large stock of these.
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everyone pays for their own - there is no insurance. therefore, no need for detailed medical records......
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hospitals use the least amount of "disposables" they possibly can.
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clean and sterile gloves are decontaminated, cleaned, and dried before re-use.
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there is not always central heat in any given hospital. In winter, patients and staff wear a lot of wool. Nurses, I learned, know about fifty different ways to tie a scarf around their neck. And of course, real Nepali Pashmina wool is the best quality...
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trolleys in an ER in Nepal. It was difficult to find a time when these were not all occupied. note that there are no drapes....
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and the sinks are not plentiful. Here is an improvised wash station so the staff can practice hand hygiene while on morning rounds.
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the unit-dose system is not implemented everywhere, and medication dispensing uses a different system.
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quiz for nurses and doctors: If you know what this object is, answer below and you may win a prize.
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morning report at the nurse's desk.
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Nepal is beginning to use implantable hardware in orthopedics, but you will still see this in use. ("Gallows traction" in pediatrics)
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In the Operation Theater ("O.T.")
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a student nurse about to do a dressing change
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even when the hospital owns a dryer, they will use solar power for hospital laundry to save power and petrol.
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neonatal resuscitation equipment in delivery suite - ready to go.
I'll try to post pictures of nursing education in Nepal in a coming blog.
Nurses who work in a hospital need to "become one with the building" and learn how things work - where to get oxygen; how to give meds; how to do the things ordered but the doctor; how to use the charting system and communicate. You can't just assume that you can walk in there, and do everything without a lot of hand-holding.
For all these practical reasons and more, you need to go with a reputable NGO that will help you navigate the system.
If you want to learn more, buy one of my two books, or go to the FB fan page for my project, CCNEPal.