238. Nepal Day 6

More screening today, starting in pm though patients have been liningup since early morning. As in the Philippines and Ecuador, we often need two translators: one to translate local dialect to standard Nepalese and the second to go from standard Nepalese to English.  Obtaining an useful medical history is a real challenge.  Ages, for example, invariably end in 0 or 5, not surpising given low education levels (most “sign” consent forms with a thumbprint). These are women who have lived their lives as substinence farmers, bending over in rice fields, carrying heavy loads everywhere. I saw plenty of tractors but I suspect a recent development.


The word that went out among local medical providers that we were looking for patients with uterine prolapse (the vagina turns inside out, extending outside the vaginal opening in a complete prolapse). So that's what we saw, no problem since the mission came with three specialists (urogynelogists who have expertise with the fixing of prolapse—essentially removing the uterus then attaching the vagina to a higher structure, such as the ligaments that hold the spine together. 

237. Nepal Day 5

I think the hospital is private but looks like it was built with public funds.There doesn't appear to be any active public hospital in this city of about 40,000. The two operating “theatres” and now empty pre-op/postop wards look like they haven't been used in weeks or months (but there is another OR upstairs next to an active labor and delivery ward which is used for cesarean deliveries), so the first task is a thorough cleaning and the unpacking of supplies. I personally brought about 100 pounds of sterile drapes, gowns and other medical items, and 50 lbs of prosthetic hands supplied by an LA foundation.

We also started some screening.  Lines didn't go around the block like in Cambodia, but there were always some women waiting to be seen.

236. Nepal Mission days 1 through 4

View from plane: Everest?  Maybe

A surgical mission to Nepal.  Treking to a mountain clinic with mountain goats carrying surgical instruments and IV bags? No, we're going to the agricultural lowlands (rice, dairy, sugar cane), near the border with India. A Nepalese ex-pat physician now working in U.S., grew up here.  His wife, also a physician, is from another area in Nepal and in alternate years the team travels there.  This is a large surgical team —six gynecologists, five general surgeons, and 5 anesthesiologists. Add nursing and other support personnel and the team adds up to 50 or so.

Marshlands and Water Buffalo

The real beginning of an overseas surgical mission begins months or even years in advance. Visas, governmental approval, lodging, ground transportation, and supplies, supplies, and supplies.

I left Wed at 2pm with an 11 hr flight to Seoul. Overnight airport hotel (part of the airfare package). Day two a six hour flight to Kathmandu, a six million urban sprawl.  Day three acclimatize, then on day four a 7 hour combination air/bus to destination. Whew. Waiting for the last flight, met a young Chinese businessman who was both surprised and impressed that our group was not sponsored by the government or a Red Cross type of organization—we travel, lodge and eat all at our own expense I explained.