Back in Kathmandu- the sweet sounds of dogs barking, horns beeping and people hoiking onto the street. It is our last day here in Nepal after 3 months working and walking our way around the country.
We have spent the last month in the Solukumbu region, well known for being home to the highest mountain in the world. Jamie, Sam, GB and I caught a rickety bus to Shivalaya and started our walk in from there. One of the things about Nepal is that you can count the number of roads in the country on your hands, making access in to most places quite difficult (and out of them even harder).
My work started a little earlier than planned, on the walk in to the villages where we were to start work. Jamie spotted a man lying under some blankets at a tea house we had stopped in (I had actually just thought it was a pile of blankets). He was a young police officer who had been in the police hospital for a month, and despite the fact that he was obviously on deaths door with weight loss and fevers, the doctors decided that because they couldn't figure out what was wrong with him, he was suitable to be sent back to work. We recruited a few robust cops to carry him back to the nearest road end (as he was too weak to walk) and I suggested he try visiting a different hospital this time.
The first village we spent some time at was Deusa, a beautiful little village perched on a hill covered in rice and millet fields. The rather run down clinic was run by Dev Kumari and Kumala, who did a wonderful job of treating and entertaining their patients (I gathered it must of been one of the afternoons activities to come to the healthpost to gossip- actually in the room with whichever patient was being seen at the time!). Almost all the children had skin infections and I soon figured out why when I realised that the nearest tap was a 15 minute walk out of the village.
There's a baby in that basket (left) and GB's home in Sotang (right)
Our next stop was Sotang, the home of our friend GB (Gyan Bahadur Katuwal). He had convinced us to come and visit his village and do some training with the 8 nurse midwives and health assistant there. His family kindly had us to stay at their cosy home, where we were fed copious amounts of delicious dal baat, and entertained by his 2 year old niece. Sotang has recently had the addition of a new health post, with small inpatient unit, outpatient area, and a delivery unit (unfortunately still no running water). The health assistant Shreedoj Rai is very experienced and was previously employed by the Hillary Trust. My job there was to do training with the healthcare workers there on women and childrens' health.
Nurse midwives at Sotang practicing newborn resuscitation on a rather scary-looking plastic doll
The training went well, as the nurse midwives were intelligent and keen to learn heaps. I also managed to put myself in the firing line for questions about womens health with a mothers group run by a local teacher. Some of the questions were straightfoward, but others were a bit more curly : "I had my uterus removed with a dead baby inside, and then the doctor left a gauze swab inside, which I later had removed, but now I have ongoing abdominal pain- how do I cure that doctor?"
We also had a chance for some practical training, which came in the form of a rather stressful experience. A woman in her 40s came in, abruptly delivered a baby (in the rather revolting delivery room toilet), but failed to deliver the placenta and slowly started bleeding away. In NZ, this would mean a quick trip to the operating theatre and maybe a blood transfusion, but in Nepal these things are literally hundreds of kilometres away. We managed to slow the bleeding with the resources we had available, and 20 hours later when it got light again, her family started off with her on their shoulders for a 12 hour walk to the nearest 'hospital' where they at least had a lab where they could possibly give her a blood transfusion. We raised enough money for her to fly from this 'hospital' to Kathmandu for definitive treatment, but I haven't yet heard whether she survived the journey.
After our time in Sotang, we headed off for Everest, for a last blast in the mountains before our return home... but I'll leave that to Jamie to write about.Here's a few photos though.