Well my last two weeks in Nepal have come to an end. As I head off back to America. I have tried and tried to reflect on my time the final two weeks I have been here but I am still at a loss for words for my time here in Nepal, hopefully once I return to the states and take time to rest and reflect in my time here I will be able to form words for my experience here. One word that comes to mind right now is grateful.
So last week I spent time in the Ortho unit. Most of the patients I saw were bandaged. I do not know much about orthopedic patients, and trying to ask and be told things by Nepali nurses and doctors can be a little difficult to understand, they do not always use the same words we use to describe things. Many of the patients had Ilizarov Apparatus which is a external fixation type of cast, and is used to treat compound or open bone fractures. The first day on this floor a nurse came up to me and asked if I could take manual blood pressures, I said yes, and so the two of us went around to all 30 patients on the floor and I recorded their manual blood pressures. Some of the patients would speak English and some of the patients, especially those with high blood pressure knew their blood pressure numbers exactly, even before I told the nurse. There were two patients who were both patients brought into the ER when we worked our night shift, who then had surgery and were transferred to the post-op floor, which then I was able to continue following the patient’s care. They also used traction a lot with jugs of water. There are no hard casts in Nepal, how they cast an injury is by taking what looks like a metal ladder and wrap thick gauze all around it and they use that to stabilize the broken limb and then they wrap the limb and brace with something similar to an ace bandage.
The other half of the week went spent doing out reach programs. One day we went and toured the local hospital and the cancer hospital to see the differences compared to the private hospital we have been volunteering at. The local hospital was very chaotic, and much older then the private hospital. The cancer hospital in Chitwan use to be the biggest cancer hospital in the country. We were not allowed to look at patent files or participate in any care at either of these two places but I enjoyed seeing how they differed from the private hospital. Another day we went to ABBS which a daycare that treats physically or mentally disabled children. We were about to watch the physical therapist come in and work with the children who had physical disabilities, because it was festival time there were not many kids. The last day of outreach we went to a local school and taught hand hygiene and oral hygiene to third graders. The third graders thought we were the greatest people ever and they were really smart and could answer all the questions we asked. They understood the importance of brushing their teeth, but we had to clarify some things about hand hygiene as Nepali people eat with their right hand and wipe with their left.
The final week I spent my last few days in the CCU before heading off the Kathmandu to explore. The most fascinating patient was an older women who had already had a valve replacement as well as a PCI, but she was still having problems. The first day I saw her she was on a temporary pacemaker, and the doctors were discussing whether or not the family could afford a permanent pacemaker. The family decided that she would receive a permanent pacemaker, and sadly I was not able to go see the placement of the pacemaker. The next day I came on the unit she had her pacemaker and they were beginning to prep her for discharge. My last day I spent time in the ER which was exciting but also emotionally draining. We had three very critical patients come in. The first patient came in after collapsing on his morning walk with right side weakness and facial drooping. After almost two hours of him sitting in the ER waiting for his family to pay for all the treatment he went to CT and they discovered he had a hemorrhagic stroke. The next two patients that came in were brothers. They had both been electrocuted and the older of the two brothers was already gone when they wheeled him in and the other brother they were fighting to save. They started an IV, put him on oxygen, and he started desating so they intubated him and once he became stable enough they transferred him to the ICU. This scene just keeps replaying over and over in my head. I see the brothers being brought in, the dad being taken to see his now deceased son, while his other son is fighting to stay alive. The mom couldn’t handle it. She ended up laying down in a patient bed shaking. The whole time I had been in Nepal I had never seen 1) this many people in the ER 2) so many family and friends come visit 3) this many people cry, and not just cry but wail. Sadly, I witnessed some deaths while in Nepal, but none of those family members showed their emotions in public like the family members and friends of these two brothers.
After quite the exciting week, I was headed off to Kathmandu to go exploring by myself around the city and the out lying towns. Traveling alone really teaches you a lot, and builds confidence in yourself that you can conquer anything. I will never forget my experience in Nepal, my second family, and all the great relationships I made. I am excited to share in person everything I have observed, experienced, and learned.