February 2016 | Issue 22

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Working with Nepalese communities to rebuild healthcare services

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By Vivegan Visvalingam
Class of 2019


At the end of last year, six of us finally went on our long-awaited week-long Overseas Community Involvement Project (OCIP) trip to Nepal. This was our first trip and served as a stepping stone to establishing a continuing project, titled Project Aasha (Aasha meaning hope), for LKCMedicine.

We had originally planned to help retrain healthcare workers in the village of Phortse in the Khumbu region of Nepal, where Mount Everest is. But we had to shelve our plans because of the earthquake that struck the country in early 2015. Even months after the disaster, communications were not completely restored, so it was difficult to work out the details of the project.

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L-R: Villagers welcome the team; and team in the midst of discussion

Instead, we went with orthopaedic surgical resident at Tan Tock Seng Hospital Dr Kumaran Rasappan and his wife Dr Gayathri Devi Nadarajan to the district of Gorkha in Western Nepal to provide health screenings and health and hygiene education to school children there.

We spent the week running a health clinic, conducting health screenings and some health education lessons at the Sree Saraswoti Higher Secondary School, and meeting contacts for future expansion of our OCIP.

At Sree Saraswoti Higher Secondary School, we taught children about health-related issues like handwashing, tooth brushing and nutrition. The older kids were also taught about the harmful effects of smoking and drinking.

The next two days were spent at the outpatient clinic in the district hospital where we conducted health screenings for the patients who had come to see the doctor. It was a tiring process as the crowd got very big during the afternoon. Most of them came from the outskirts of town and wanted to get a consult before the last bus left for their village.

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L-R: Village children with the handwashing poster we used to teach them basic hand hygiene; and a villager has her blood glucose level checked at one of our clinics

On the last day of our project, we went to the village of Kattel to conduct some surveys of the villagers there. We quickly saw that the village was still in the recovery stages from the earthquake. The houses were still in ruins and most people were living in makeshift zinc shelters.

While we were conducting the health surveys, Dr Kumaran and Dr Gayathri ran a health clinic in the village centre for older patients who were not able to come for the afternoon session, which was going to be set up in the village school. There were about 30 patients who had come to see them that morning and almost all of them had the same issue – chronic knee and/or back pain.

Later that afternoon, we saw some more patients, both young and old. We were assigned to different screening stations, prescribing medications with the doctors and surveying those who came to the clinic. The day ended with a campfire organised by the school scouts together with the teachers, and many school students also joined.

The entire trip was a big eye opener for us. On the day we arrived at the school, almost all the students were lined up from the start of the pathway till the entrance of their school, all ready with garlands and flowers to thank us for the donation we had sent after the earthquake, money they had used to build emergency shelters ahead of the monsoon season. They even had an opening ceremony with performances organised by the students themselves.

We felt quite embarrassed as we did not feel that we did enough to be receiving so much from them. In addition, the resilience of the villagers really inspired us. Despite their houses lying in rubble, and having to live in smaller houses than before, the people of Kattel had moved on. They continued with their daily routines, not letting the destruction set them back.

At the same time, we also learnt that there is a widespread belief that foreign medication and doctors are also better. And with transportation more-or-less restored, people have ready access to Gorkha Hospital (as we learnt through our surveys). Despite already having the proper medications for their ailments, the villagers wanted to see us, foreigners, because of their belief. It is possible that running such clinics may do more harm than good as we should always work together with the existing infrastructure and not against in order to ensure sustainability.

That is why when we go back this December, we are thinking about focusing more on non-medical treatments, like physiotherapy, to help them cope with some of their chronic health conditions, such as back and knee pain. We also want to re-visit the school and help build better toilets with proper handwashing facilities.

Other options we are exploring include a trip to the village of Bhung to help reduce the high mother and infant mortality rates stemming from improper birthing techniques. We also hope to plan a medical camp where we bring in an eye surgeon from Singapore to perform cataract surgery for patients affected by the condition.

To conclude, the trip was a success. We got a good idea of the demographics of the villages and we also learnt what is useful and detrimental for them. It is a very good beginning to what I hope will be a series of projects that the students can participate in, to serve a community in need and to have an adventure at the same time.