Engineering World Health DTU

Almost 6 weeks in Nepal are now history and the flight ticket home is scheduled in 4 days. Tomorrow Mads, Sofie and I will present the results of our stay at Phaplu District hospital for the hospital staff, some local students and the personal in the health district office. Some of the headlines in our presentation are: 45 medical devices have been put back into service, a few selected of the hospital staff have completed a course in simple electric fixes and soldering, and thorough interviews with the doctors regarding the hospitals need of specific medical equipment have been conducted.

I personally believe that our one month stay at Phaplu hospital contributed to an enhanced patient care for the people in Phaplu and the local area. We have repaired 45 devices including multiple oxygen concentrators, an infant incubator, an infant warmer etc. which is both expensive devices but also providing a lifesaving treatment.

I further believe that the hospital moving forward will be able to handle more repairs themselves with the newly achieved knowledge regarding electrical fixes and safety. This is by far a much greater achievement that the hospital in a smaller degree relies on help from outside since Phaplu hospital is located very remote.

Nepal has been such an amazing country to live in. The nature is truly magnificent and unique. Waking up at 6AM looking out the window at the Himalaya mountains is indescribable and something everyone should try.

The Nepali people are the most welcoming and warm hearted people, I have ever met. Wherever we went, there was always a kind person to show us the correct direction, translate nepali or enlighten us with nepali culture.

Right now I’m sitting at a coffee shop waiting for my tuna sandwich and cafe latte. In a few hours I will be flying to Hong Kong where I will stay the next week. I look forward to a week that will be very different from my last six weeks in Nepal and probably also from the last year in Denmark. I will be on vacation doing absolutely nothing! It’ll be great!

Friday we first said our goodbyes to our wonderful host family and later to our friends at the hospital. When we hugged Rameesh (one of the technicians) his eyes got all teared up. Hugging is actually not an acceptable thing in the Nepali culture, or it of course depends on the person and how close you are, but both Sara and I decided to give all the technicians hugs, which ended in a lot of awkwardness.

 I’m amazed by how good a relationship we got with the maintenance staff in this short time period, especially because of the huge language barrier. It’s been amazing working with them and I kind of promised to visit when I come back to Nepal again. Which I hope I can keep.

Working in a developing world and being out of my comfort zone for six weeks has been challenging, frustrating, interesting, educational but most of all it has been amazing. I’ve had my ups and downs and sometimes I felt that I had more downs than ups, but in the end looking back at it now, it has been a great adventure that I would not have been without.

We managed to fix 66% of the 53 equipment we looked at, but the thing I find the most important is all the social relationships we have established at the hospital. Trust is an important thing anywhere you go and building up the trust between us and the hospital staff has been difficult, but we managed and have a really good network which hopefully will be useful for the next volunteers coming to Bharatpur District Hospital.

The person that affected me the most has been Dr. Rameesh, the surgeon in charge of the OT. Last week we interviewed him to get a better understanding of the equipment at his department and which new technology he would like to have. To every question he would just answer: “We work with what the government gives us…but we manage.” Every sentence always ended with “but we manage”. He has been working at the hospital as a surgeon for 15 years and even though I have never seen him operate I believe that he is an excellent surgeon. He is a very passionated man. He would just open up biomedical equipment without having any electrical training at all. He could easily get a very well paid job in Kathmandu with the best biomedical equipment and a clean OT, but he is in Bharatpur helping the poorest people in the district and this is what changed the way I saw the hospital. For a long time I had distanced myself from the hospital, the patients and the staff, but after this interview I started to respect the place. We need more Dr. Rameesh’s.

It’s incredible how fast the last six weeks has passed by. I’ve learnt so much, not only about the biomedical equipment, but actually mostly about cooperating with people whose way of approaching life and mindsets and are so different from mine. I’ve learnt that if we want to work together the culture- and especially language barrier is not a problem. We are all human beings that do not need language to communicate and become good friends. Speaking helps a lot and makes the process much faster, but if  you truly want to understand the person in front of you the language will not be a problem.

This trip definitely have had an impact on how I will approach different cultures and cooperate with people in the future. I have definitely become a more patient person. Patience in Nepal is very important since delays and unreliable people are common problems, compared to Denmark where you would apologize for being five minutes late.

It’s been a real adventure and I’m eternally grateful for everyone I have met. I hope we’ll see each other again.

Saving equipment, saves lives!

I think I’m getting used to Bharatpur, not the hospital, but the city. I’m not sweating as much as I did the first couple of days and I’m getting used to the daily routine. We wake up at around 7 am sometimes with the fan on (really nice), but sometimes in the middle of a power cut, which means that I will be lying in a pool of my own sweat (not so nice). The homestay family is great and they make  the best Nepali chiyaa (tea).

The hospital has a maintenance department with 3 technicians where only one of them is doing any work, Ramesh. The other two can sit for hours under the fan doing absolutely nothing. We work close together with Ramesh, he knows a lot, nothing about biomedical equipment but he has a good understanding of  electrical circuits, which is really useful. The language barrier can be challenging since teamwork requires a lot of  oral communication and Ramesh’s english is very limited. We are doing our best and today we fixed an anesthesia machine together. We mostly communicate by watching what he is doing and trying to figure out what goes on in his mind. It works most of the time.

Yesterday I got sick, it was just a cold, but since I wanted to go to work I decided to buy some pills for the symptoms. I visited the local drug store, explained him the situation and got some pink pills. He said they where good. I took the pills before googling the name, bad idea, but I was desperate. I later found out that it was antibiotics, so now I’m on an antibiotics cure for a cold. No wonder we are developing multi resistant bacteria.

Two weeks of work at Phaplu District hospital has come to an end. To work with the local doctors is a very different experience from what is to be expected from back home.  Time schedules and meetings are rarely on time and deadlines are in Nepal a less used working tool. The doctors medical professionalism and commitment is however overwhelming and very much of a surprise to me. Being a doctor at Phaplu District hospital is not only about treating patients for illnesses but also to be a front runner and a role model for the local society. Walking down the streets accompanied by a doctor is often a time consuming matter due to all the greetings, gratitudes and friendly exchanges between the villagers and the doctor.

Mads, Sophie and I have been working and to begin with, most of our time went by organizing and cleaning medical devices which had been put out of service.  Now two weeks into the project we have successfully repaired 24 devices and amongst those are several oxygen concentrators and manometers, a radiant warmer, two pulse oximeters, a pulse oximeter monitor. The next two weeks will hopefully be just as successful as it has been so far!

The first few days in Phaplu has passed and what an experience it has been! Everything from the small wooden houses to the amazingly beautiful mountains are new to us.  Acclimatizing to both the altitude and the local culture has been in focus even though the latter seems to be the most difficult.  Mads, Sophie and I have been allocated with a local family consisting of a grand dad (the family’s head), a grand mom (the master chef), the oldest son (the shopkeeper) and his wife and two children. Several daily helpers are also staying with the family which in return for their service provide accommodation, food, education and care. We have all been friendly received with open arms and are looking very much forward to our stay.

July 16th 2073 (Nepali time).

I really enjoyed my time in Pepsicola. I lived with a great host family (and their washing machine). We had a lot of mito chha food and learned more about the nepali culture and especially the caste system, which is really interesting.

Sunday we (Sara and I) said our goodbyes both to our host family, and also to the 15 other engineering students who are all now scattered out in Nepal working at different hospitals. We are in Bharatpur together with Umesh, a Nepali electrician from Janakpur, working at the local district hospital and had our first work day Monday the 11th.

The hospital is nothing like I expected. Bharatpur District Hospital is the largest district hospital in Nepal and also one of the busiest hospitals. Since it’s a district hospital it is only visited by the poorest people in the area. The typical occupancy rate is 120% and the daily out-patient number is around 1500-2000.

We have been working there for a week now and it is extremely challenging (without overestimating it). I was expecting bad conditions, but I would never be able to imagine these conditions. Hygiene is not a priority. It’s been difficult to find a spot to wash my hands and I have not yet seen alcohol dispensers for disinfection. There is garbage and stray dogs everywhere. There are not enough beds in many parts of the hospital and seeing especially pregnant woman lying on the ground, in the maternity department, a few hours from giving birth has been difficult. They lie on few mm thick mattresses rubbing their stomachs and there is nothing we can do about it, which is really frustrating. The hygiene we want to help with. Setting up alcohol dispensers is not a problem, but we need people who can fill them up when we are not there, so now we are trying to make friends with the staff, especially the nurses.

 In Nepal they work 7 hours a day 6 times a week so saturdays are our only days off. This precious day we spent sightseeing in Devghat with Patrick and Jon, two of the other volunteers. In Devghat we saw the junction between two of the major rivers in Nepal, which is a religious place in Hinduism. It was nice getting away from the city and the noise.

 The hospital is definitely going to be a great challenge, but I really believe that we can make a difference. I look forward to the next three weeks which I know will be filled with a lot of frustration and hard work, but hopefully also a lot of fixed equipment.

Today we the EWH DTU Nepal SI 2016 Bhaktapur group donated 4kg of Lego to a local school, Sunrise National School.We were able to play with them and help them build towers as this is the first time they’ve ever seen Lego. It was great fun and we could see their creativity blossom :)

/Carita

I have by now completed a 3 week intensive engineering course and 10 days of Nepali language training, and I am more excited than ever to travel to my hospital location and to meet my homestay family. I am going to stay here for 4 whole weeks with the intention of repairing and structure medical equipment for Phaplu District hospital as well as becoming as integrated in the local culture and society as possible. Both tasks seem possible due to the well-arranged preparations, and the longing for actually utilizing the newly gained skills grow by each day and each class.

We’ve been in Nepal for a week now, but it’s first today I have some time and a semi-good internet connection.

We spend the first five days in Dhulikhel in our own little european bubble at a resort. We started our language classes and learnt the most important do’s and don’ts in Nepal. We practiced eating with our hands and saying thank you in nepali ( [daneebad] which I still have difficulties saying perfectly). The hardest thing about learning the nepali culture and language is that the locals will never correct your mistakes, so you can go for weeks before you meet a kid who will correct you. The first time I was corrected was at the Sunrise orphanage because I didn’t sit correctly while eating.

Now we are in Purano Sinamangal, aka Pepsi-cola, at our homestays. I still feel that we are in our european bubble. We have a “normal” toilet, cutlery, and ones in a while we also have internet and hot showers. We get a large variety of really tasty food. Of course we also get dahlbat (rice and dahl) but that is actually quiet nice and I am not tired of it yet, even though we eat it twice a day.

We have been sightseeing in both Dhulikhel and Pepsi-cola where we have seen a lot of temples, both buddhist and hindu. The 2nd of july we visited an orphanage (The Sunrise) where we helped them with their homework, gave them LEGO and of course played football on their rooftop. It was a nice evening with a bunch of really great children. It was clear to see that school and friendships are the most important things in their lives.

I’ll be in Pepsi-cola until the 9th of July. The 10th I’ll start my work at the hospital in Bharatpur.