University of Manchester 2012

Medical, Nepal Pokhara

When choosing where to go with my elective I was faced with endless possibilities from beaches in Africa to world famous hospitals in the USA. After long deliberation I settled on Nepal, a choice I will never regret. It was the mountains that drew me to Nepal but it was so much more that made me fall in love with it.
Arriving in Nepal on my own was quite a daunting experience. But the fear subsided almost immediately as I was greeted by a friendly face at Pokhara airport and taken back to the house. Within minutes of being at the house I had been made a cup of tea (clearly they are used to the English), introduced to other students and shown to my room.

The Work the World house is perfectly situated a short bus ride from both the hospital and lakeside. It is kept beautifully clean by the wonderful housekeeper – it didn’t take long for me to adapt to having my bed made for me again. Full of other students it was a great way to really get to know each other. The atmosphere was sociable and relaxing, just what you needed after a day in the hospital. You will never be short of people to do things with a constantly varied selection of people in the house. By the time my placement was up, I had built up what felt like a family network and leaving was overwhelmingly emotional.

Life in Pokhara

Life in Nepal is very different but it didn’t take me long to adapt. Pokhara is Nepals second largest city yet has an amazingly relaxing atmosphere. Lakeside is the tourist area of Pokhara and is packed with shops, bars and restaurants that overlook the stunning Phewa lake. Throw in the mountainous backdrop and it couldn’t get any better. As you can imagine much of our spare time was spent here.

It took a few days to get used to the stray cows in the streets and the endless car horns but by the end of week one I felt fully at home. Despite all the phenomenal scenery, the best bit about Nepal for me was the people. Everyone so friendly, welcoming and even willing to give up their seat on the bus for the tall crouching English man. You will need to learn how to barter however. Every shop keeper will assure you they offer a “very good price” but this is not always the case. Don’t worry with a little help from the language lessons you will be relishing in this experience in no time.

Despite all the phenomenal scenery, the best bit about Nepal for me was the people

I can’t talk about Pokhara and not mention the mountains; they were after all what drew me here. I couldn’t come here and not go trekking and this was one of the best experiences of my life. To be so close to the world famous Himalayas is an experience I will never forget. Along with the views comes the kindness and “mountain service” offered by the locals and the amazement at the strength of the Sherpa people carrying somewhat ridiculous loads up the mountain side. With treks varying from 2 days to 2 weeks there’s one perfect for everyone.

My placement

What was most interesting about the placement was to observe the contrast to health care in the UK. One of the biggest differences that I noticed was in the interaction with the patients. Doctors in Nepal are viewed very highly and govern a lot of respect from the patients. There seems to be little room for small talk and on ward rounds the patients are barely spoken to at all.

The local government hospital was very busy and navigating the corridors was often the most challenging part of the day. I quickly learned the importance of family and communities to the Nepali people. Patients were always surrounded by their full extended family and should a patient pass away the whole village community would arrive at the hospital to pay their respects.

I had the opportunity to attend outreach clinics, where a doctor would travel to remote communities that have no immediate access to health care. There, they would run what is essentially a drop in clinic. As many of the patients were very poor, the option of referring them to the hospital was limited so in most cases the doctor needed to formulate a diagnosis and treat it there and then. As he only has with him his stethoscope and no other means of investigation this often relied on guesswork.

I had the opportunity to attend outreach clinics, where a doctor would travel to remote communities that have no immediate access to health care.

My hospital placement was a great opportunity to witness and learn about conditions that we see much less of in the UK such as Rheumatic Heart Disease, post viral glomerulonephritis and organophosphate poisoning. It also provided the chance to observe a different approach to medicine which will leave me plenty to think about when I begin to practice myself.

Village Experience

One of my highlights of the trip was my village experience. We stayed with a local family who couldn’t have been more welcoming.

This gave us the opportunity to see how the rural community in Nepal really live and how different their lives are from ours. By day we helped out on the health post seeing patients with all sorts of complaints from high blood pressure to arthritis. Our advice on pain medication regimens and the treatment of viral illnesses without antibiotics was welcomed. It was rewarding to see that the knowledge we brought with us could make a difference to these people and that they trusted us. In the afternoon we took part in cultural activities such as visiting the temple and even attending a local wedding. We would then sample the real local cuisine with the family before retiring to bed. In the week that we were there we were made to feel both a part of the family and the village community.

Nepal is a poor country and many of the people struggle as a result. Despite this, the people emanate happiness and positivity. Religion and family takes precedence over anything else and their attitude to life is inspiring. Nepal is blessed by stunning scenery everywhere you look but its greatest gift is its people. For me, doing my elective in Nepal offered me everything I could hope for and it was work the world that made this possible. I honestly believe it has something for everyone so if you choose Nepal you won’t be making a mistake.

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