University of Manchester 2018

Medical, Nepal Pokhara

Pokhara is a wonderful place, bursting with culture and full of incredibly friendly people.

Lowe, DominicIt is built around the beautiful Phewa Lake and fairly close to the start of many trekking routes that lead into the Himalayas. I arrived in Pokhara by plane and one of the fantastic members of the Work the World team was there waiting to take me to the Work the World house.

The house was situated near enough to Pokhara's central area such that we could visit bars and restaurants easily, but not so near that it was a bother. The house was a great place to come and rest at the end of the day, and I found it therapeutic to hear other student’s stories and share my own. The catering team made excellent food each evening and a substantial breakfast in the mornings too. On Thursdays we had BBQs on the roof—the views on clear days were breathtaking with the Himalayas towering over the horizon.

Lowe, Dominic

A couple of times a week we would have language lessons given by our wonderfully enthusiastic teacher. His lessons about the culture and language made our time in the hospitals easier, making sure we didn’t come across rude and could communicate with patients. Most doctors spoke fluent English and all the medical notes were recorded in English too so it was easy to follow what was going on day to day.

The Work the World team at the house were very welcoming, always asking how we were and helping us in any way they could.

I spent six weeks in a hospital in northern Pokhara. I divided my time  between the Emergency Department and anesthetics.  As a medical student, I took on a primarily observational role, but as time went on and as I built rapport with the medical staff, they asked me to help out in procedures more and more.

This included performing an intubation and carrying out chest compressions. Although the science of medicine is the same in Nepal, the cultural settings and resources surrounding it vary greatly from that of the UK.

Lowe, Dominic

Patients often presented with diseases much further advanced than they would be in the UK. And they seemed to complain very little, even with conditions such as (alarmingly large) plural effusions or dramatic fractures.

The facilities in the Emergency Department were not modern. There were no computers, and only some beds had working monitoring equipment. Most of the beds lacked curtains.

The facilities in the operating theatres were more comparable to the UK, with many pieces of modern equipment.

Lowe, Dominic

Families often accompanied most patients arriving in the Emergency Department. There were, sometimes, up to 15 familly members per patient. These ‘patient parties’, as they were sometimes referred to, were heavily involved in decision-making, and responsible for covering the cost of investigations and procedures.

All procedures and investigations had to be paid in advance of them being carried out.

In some cases treatment had to be stopped, as the families weren't able to pay for continued treatment. This was quite challenging for me to observe.

While spending time with the anesthetics team, I witnessed many different techniques and operations. These included laparoscopic surgeries and many C-sections.

Local doctors were great teachers and I was in awe of their knowledge and ability to provide medical care with limited resources. The patients, who often persevered through incredibly severe conditions and who expressed deep family bonds, also inspired me.

Lowe, Dominic

The weekends provided opportunities to explore Nepal. We went on many adventures as a group of students together from the house.

Two of my favorites were a trek up Poon Hill to see the sunrise above the Himalayas, and a weekend in Chitwan National Park where we saw lots of wildlife and joined in with some pretty spectacular traditional dance.

Lowe, Dominic

There were many great activities to do in and around Pokhara itself. Paragliding and relaxing boat rides on the lake were popular choices.

Lowe, Dominic

I loved my time in Nepal. There were some challenging days in the hospital for sure, but it was certainly an eye-opening experience. It made me appreciate how much we have available to us in the UK.

I made some great friends, went on awesome adventures and learnt some valuable lessons that will make me a better clinician. Work the World were great in both the run up to the trip and during the trip itself.

I could not give higher praise to the team in Pokhara. I hope to visit again one day, and I couldn't recommend this placement more.

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