Hull York Medical School 2018

Medical, Nepal Pokhara

Annett, JessicaI wanted to experience a different type of healthcare as part of my elective, so when Work the World were recommended by a friend, I chose them. And I’m so glad that I did!

Everything about my trip was well organised and I was able to tailor it to suit what I wanted.

I chose to go to Pokhara in Nepal — the second largest city in Nepal after Kathmandu. Pokhara is well known as the jumping off point for many treks into the Annapurna mountain range in the Himalayas.

The city is situated on the edge of the beautiful Lake Phewa, with mountain views for most of the year (except during monsoon season).

Nepalese people are known for being friendly, with strong family values. Many of them are interested in people from outside Nepal, so expect to be asked where you are from!

I felt very safe walking around Damside and Lakeside with other people from the house (these are the main areas in Pokhara). They host numerous cafes, bars and souvenir shops.

Look out for places holding yoga and meditation classes — a must if you want to experience Nepal’s more spiritual side.

Annett, Jessica

Nepalese religion is mainly split between Buddhism and Hinduism. Be sure to visit local temples and monasteries to enhance your religious awareness of the country.

You’ll see breathtaking architecture in beautiful, bright colours. Although do be aware that if you join in to listen to Buddhist chants you could be there for some time!

I was based in the Teaching Hospital, located North of Pokhara. I spent one week in general medicine and two weeks in OBG.

Nepalese hospitals are pretty chaotic. The patient rarely comes to hospital alone — most patients have anywhere between two and five family members with them at all times.

The families cook meals for the patients, provide personal care and occasionally nap in spare beds whilst you do the ward round.

Annett, Jessica

Patients and their families fund all visits to the hospital themselves, including emergency care.

Healthcare is very costly to the family, not only to pay for investigations and treatment, but also through loss of income — family members are unable work whilst caring for a relative.

There isn’t always a discussion with patients about their care. The decision-making process seemed quite paternalistic. This was different from the UK and took some getting used to.

Family members are often told more about the patient’s care than the patient themselves.

Western Regional Regional Hospital in PokharaIn general medicine, you will see a variety of diseases not seen in the UK. Typhoid fever, tuberculosis and snakebites included.

You will also see conditions similar to those in the UK. Alcohol dependence, attempted suicide and mental health problems are common, but these patients are managed in a different way to back home.

There seemed to be more stigma attached to mental health problems than we see in the UK.

Due to strong family values that Nepalese families have, I expected the birth process to be supported by the family. In rural locations, this is still very much the case.

In the hospital however, birth is often medicalised. There was routine use of prescription drugs to augment labour, and routine episiotomies.

Pain relief and local anaesthetic are used sparingly, if at all, which can be difficult to watch when you are used to a different approach to birth in the UK.

DestinationBut don’t worry — you’ll have plenty of time each day to talk with your housemates about what you’ve seen. The same goes for members of the Work the World team at the house.

The Work the World house team’s insight into the Nepalese people (being Nepalese themselves) helps to explain cultural concepts that are sometimes difficult to understand.

As for what you should do in free time, I would thoroughly recommend trekking. There is something magical about seeing the white tops of the mountains emerging from above the clouds

During our three weeks in Pokhara, we managed a three-day trek to Poon Hill — a viewpoint that has a great view of the Annapurna and Dhaulagiri mountain ranges.

Drink plenty of masala tea, eat dhal bat, and enjoy meeting people from all over the world!

Go paragliding. Flying through the air with the wind rushing past, and the beautiful Phewa Lake down below is a fantastic feeling.

TRAVELAnd make sure you bring a good pair of walking shoes even if you aren’t interested in trekking.

There are a lot of places you can visit in an afternoon after placement such as caves, Tibetan settlements and the World Peace Pagoda.

If you are considering travelling abroad for your elective, do it!

Its nerve-wracking but exciting, and it will change your ideas about healthcare forever.

It is a fantastic opportunity to travel abroad, and Work the World will be supportive wherever you go.

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