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my NEPAL and her PEOPLE's health !!!
Posted 25-06-2008 at 09:18 AM by Mati
While talking about the career and further studies, one of my friends from UK told me, “I know you have great future in far end of the world referring USA and USMLE but if you happen to think about Europe, let me know!” It came to me by very difficult because so far, USMLE is a way down in priority. In fact, it is not there in priority.
When I travelled to Kathmandu many of my well wishers in my home District suggested me I try for abroad. They thought I have good English (keeping in mind that I’m from Government schools) and equally great zeal to study so I could be going for that.
It was like “May be” when I found some nice opportunities e.g. Aeronautical engineering in Germany! But I was all set with MEDICINE and my interest to serve the people in my home country, the fellow citizens. Yes, it is that factor – Medicine and service I got stuck with.
When I got into medicine, the developments started to be seen in a way I had not expected and it is in the peak by now! Everybody’s ultimate dream is to go USA !!! Why ??? You all know about it. I don’t have to put anything that all know here. It is huge amount of money, hard work, and time investment! It is worth, of course.
When I was towards the end of my third year and running fourth year, I decided myself so strongly to be involved in Government job from civil service. I still stick to it. At least 10 Lakhs NRs money, a year of time, energy and not sure of it! I don’t have all those. That amount of money and time, I can be well settled here. Next thing is all about my interest which is not being done justice by USMLE of current trend. I want to do some work which is for all, if I’m outside the country. But if I’m doing the same thing that I can do from my country, there is no point leaving it. I guess I leave the stuff here without much fuss. But it is sure, if I’m dumped by my country’s system I will flee away where I can work better and use my expertise, be it Darfur or be it Dallas!
Episode 1
There was a six year girl from the very nearby district of Kathmandu, Kavre last week. She had simple fracture of her tibia. Very simple fracture! What the local people did with that they applied “Kavro”. It is tying of sticks together, wrap around the fracture site and tie it. They did it. They applied it so tightly that it went into ischaemia. On third day they removed it and too her to the health post. There the little finger was falling. The health worker in the health post did dressing about a week and the foot went on further gangrene.
Then the parents brought the child to Kathmandu. It was one of the Nursing Homes where they finished some amount of money they brought with few investigations. Of course, they couldn’t afford more than that so they were sent one of the tertiary centers where it has been written all findings and need of urgent operation! Definitely, they referred to another center where the parents landed with NRs 200/-! The leg had gas gangrene! Fingers were falling, maggots roaming and all foul smelling. The X-Ray of the leg showed gas even in the posterior compartment of thigh.
The mother was so ignorant and innocent; she didn’t know the district she came from!!!
Patient had no choice but choose for life from gas gangrene! The deadly limb!!! The doctors did great job running all around arranging bed, admitting, and shifting to free bed, finding every doctors drawer for some medicines e.g antibiotics, painkillers and syringes! Finally after one day, the orthopedic surgeons were able to take her OT. From the point of view of putting prosthesis and her life’s bread and butter, knee disarticulation was done first but the gangrene had gone up! Everybody in the OT were so sad for the little beautiful girl who is losing for limb for the fracture for which it would have been more than fine if left like that. So mid thigh amputation was done. The OT started 12.30 AM midnight and surgeons came of OT at 3AM. It is so sad.
Episode 2
Similarly, three weeks ago another guy of 42 years of age had fallen off the tree and had tibial fracture. There again same story had been. When the patient came in Kathmandu, all gangrenous and maggots running! When told about amputation, they are reluctant rather refusing of losing limb. Of course, who would give direct amputation! Everybody of that level would like to take chance if the limb survives. But there was no chance! The patient underwent knee disarticulation.
I’m telling the above stories because they are completely preventable and unnecessary loss. If they don’t do anything, that’s the best rather than above measures. That’s why in medicine, we say “Do No Harm”. It is so relevant here. But there are not medicos in the village and there is no question of “Do No Harm”. The local people are doing what they know and have inherited from the old traditional learnings. We can’t blame them.
There are so many others like RTA and roll over then amputation. Bomb blast and amputation and so on so on! But the scary thing is about these people who don’t have any awareness, facility and education. This is the tip of the iceberg of our society, healthcare and sufferings of the people.
It is so sad.
Best wishes,
mati
When I travelled to Kathmandu many of my well wishers in my home District suggested me I try for abroad. They thought I have good English (keeping in mind that I’m from Government schools) and equally great zeal to study so I could be going for that.
It was like “May be” when I found some nice opportunities e.g. Aeronautical engineering in Germany! But I was all set with MEDICINE and my interest to serve the people in my home country, the fellow citizens. Yes, it is that factor – Medicine and service I got stuck with.
When I got into medicine, the developments started to be seen in a way I had not expected and it is in the peak by now! Everybody’s ultimate dream is to go USA !!! Why ??? You all know about it. I don’t have to put anything that all know here. It is huge amount of money, hard work, and time investment! It is worth, of course.
When I was towards the end of my third year and running fourth year, I decided myself so strongly to be involved in Government job from civil service. I still stick to it. At least 10 Lakhs NRs money, a year of time, energy and not sure of it! I don’t have all those. That amount of money and time, I can be well settled here. Next thing is all about my interest which is not being done justice by USMLE of current trend. I want to do some work which is for all, if I’m outside the country. But if I’m doing the same thing that I can do from my country, there is no point leaving it. I guess I leave the stuff here without much fuss. But it is sure, if I’m dumped by my country’s system I will flee away where I can work better and use my expertise, be it Darfur or be it Dallas!
Episode 1
There was a six year girl from the very nearby district of Kathmandu, Kavre last week. She had simple fracture of her tibia. Very simple fracture! What the local people did with that they applied “Kavro”. It is tying of sticks together, wrap around the fracture site and tie it. They did it. They applied it so tightly that it went into ischaemia. On third day they removed it and too her to the health post. There the little finger was falling. The health worker in the health post did dressing about a week and the foot went on further gangrene.
Then the parents brought the child to Kathmandu. It was one of the Nursing Homes where they finished some amount of money they brought with few investigations. Of course, they couldn’t afford more than that so they were sent one of the tertiary centers where it has been written all findings and need of urgent operation! Definitely, they referred to another center where the parents landed with NRs 200/-! The leg had gas gangrene! Fingers were falling, maggots roaming and all foul smelling. The X-Ray of the leg showed gas even in the posterior compartment of thigh.
The mother was so ignorant and innocent; she didn’t know the district she came from!!!
Patient had no choice but choose for life from gas gangrene! The deadly limb!!! The doctors did great job running all around arranging bed, admitting, and shifting to free bed, finding every doctors drawer for some medicines e.g antibiotics, painkillers and syringes! Finally after one day, the orthopedic surgeons were able to take her OT. From the point of view of putting prosthesis and her life’s bread and butter, knee disarticulation was done first but the gangrene had gone up! Everybody in the OT were so sad for the little beautiful girl who is losing for limb for the fracture for which it would have been more than fine if left like that. So mid thigh amputation was done. The OT started 12.30 AM midnight and surgeons came of OT at 3AM. It is so sad.
Episode 2
Similarly, three weeks ago another guy of 42 years of age had fallen off the tree and had tibial fracture. There again same story had been. When the patient came in Kathmandu, all gangrenous and maggots running! When told about amputation, they are reluctant rather refusing of losing limb. Of course, who would give direct amputation! Everybody of that level would like to take chance if the limb survives. But there was no chance! The patient underwent knee disarticulation.
I’m telling the above stories because they are completely preventable and unnecessary loss. If they don’t do anything, that’s the best rather than above measures. That’s why in medicine, we say “Do No Harm”. It is so relevant here. But there are not medicos in the village and there is no question of “Do No Harm”. The local people are doing what they know and have inherited from the old traditional learnings. We can’t blame them.
There are so many others like RTA and roll over then amputation. Bomb blast and amputation and so on so on! But the scary thing is about these people who don’t have any awareness, facility and education. This is the tip of the iceberg of our society, healthcare and sufferings of the people.
It is so sad.
Best wishes,
mati
Total Comments 3
Comments
 | We all know, from long time our people are dying for foreigners, we are working for them. Working in foreign land as LAHURE, British and Indian army and now in Arabic countries. Now most of the young people in Nepal are willing to go abroad, some of them to work, and others to study. But the main aim to earn money and establish themselves there . Medical doctors are highly respected in Nepal, I am not talking about the politicians, but the general people. But most of us think that the USMLE is the best option, for our career. We talk about the more facilities, good education , modern technologies. We say these things are not possible in Nepal, so we go abroad. May be its true. We blame our country, here is no good career, no opportunities . after being a specialist, again we say, there is no use of our skill in Nepal, the government does not respect our talent. . But we don’t think about the basic need of our people. Our people are dying from simple fractures, but we are busy serving foreigners. We talk about the facilities, but we forget the reality. The reality is what MATI presented in the above stories. These cases are happening everyday . We can do many things, change the face of the country. People respect doctors, that’s why doctors have more responsibility. May be we are not made to run only after money. |
Posted 26-06-2008 at 02:08 AM by BGM3  |
| | Whom to blame?It's so sad to hear these kind of news fo every Nepal. Just remeber our childhood, our parents use same Kavro to take as first aid and had use urine to disinfect cuts. We aslo did same thing in our childhood when we cut our hands and fingers when we were cutting grass. That was helpful but today every thing changed. Our innocent Nepali are nto changed; therefore they still worship a compunder and medicine sales person more than doctors. A doctor change minimum Rs 250 for her first visit and patients are forced to buy expensive medicine as doctors should sell medicine for their pharmecy. They also get commission too. Don't we think the reason behind Nepalese medical problem are medical personnel. Nepales are innocent but they think they are smart. They wan tot save money so they buy medicine from sales man and health assistance because of convenience and low price. Then, they wait untill week or so then they visit clinic to pay high bill. The clinics took all the money patient's have and finnally they focred to patient to go to hospital being broke. The doctors in hospital do their best to medicate them. The situation already so worse. Doctors are human but not the god, herefore they can't reverse time and fix the situation. The doctors in hospital have to face criticism. How a single person cna change Nepale and tradition of Nepalese. That's the only reason doctors from Nepal want to be in overseas as they have ot pay the debt what they invested to be a doctor. They have to fulfil their paerents' dream and own expectation. Most of classmets and friend flew abord, they tell wonderful tale. We don't realize untill we won't face situation ourself. Parents told me, "hey son, first be a father then u will realize how hard it is to be a responsible dad. Unless u don't see the world urself u won't be right." If u give up doing USMLE and being in the USA, u always want to be there. If u have to do in ur old age , why don't u do today? Once, u love ur motherland, u never hate. I am sure that u r born to mediacte Nepalse, u'll return after spending some days in the USA. Stupid Puru |
| Posted 02-07-2008 at 02:51 PM by nc_nepali |
| |  Dear BGM3 and nc_nepali for the in depth view of the issue, Yes BGM3, our society, economy and tradition is such and if we see deep inside the root of our system. These are the few better options where our fellow citizens can find little bit money for their bread and butter at the cost of their hard work, intense sweat, dedication and honesty at the stake of their life! It is sad. Yes, of course, I agree. Everything is not after MONEY BGM3. We have that kind of prevalence of attitude blaming others but not doing justice to our own responsibility. That's very much true. Hope this attitude will change as time passes and we move ahead. Thanks so much nc_nepali for your detailed post about Kavro and vivid explanation of the setting! I'm so nostalgic on it and to my village, people and tradition. I will go home after few months!!! Yes, we lack some serious bridging there From PEOPLE to HEALTH CARE DELIVERY personnels. There are very limited or nil presence of the health personnels but whatever available the efficacy is also another important matter. How effectively you can deliver the right message. But for the time being we need more manpower and the MAN POWER who is suitable for the settings! I'm strongly in favour of generating middle class man power like CMA, and HA! They will be very nicely serving to the people and referring to the higher center from the very grassroot levels. It is so important. Then GPs!!! We need to reassemble and reformulate our system and produce the man power accordingly. Then keep on producing higher and qualified people and mobilize them as per the settings, qualifications, infrastructure and all that. Hope things will go OKAY with NEW NEPAL concept!!! Just HOPE! and DO OUR DUTY!!! Once again, thanks to BGM3 and nc_nepali for the interest and comments on the topic. Best wishes, mati |
| Posted 04-07-2008 at 07:33 AM by Mati |
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