28.03.2010 - 11.04.2010 30 °C
Nepalese people are a tough bunch. In the Sherthung village where we set up our first medical camp using a school property, men and women are exposed to high UV content sun light on a daily basis by working in the field or other physically demanding outdoor chores. Not to mention to heavy amount of smoke inhalation from fire and cross contamination between feces and water/food due to lack of basic health education.
As a result of these factors, some common complaints include knee pain, diarrhea with worms, difficulty breathing, burning sensation all over the body and frequent tearing in their eyes. I was assigned to the role of triage at the clinic, which I felt completely comfortable with given the fact that I work in an ER back home in Canada. We saw over 200 people on our first day. Everyone was given their own station to see patient. The set up was basic. I was given gloves, BP cuff, thermometer that usually didn't work, and my most valuable asset - my translator. We all had our share in the difficult decision making process when it came to medicine in this remote region.
One of the challenges I had to come to terms with was the lack of resources. During our stay in the village of Jharlang, we received an emergency case where a man came to us carried in a basket. Been complaining of abdominal pain for a few days with a history of alcohol abuse. Pale looking, hypotensive, tachy with a fever. After the few blood work we were able to run, hemoglobin was in the 70s. Consider this situation if I were back home working, I'd be on my way in pumping IV fluid and antibiotic, mostly likely a Pantaloc infusion, hasseling blood bank to hurry up with the cross match, taking him to CT and anticipating a scope at some point. The reality was that I was somewhere in the Himalays with not much of anything. We gave him fluid and antibiotics. One of our doctors kindly donated a unit of blood to this patient. The plan was that if he stabalized over night, he would go to a hospital in Kathmandu for an endoscopy. We had to take into consideration that the patient would survive a trip to the city, which was a few days away, being piggy backed by a somebody else - patient transfer Nepalese style. Heck, it took us a day of driving and 3 full days of trekking to get here.