2018

Arrival and First Week - Johannes Kruse

Date: 05.07.2018

Namaste (“I respect your soul/god in you” the greeting in Nepali).

The DTU-EWH Summer Institute Nepal has begun, and we are up for a good start. I arrived in Kathmandu the 1st of July – smooth travels from Copenhagen with two layovers (London and Doha).

When arriving in the the airport I was greeted by two friendly EWH staff members, one of them was Dinesh, one of the coordinators, who had arranged transportation to a nearby hotel in Kathmandu. I arrived in Nepal a day before most of the other participants (the program officially started the 2nd of July). And with no time to waste I started my first day in Nepal with an action packed program – cite seeing, monkeys, and dal bhat (the national dish in Nepal).

The day after my arrival the other participants arrived and after picking them up at the airport, the program was to begin! We drove by bus to a nearby city, Dhulikhel, an hour or so from Kathmandu. Here we were to stay for until Friday before we head back to Kathmandu for more adventures.

This first week is very well organised with a bunch of cool activities; Nepali language & cultural lessons, temple tours, visit to the local hospital and others. Most of the activities and all the meals are enjoyed together which creates a great atmosphere!

Everybody is excited for the time to come, stay tuned.

//Johannes

First Week and Host Family - Tharsiny 

Namaste!

The first week of Nepal SI 2018 is now over, and we have already gained a lot of knowledge and several impressions of the many faces of Nepal. The first couple of days we stayed at a beautiful spot at Dhulikel (see the pictures of the amazing view), where we got language and culture lessons, got introduced to the famous daal bhat and tried to get used to the hot and humid temperature.

We explored the area around the resort, and saw Dhulikel Bazaar, Dhulikel Hospital and Kali temple. There are 1000 steps to the Kali temple, where you can have this amazing view over the valley. Even though we are a group of mixed people, we have been good at bonding and teaming up. In the nights we danced to Nepali music with the locals, drank Nepali beers and played card games.

After the days in Dhulikel, we got moved to different host families near Kathmandu. The bus ride was special, and you just keep getting impressed over the traffic. We agreed that if you can drive in Kathmandu you can drive everywhere. Beside the honks there is thousand other sounds and noises, and you begin to understand why Kathmandu is called an environmental disaster.

4 other girls and I lived at a host family in a place called Pepsi-Cola. Especially in Dhulikel you saw the life outside tourism, while on the tours to Boudhanath, Patan Durbar Square and Thamel from Pepsi-Cola you got some other impressions. We had some lovely days being tourists and got to see some really exiting places near Kathmandu. The Nepali people I met seemed so friendly and curious, so it just exited me even more to get out to the hospitals and practice my Nepali. These days have been some great days to get used to the life in Nepal, before we get out to the more rural places.

- Tharsiny

 

First Day in Hospital - Marie Garnæs

Wednesday the 11th of July

Early in the morning we were leaving Kathmandu to go to our new destination, Bharatpur, where we’ll be working in the upcoming month. Bharatpur is a relatively large city with a similarly large government hospital.

Our journey unfolded with Nepali music playing in the background as we were driving along mountain roads. This was our first meeting with the Nepali hilly nature which was a beautiful sight. We made several stops along the way to enjoy the view and get closer to smaller Nepali communities placed in the upper mountains.

6 hours later we arrived in Bharatpur. We soon discovered Bharatpur to be less dense and less polluted than Kathmandu, but definitely way hotter.

Thursday the 12th of July

The first day at the hospital, consisting mostly of a tour, was a strange experience. What made the largest impression on me was the lack of capacity and resources, as the patient rooms and hallways where heavily crowded with patients and their family members. In Nepal the hospital solely provides the patients with beds and medical treatment and the family of the patients are therefore expected to help with everything else (to provide food and help feeding, change their clothes, help them to the bathroom ect.). In the hallway and waiting rooms so many people where gathered on the floor while sitting/sleeping on very thin sleeping pads. Even mothers with newborn babies were lying in the hallways on the floor next to the neonatal clinics instead of being in them.  Similarly, the technical work takes place in a messy little shed with old broken and rusty equipment everywhere in big piles. Contributing to the hospital in any way I can will be a great honor.

Saturday the 14th of July

In Nepal they only have a 1 day weekend. Ours began early in the morning tracking with the local Hindus to a temple on one of the hills nearby (1800 steps). As we reached the top of the hill it was possible to see all of the city and people were performing various religious rituals while music, singing and dancing took place.

Arrival in Beni - Andrea Frederiksen

The second week of the program has been a great change for all participants. We have all arrived at the small local towns and had our first days at the hospitals. In Beni we were welcomed with open arms at the hospital, and the staff showed us around and talked about their equipment. However, there were not much and the little they had worked well, because of the biomedical engineering, Sabina. It did not look like we could contribute much. We went around the hospital to look for all opportunities to be of use no matter if it regarded equipment or not. We got a few friends at the hospital that day. When the biomedical engineering arrived back from her trip to Kathmandu our workload escalated, which we were very happy about. By Sunday we had the key to the workshop, where the hospital staff puts their equipment, when it is broken. Furthermore, we were shown a room with all the equipment that are not in use for various reasons. We have repaired a handful of equipment and forgotten about our first fear of not having any work to do.

The experience with the host family or guest house have been very different for the groups. In the little town Beni, we live in a relatively nice hotel with nice food and good toilet facilities. We have had some challenges getting in contact with the locals though. But slowly by asking simple questions in very insecure Nepalese we are starting to have more and more interaction with them. On Saturday we had the first day off, where we met up with the participants from Pharbat and Baglung. Our hike was three hours delayed, because the host family did not eat proper breakfast before nine o’clock. However, that was no problem because everyone wanted to share their first experiences and impressions of their town and hospital. We walked and talked through the beautiful green hills passing by women planting rice and many local kids saying namaste.

 

 

First Three Weeks - Victor Holm

The first 3 weeks have been very exciting. The first week we live in Dulikehel an hour from Kathmandu, and here we learned a lot of the culture here in Nepal and how to talk in Nepali. The language is very difficult, and the sentences are structured different from both English and Danish. Some of us are very good in Nepali and can almost have an entire conversation in Nepali. I learn some of the basis stuff like, my name is Victor, I come from Denmark etc. If you know only a few words in Nepali like, my name is Victor, then the Nepali people are very impress. It was also in the first week we meet all the ground coordinators, and some other staff members. After the first week were divided into 3 groups were each group live with a hostfamily in Kathmandu. Here we were more like tourist in Kathmandu and we visited a lot of places’ like, the monkey temple and Boudhanath. We also did have some language lectors in Kathmandu, so we could be extra sharp in our Nepali. After we have been in Kathmandu in some days, we were again divided into groups of two or three people and then we were spread to the hospitals. I’m in group with Anders Sonesson and we are working in the Kapilvastu District Hospital, that’s in the southwest Nepal. It’s a small hospital and it’s a new cooperation between the District Hospital and EWH, therefore the first days we used to make an office and we notated all the different medical equipment there were in the hospital both the equipment that is working and the equipment that doesn’t work. Now we are trying to repair as many machines we can.

Week Three - Marie Gadeberg

Week three in Nepal has come and gone and I’ll do my best to engage you in the rollercoaster of emotions this first full workweek at the hospital has offered.

I am stationed at Parbat District Hospital in the small town of Kusma which on the locals account houses somewhere between 5000 to 150.000. My guess would be, that we are a lot closer to the former!

The very first day at the hospital we were eager and excited to begin the work. It is not always necessarily a given, that they will trust you with their expensive equipment from the get go - sometimes you have to prove yourself first. With this in mind we were very determined to fix the first couple of devices they brought our way. More luck that wits had us fixing a hematology analyser the very first day which subsequently let to the recovery of the lost key to the workshop/storage room. If the two are related I am not sure but if not it is quite the coincidence. With access to the storage room our spirits were lifted as we now believed we would have an overload of equipment we could dig in to. The room though turned out to be more of a home for cockroaches, year old dust and the equipment left from the participants last year which is in such a bad condition they are beyond repair.

After clearing out the room and establishing a proper work area some equipment started heading our way. Some of it needs fixing outside our capabilities but others we are able to get back up and running with some cleaning, reconnection of wires or the application of an improvised spare part.

So with the hospital work started we are slowly learning the ways of the Nepalese health care system. When we are off from the hospital we spend our time drinking tea with the locals, trying to learn some more Nepalese or simply enjoying the marvellous nature surrounding our new home.

Till next time,

Marie Gadeberg

Fourth Week - Malin Schnack - Heutada, Nepal

The fourth week of our stay in Nepal as participants of the EWH DTU Summer Institute has now officially come to an end leaving us with only two more weeks at the hospitals repairing medical equipment.

My Nepali partner Anju and I have been stationed south of Kathmandu just above the Indian border at Hetauda District Hospital in Hetauda, where the temperature range is about 25-35 degrees Celsius.

With no time to waste we began our work on the 12th of July getting familiar with the hospital staff as well as the hospital itself and its resources. With Anju knowing Nepali the hospital quickly accepted us and the biomedical engineer of the hospital helped us setting up a temporary work shop for the summer.

At this point in the program we have fixed several medical devices, the latest being the suction pump illustrated with me in one of the attached photos. With access to several storage rooms we continuously discover new medical devices to repair. The equipment is however pretty hard to find as they are mostly covered by many things and hidden under what seems like a 100 years of dust, dirt and spider webs. Finding and repairing equipment hidden away like that really makes everything worthwhile and I find it to be such a rewarding job - troubleshooting, improvising spare parts, redoing the wiring etc.

During my stay in Nepal I have been receiving language training, gone to a wedding reception in traditional clothes, gone hiking, visited multiple temples, been to Chitwan National Park and among many other things such as visiting Kathmandu been climbing an infinite amount of stairs.

I am still in awe of the nature and mindset of the Nepali people and it is hard to justify just how nice and welcoming they have been. So far it has been such an incredible journey and experience getting to know the culture of Nepal.

For additional updates, stay tuned.

// Malin

Damauli - Anders Olsen

More than two weeks have passed since my Nepali hospital partner Lokendra and I first set foot in Damauli, a warm and humid town situated by the highway between the two largest cities in Nepal. The temperature was more than 35 degrees when we arrived but has since decreased and the environment is now much more comfortable. Since Damauli receives virtually no tourists at all, people staring on the street and loads of children yelling “hello” is part of everyday life.

The district hospital in the town is not the largest one. However, since it has no technicians, we have had plenty of work right from the start. The host father of our homestay is a health assistant and the store keeper at the hospital. He is much respected by the other staff and has been very cooperative and helpful to us. He has been our main provider of work. As such, our presence at the hospital has been welcomed, but it has, admittedly, been easy to communicate with the staff since Lokendra speaks Nepali and has good communication skills.

Because of its small size and lack of exposure to technology, the hospital has no staff trained in using more sophisticated donated equipment such as infusion pumps and ventilators. Hence, one of our next major projects will be to install this equipment as well as teach how to use it, hopefully helping the hospital save lives!

Lokendra and I have been travelling quite a bit during the first two weeks. We have visited our second hospital in Bandipur, which is in better shape that the one in Damauli. It even has a technician. So, we made a shopping list of spare parts to buy for the hospital and decided to only stay in Bandipur the last 3-4 days of the program. We have also stayed with Lokendra's brother in law a couple of hours from here and last weekend we went trekking with the Gorkha and Dhading group.

Health Center and Charikot  - Johannes Kruse

Namaste,

We have now spent more than half of our time at the hospital, and we have less than two weeks left. Team-Charikot is doing good, we have repaired 28 pieces of equipment so far.

Roshan and I are working at Charikot Primary Health Center, which was founded by an American organization – Possible. The hospital is very well organized and managed, and we start the workday every morning at 08:57 am. All departments brief and inform the other departments about what is going on or if something has happened. This is followed by a presentation at 09:15 in the conference room. The subject and the intended people varies from day to day, sometimes it is the doctors, the nurses or all of the staff.

We have had a good time in Charikot and both the local people and the staff at the hospital have been very welcoming, and even though we cannot fix all the equipment they give us, they have expressed their appreciation of us being here and us trying our best to help.

Charikot is a smaller city but still big enough to have a few good coffee places and restaurants – which is nice! We have a day off on Saturdays which we have spend exploring the nearby attractions, such as the Dolakha Bhimsen Mandir (a small temple, famous for its crying Bhimsen statue which is said to cry when something terrible happens in Nepal.), the viewtower (unfortunately foggy when we finally reached the top), and Kalinchowk (a small village with an famous temple – the altitude is almost 4000 metes, making it chilly. The view was absolutely fantastic!).

// Johannes Kruse

Hospital and Free Time Experiences - Tharsiny Thanendran - Gorkha, Nepal

Here is a little update from Gorkha!

Nora and I have been working on Gorkha District Hospital for a while now. We have been repairing quite a lot of medical devices and other equipment. The staff is very friendly and already on day 1 we were repairing medical devices. After the doctors had seen our abilities and gained our trust they came with even more equipment. Gorkha is very beautiful and have some great hiking spots – one of the days we were up hiking and saw the Himalayas which is rare in the monsoon season. We were both very excited.

Our hostfamily have been very welcoming and we attended af wedding in Chitwan and a birthday party in Gorkha within one week. Even though I love our village and hostfamily, it was great to travel to Pokhara this weekend and meet up with some of the other EWH DTU students. The van picked us up 3 hours late, so we had time to find a waterfall and take a bath. It was needed and very beautiful! We are getting used to the time mentality in Nepal and utilize the time.

Saturday, we used for sightseeing around Pokhara. We got to see Davis fall, Phewa Lake, Mahendra Cave, Sams house and even more. We get Daal Bhat every day, so we were very thankful to try something else for a weekend. It was a lot of sightseeing, “real” coffee and catching up with the other teams. After the weekend we went back to Gorkha, where we planned and started our secondary project. When the secondary project is finished we are going to Ampippal Community Hospital for the last week.

//Tharsiny

Hospital Experience - Andrea Frederiksen – Beni

This week the two technicians of the hospital chose to go away on a minute’s notice. We were now the technicians of the hospital. The staff could call, whenever a piece of equipment did not work. A nurse quickly contacted us and showed us a room with three autoclaves not functioning properly. We tried to fix the first one, but we just made a bit worse than before. The nurses did not get angry and showed of what was wrong with the next one. She was just thankful that we took us the time and gave it a try. We had to try many things without succeeding, which was very frustrating for the nurse and us. However, on Friday we could leave the room with three functioning autoclaves. The two OTGC’s had been very helpful with good advice during this process. It was a nice experience to be challenged and test our ability to keep on going and not give up.

Besides that, we have started our secondary project. The dentist at the hospital had required a wish of having distilled water for his equipment. During our time at the hospital several nurses had stopped by the workshop with equipment not functioning because of a leakage. The leakage was made by a deformation of the equipment caused by caulk coming from the tap water, they were using. Distilled water is too expensive for the hospital to buy. The method of making distilled water yourself is very simple, however it requires a cooling element. With the many power cuts at the hospital, it was not possible to keep anything cold enough. We found a method that produced a good approximation of the wanted result. A nurse caught of working on the project and took pictures of the quick guides that we made. The technician had informed her that it was important to use distilled water, so she was very interested too hear what we could teach her. It has been nice to experience a staff that has been willing to work with us and wants to improve the condition at their hospital.

On our day off we went on a hike in the beautiful green hills with a local friend. He and his wife showed us the way pass rivers, rice fields and very steep passages, before arriving their small house. The house was very primitive but cozy as many of their friends came by for a talk. They served a simple but tasty meal cooked over an open fire and fresh milk from their own buffalo.

//Andrea 

End Thoughts - Victor Holm - Kapilvastu District Hospital

Now it is close the end of the program and there have been so many tings happing and it feels like we arrive in Nepal just a couple of days ago. When thinking back on what we have fix or what we have try to fix, then a lot of medical machines come up like ECG, ultrasound machine, infant warmer, autoclave, oxygen concentrator and so on, but some other machines that are not very medical machines like generator, refrigerator, voltage stabilizer and fans also comes up. Of course, it has been very interesting to look at all the medical machines and using the knowledge we have learn from the course just before departure to Nepal and troubleshoot these machines, but it was also very fun to learn how a generator, or a refrigerator works because now we have developed skills to fix more normal things like a refrigerator. When looking back at all the machines we had look at, we almost always had to find out more information about the machine and we had to read about how different components works, therefore I think the most important thing we have learn from these 4 weeks are to acquire new knowledge and be able to use this knowledge.

Besides working a lot at the hospital, we have also made some new friends and seen some places in Nepal that you don’t normal see. We have been working close with the local medical doctors and therefore also been good friends with them. One day the medical doctors invited us to a swim 20 km from Kapilvastu and after that dinner at a local place. I was a little surprised at first, but it was very fun and relaxing after a long and warm day at the office. The dinner place was very good, very local and with fresh and natural ingredients. It had been a very good and special experience that I’ll never forget. Hope to see you soon Nepal.

//Victor