Kathmandu: Week 3
A trek outside the capital shows the challenges faced by hospitals in remote areas.
The Nepalese celebrate over 30 public holidays a year, and this year three of them happened to occur consecutively: Mahashivaratri, International Women's Day, and Ghyalpo Losar occurred on March 5–7.With this in mind and needing a break from the oppressive smog in the Kathmandu Valley, it was time to get away from the city and visit the mighty Himalaya Mountains.
The destination was Kunde Hospital, a small center founded by Sir Edmund Hillary, one of the first two climbers to summit Mt. Everest. The hospital was founded in 1976 and initially was staffed by overseas volunteers. However, since 2002, it has been wholly staffed and run by local people. I was curious about what kind of needs this hospital may have and how I might assist. All I had to do was get there.
Fortunately, the Airbnb host, Birendra Prasad Chudal, whom I was staying with also runs a trekking company called Adventure Club Treks & Expedition. He helped set me up with a guide and after a short 35-minute flight to Lukla, I found myself surrounded by the tallest, most dramatic mountains I had ever seen. The trek to Kunde would take three days. Along the way, we passed through beautiful Sherpa villages and made a short detour to the Everest View Hotel for tea. The weather was perfect and we had views of Mt. Everest on the horizon.
Once we arrived in Kunde Hospital, I was warmly greeted by the on-duty physician Dr. Mingma Sherpa, and chief medical officer Dr. Kami Temba Sherpa. I was very impressed to see that they had a Korean CR x-ray machine and a Toshiba ultrasound unit. I told them about the work we did at Bir hospital, and they were particularly excited about the DICOM grid-cloud based PACS. They did not have a dedicated radiologist and would benefit greatly from the ability to consult radiologists remotely with more difficult cases. I promised to pass their information along to organizations who might be able to facilitate a DICOM installation.
While waiting for my flight home, I came up with an idea for a medical equipment porting service to rural hospitals in Nepal. If there was one thing I had learned trekking over the past few days, it was to pack light. With this in mind, I am sure that many visitors that come to the mountains of Nepal do not bring a second checked bag from the United States. What if we could utilize this unused second checked bag as a way to cheaply transport medical supplies to Nepal? U.S. visitors could use the Supplies Over Seas Custom Box Program to have supplies affordably delivered to their address in the U.S. They could then take the supplies with them to Nepal and we could arrange full-service delivery of the supplies to hospitals in need. I could not wait to ask Birendra when I got to Kathmandu.
When Birendra heard this idea, he was immediately interested. In addition to his trekking company, Birendra also operates a non-profit called Himalaya House Project, which helps rebuild earthquake-damaged housing in the Himalayas. After some calculating, Birendra said that he could arrange affordable transport of the medical equipment from Kathmandu to these remote areas. I am hopeful that within the coming months, we will be able to bring this idea to fruition.
By Wojciech J. Kapalczynski, MD, University of Texas Health Science Center at San Antonio