From the Team Leader
It would be an understatement to say that it was an interesting experience.
Our Final Days in Dharan
Today was our final day in Dharan. Our morning was spent giving a few lectures on tissue engineering research, stomal care and stone management. We then completed packing our supplies, visiting our surgical patients, and participating in a farewell ceremony. Over the last few days, our hosts have been giving us an astonishing assortment of foods throughout the day. The quantity of food is definitely much more than we are used to back home, but is commonplace for special occasions and honored guests.
These are pictures from our Thursday dinner taken at the Dharan Kitchen restaurant. Take a look at those tikkas that the ladies on our team were wearing. The Nepali nurses were awesome to work with and extremely gracious. When interacting with them, they are called “sister” as a sign of respect.
On Friday morning, we met with the OT nurses outside the OT suites and they performed a traditional ceremony to thank the IVUmed team for coming to Dharan and for all of our hard work. Everyone received a red dye mark on the forehead and a scarf. The men were given some cool Nepali hats!
Well, it’s getting late and I’m completely exhausted from a week of challenging cases and the workload. Tomorrow, we’re working our way back home via Kathmandu. Bob has planned out the next few days and it sounds like it’s going to be magnificent. I’ll keep you posted!
Nursing Update
We are so pleased with the receptive audience for our teaching efforts! About 30 nurses from the O.T. attended our talks on Practical Application of Sterile Technique (Norma) and Caring for the Patient with a Mitrofanoff (Barbara and Jean). It was great seeing the nurses in the O.T. that day attempting to gown and glove just like Norma had demonstrated. Now getting the Nepalese surgeons to adopt this new method is something else! We applaud our colleagues for trying. We have done Mits on two adult patients and the ward staff was anxious to learn more about the care and patient education. Yesterday, Jean and I had a great session with the residents (about 15) and ward nurses (8) and then went to the patients’ bedside for further instruction with the patients. Those low-tech flip charts are working out just great for this type of teaching! We are scheduled for another nursing in-service today so we will let you know how that turns out. We have a great team– meeting challenges and being innovative as we go. Such as fashioning a ileostomy bag from a empty IV bag secured with lots of mastisol and tegaderm! My WOC nursing colleagues will love this photo! As well as using the finger of a sterile glove for a penrose drain! Gotta love it!
More later,
Barbara
Jean
Norma
Snapshots of our work day
Barbara is tending to the little ones with her Southern charm.
“Somebody has to watch over our brand new coffee table with matching chairs.”
More From Nepal
From the Team Leader
Wow… what a crazy ride.
We are finally in Dharan and have operated for two days.
An amazing amount of stone disease and cancer.I am so thankful for such an wonderful team. Everyone has been working so hard.
There are some interesting politics here that prevent us from seeing all the patients we wanted to see. But nevertheless, we have already done 14 cases (many of them are major cases like nephrectomy, pyelolithotomy and URS). I think we were able to show them several new techniques. They were so impress with how quickly we do things and the size of our incisions.
Norma, Jean and Barbara have been the backbone of the group. Getting the OR set up and taking care of the patients post-operatively. They were able to doing some teaching and patient education. There is a nursing school here so there are alot of nursing students anxious to learn the way we do things in the States.
Claire is such the diplomat. Based on their culture, the Nepalises have some preconceived notions of what women can and cannot do. But with her charm and tact, she was able to show the anesthesia staff a few things about modern anesthesia.
What an awesome surgeon and person Rich is. Not only is he responsible for this blog, he has been doing cases (many of which are adult cases) with a big smile; and nothing seems to make him angry or frustrated. A team always need one such person.
Thank goodness for John. There are so many cancer cases here. His expertise is so much needed. They only do 2 cystectomies a year but have a ton of patients with muscle-invasive TCC. He will truly make a difference for these people.
Okay, got to start off another day… Stay tune for the futher adventures of the Stream Team Nepal 2009.
Bob
Read MoreBandhs
Let me tell you about bandhs (sp?). They are organized protests that occur regularly in Nepal and usually are held by one of many tribes. Of course, each protest has certain demands which usually include increased representation at the local or national level. However, almost daily we hear some news about these protests because they effectively shut down almost all transportation between major areas in Nepal. I forgot to mention in my earlier blog that we rode in ambulances to this location because only ambulances (medical transports) would be allowed past any road blockades. When asked about the duration of protests in general, the locals always say it’s unpredictable. However, that should not affect our departure.
The location that we are staying in is very safe because it is a self-contained city within a city with its own power generator and water purification plant. It has a communal feel to it. Honestly, it is paradise compared to the poverty that lies outside the walls of the medical center.
Well, in terms of the medical update, we are planning our remaining cases for the next few days and will perform surgical cases up to Thursday. Friday will be for sightseeing and Saturday we will be headed back to Kathmandu. So far, we have worked primarily on adult urology cases, which was quite unexpected and somewhat frustrating for most of our team members. Nevertheless, everyone is holding up well and just focusing on helping out as best as we can.
All my best to everyone out there and I’ll blog with you again with more incriminating photos.
~Rich
Read MoreNursing Perspective
It is always interesting to share information with the host nurses during IVUmed visits. Oops, short delay the power just went out! We are back in business with Rich’s hand cranked LED light (you can tell he lived in Houston and is hurricane-ready)! Jean has also retrieved her head light!
Today we met several nursing students in the OT (operating theatre). All spoke Engligh allowing us to have a good conversation. They are so excited we are here and eager to share information about our nursing professions. After high school graduation (10 grades) nursing students take two years of basic science courses and then 4 years of nursing education leading to a BSN. Upon graduation they are qualified to be educators, researchers and administrators. Nurses work 8-hour rotating shifts. No one like nights! Tomorrow we will be presenting principles of sterile technique to the operating staff and later in the week presenting various topics on pediatric urology. All of the nursing staff are very helpful and good at their jobs!
More later we are in the middle of a thunderstorm!
Barbara (signing off)
Jean
Norma