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Kanti Hospital

Written on: Wednesday June 13th, 2007

A journal entry from: Elective

I thought I should say a little bit more about the hospital we are working at, as I only mentioned it briefly yesterday. Kanti is the only children's hospital in Nepal, so as you can imagine it gets quite busy! The hospital itself is in Magarajgunj, a part of Kathmandu, and is quite large with various different departments.

 However, it is not very well funded at all, and the facilities are definitely lacking. As I mentioned yesterday, the corridors are all very damp, and dark, and the wards are not much better unfortunately. Today I noticed there was water dripping from one of the lights in the ceiling in one bay. This is the type of thing we will have to come to expect!

Each bay has anywhere between 4 and 8 beds, and they are not separated by curtains like in the UK. They are the most basic of beds, where the children stay with their mothers. The bedding looks quite dirty, but nobody here complains as they know no different.

As for the hospital food - if you think it's bad in the UK, think again. The children here eat with their hands, and are mainly fed rice and watery substances that I wouldn't like to guess at what they are! It can get very messy, but they are getting the basic nutrients they require so they are happy.

The patients who need oxygen are provided with this, but it is completely different to Britain - the oxygen canisters are as big as I am! Small babies are simply placed under a large plastic box, into which the oxygen is pumped. We saw one baby yesterday that was so small it fit into the entire box! Despite the impracticalities of the size, the doctors and patients are all glad to have a supply of oxygen at their disposal!

Our days at the hospital so far have consisted of an early morning session with all the doctors, followed by ward rounds. The early morning session is to hand over patients from the night, detailing how many beds are full, how many new admissions, how many surgeries have been performed and how many deaths there have been. I was relieved to hear that no patients had died overnight this morning, as the baby I mentioned above was very sick yesterday with meningitis, and being premature as well I was not convinced it would make it through the night.

The ward rounds last until 12, which is the deadline to be finished as any investigations that need to be sent off all go at 12, and if you miss it then that's it. There are several wards, as I mentioned yesterday, and each doctor sees so many patients in each ward. So far we have seen some interesting cases - a lot of meningitis (feeling glad we had the vaccine now!), pneumonia, gastroenteritis, cerebral palsy and malnutrition. We saw a case of hydrocephalus (water around the brain) today, and the child had the biggest head I have ever seen! It was shocking! The ward rounds are pretty hectic, with several doctors all crowding into one tiny bay! There were 9 doctors today, with the two of us as well, which makes the room stifling hot, and very difficult to concentrate! Speaking of concentration, there's only so much we can do, given that the rounds are conducted in Nepali! The notes are all written in English, so we have been getting by by peering over the doctors' shoulders and picking up whatever scraps we can!!

The wards themselves are basically rooms separated by glass windows. There are no sinks on any of the wards, and the only place to wash your hands is by the nurse's station. There is a procedure room which is absolutely tiny, but does the job. We observed a lumbar puncture there yesterday! Not much else to describe other than the smells! The wards have quite a pungent smell, and aren't very pleasant, so I'm hoping I can get used to it!!

Following ward rounds, we have an option. Today we chose to go down to the outpatients clinic with Dr Renu (the lady we are staying with) and we saw some patients there. Talk about chaos! There is no organisation to the system whatsoever. The patients are given a yellow card when they arrive at the hospital, and then they wander around looking for a cubicle where the doctor looks to be almost finished. There is no privacy at all - people just walk in on consultations and stand there waiting to be seen! And it's not only the patients - drug reps are everywhere, waiting to present their latest development! They give the doctors free drugs, rather than the free pens and torches that we get in the UK! I also noticed that the tongue depressors the doctors used were wrapped in newspaper - a far cry from the sterile packaging in our hospitals back home! Pen torches appear non-existent, with proper torches being used instead!

I suppose the final thing to mention is a problem that was brought to our attention today! Apparently, a lot of the patients that come in have already been to a drug store, as they can buy any drug over the counter here. They advertise that they have doctors working there and basically fleece people out of their money, buying treatments that won't work! By the time they come to the hospital they have run out of money to pay! Not sure how they will get round this, if they can at all!



From Julia Hardy on Jun 13th, 2007

Hi Kim, it sounds as if you will have many memories from this experience. Enjoy the food. Lv. Mum xxx

From Martyn on Jun 13th, 2007

Do they need any nurse call equipment?, I could get commission hehe Love ya

From Loraine, Paul & Ang on Jun 13th, 2007

Hello Kim, It all sounds amazing! Take care. xxx