Adventures — 4 November 2018 at 7:38 pm

Wild Nepal

Following the devastating earthquake of 2015, Dr Nathasha Basheer was inspired to return to Nepal, a country she first visited following her foundation years.  Despite her ongoing commitment to paediatric training in the UK, she organised to spend two weeks volunteering with The Wild Medic Project.  Here she recounts her trip as a ‘Wild Medic’ and how she felt returning to Nepal.

Momos trigger a memory

It’s not quite the momos that trigger a memory, but the spicy sauce that comes with it.  Mmmmm. Soft and warm, just perfect for a cold Scottish day, or indeed a cold Himalayan day, whichever takes your fancy. This memory takes me back to 2016, when I was setting myself up for a little adventure with The Wild Medic Project. This adventure took me to Nepal, to Kathmandu, Chitre, Dodin and Thalo and to the Helambu region – one of the worst hit regions of the April 2015 earthquake.

My name is Nathasha Basheer and I’m a paediatric trainee from the UK.  I fell in love with Nepal following my foundation training. On hearing about the earthquake I felt that I had to go back and do something, anything really. Being in the midst of MRCPCH examinations and various rota commitments I was unable to take the full six months that I had originally sought.  So, I found other ways and it’s been great!

The Wild Medic Project is an Australian based NGO who run volunteering programmes to Nepal and Vanuatu, though there are other projects in the pipeline.  I loved their enthusiasm, the fact that they accepted me as a paediatrician when previous volunteers had been paramedics, and most importantly, their projects ran for two weeks.  Through a combination of annual leave and study leave, not to mention a little luck, I was able to take the time off from work.

This project suits anyone with a recognised medical qualification – paramedics, nurses, allied health professionals, doctors.  This was the perfect trip for a first time expedition medic, like me. Wild Medic are very open to question and queries from anyone, including students.

The project itself

The projects generally last a fortnight. The first week is mainly orientation and expedition work, the second week involves a little trekking.  Do be warned – day-to-day itineraries can move around depending on local festivals and last minute school closures.  Be flexible and make the most of the opportunities whilst there.  This is, after all, the Nepalese way.

Health clinics are in remote and rural locations where access to health care is limited.  This showcases primary health care at its best.  The recurrence of regular teams allows for an element of continuity and  patients know what to expect. On our busiest day we saw up to 115 patients in a six hour period.  It could be very intense but was really enjoyable.

Teamwork was key and we had such a great skill mix.  There were five paramedics from Australia, myself as a paediatrician, a local Nepali doctor and a non-medical volunteer.  One of the paramedics was an ex-pharmacist so between us we revised the Drug Therapy Protocols and introduced a solid paediatric section.  Jeevan was our in-house guide and guru and DB, Bondari and Yuvraj were our guides, cooks and friends.  We met so many kind people along the way.

Besides health camps, we spent a day at a school carrying out health checks.  This day was insane – 240 kids in one day!  And here was me thinking my winter night shifts were busy.  I was lucky enough to spend some time with the older teenage girls, learn some basic Nepali phrases and get to know their future aspirations.

The second week was spent trekking.  I have to admit I was the first to say, ‘I want more time with the kids and patients’ but actually, this part of the trip was really crucial. It provides income, a job, a purpose and not to mention key tourism – important after the country had just suffered a major earthquake.  2175m was the highest elevation on the trek, so the altitude was not an issue.

A Wild Medic project costs between $1599-1649 AUD. All the money goes towards the project and expedition. Meals are cooked up by an wonderful team of local cooks and guides.  You can of course supplement at the end with tips (recommended) and bring extra for any goodies and souvenirs (also recommended).  Please note that flights and visa are not included, though assistance through Wild Medic can be sought for flight information.  Additionally fundraising is welcome though not essential.

A wide and varied case mix

There are a few stories really stand out in my mind.

The first was a 9 year old girl who presented half-limping, half-carried by her father.  She had a giant, weeping abscess in her left groin/upper thigh area which had tracked down to her knee..  It was clearly a nasty infection that required surgical debridement and aggressive IV antibiotics.  Thankfully our Nepali doctor was able to make a referral, though whether they made the journey to Kathmandu is unknown to me.

The second was an elderly lady who had previously suffered a injury after falling on an outstretched hand.  It had been fixed and put in a cast but she presented with on-going pain and tingling. It was visibly deformed and she was obviously incredibly distressed by it.  Tertiary level adult orthopaedics was not within the remit of our project and unfortunately, as our local Nepali doctor told us, even if she was able to make the long journey to Kathmandu, her high anaesthetic risk would make an operation unlikely.  We gave her every medicine we had from omeprazole to toothbrushes, but just not the medicine she needed.

The third was a 5 year old boy who had injured the underside of his big toe on some glass and had wrapped it in leaves and rags.  The wound was moist and most certainly not healing. Between translators, sign language, a mixture of English, Hindi and Nepalese we managed to, at the very least, clean and debride the wound with my paramedic colleagues bandaging it in gauze impregnated with betadine and lignocaine.  There was no way he would permit sutures, so a compromise was met.

However, my favourite patient was a four year old girl who, when asked why she had presented replied, ‘no problem!’.  She had just come for the craic because her whole village was getting checked out.  I sounded her chest and off she skipped with a handful of vitamin tablets that looked, though no doubt did not taste, like sweeties.

Memories made

I had a lot of fun, in an incredible country full of incredible, sincere, warm, generous and open people who are full of good humour.  There was a good bit of walking, some entertaining car journeys, camping (electricity provided) and the best food you will ever eat in your life.  I made a whole bunch of new friends and many, many great memories.  I also learned a little expedition medicine along the way.

There are the inevitable downsides – I wasn’t a massive fan of the spiders in my tent. Thankfully other people were less bothered and helped me out!  Some of the walking can be tougher than initially anticipated, but each group will be different.  And as already mentioned, Nepal has many festivals which means that closures do happen. Keep an open mind and everything will work out.

Working with The Wild Medic Project has opened up opportunities within the expedition medicine community that I had never dreamt would be open to me.  It’s a great family to be a part of, it’s 100% against the grain and that’s absolutely what I loved about it.

Nepal will not disappoint, I promise.  So, what are you waiting for?!