Medic Becky Thomas – Experience in Chisang Clinic in Rural Eastern Nepal (Vol. I)

Compared to my home in the UK, night time in Nepal is somewhat different. The sun goes down, the lights go out and with no regular electricity the area is often plunged into a peaceful darkness.

It is at this time that villagers bring in their goats and cattle for the night, and everyone settles down after a hard days work.  The air erupts with the evening chorus of bugs and frogs. It was always at this time we had the most serious of patients. And at this time just over a week since I arrived at the clinic, was when we had our first major trauma case.

Our Chisang Clinic team at this point was made of the three wonderfully supportive and diligent permanent staff; Alaka the Health Assistant, Gita the Nurse and Yamuna the Lab Assistant. Working with them were the three international volunteers; Corinna public health student, Ashley human rights student and me, Becky, medic. Working as part of such a supportive team completely made ease of working in such a new environment.

Kopila on the balcony

That evening we had been invited to the house of a lovely couple named Chinnie-Maya and Tej. We had spent the evening laughing and joking with Chinnie, comparing fashion tips and trying on Saris. We were just winding down standing on their balcony, drinking our Chia and watching the sun go down, when Chinnie-Maya left to take in her cows. After a few moments we heard a loud cry  “GUHAHR!”. Not yet knowing much Nepali we looked over at Gita and Alaka to find fear cast over their faces.

We ran down stairs to find Chinnie-Maya drenched in blood and clutching her head. “KE BHA YO?” “WHAT HAPPENED?” Her bull had charged her as she was leading him home.  Animal accidents are common in this area. We just had time to give her some cloth to compress the wound, when she lept up and started striding out ahead of us towards the clinic. We scuttled along after her. As we passed through the winding village paths, our neighbours, alarmed to see Chinnie-Maya in such a state, joined the procession in escorting her to the clinic. By the time we all arrived at the clinic night had fallen, and with no electricity available the clinic was dark. We settled Chinnie-Maya down, cleaned the wound and by torchlight prepared for sutures. With the windows blocked with spectators it was gaspingly hot. Yamuna crouched beside Chinnie-Maya with one hand fanned her face and with the other shined the torch for us to see. With no adequate light and a large audience of villagers we shakily began by cutting back her hairline to reveal a 8cm gash in her scalp. In a hasty team effort from Alaka, Gita and I, we had doused the bleeding and stitched up the wound. And after her TT shot and some skillful bandaging by Gita she was free to return home.

The team in action, stitching the wound. (Photo by Corinna Heiberg)

The wound quickly healed and after 5 days the stitches were ready to be removed. Chinnie-Maya was so happy with the results “Ramro” “beautiful” she said as she inspected our handiwork. It than dawned on me after all the excitement had passed how critical our service is to the community. If the Chisang Clinic was not open, Chinnie-Maya would have had to travel miles either on foot or by the excruciatingly expensive nighttime taxi to the overfilled, under staffed and over expensive hospitals nearby.

The day following this incident we all got to work organizing and labeling our stocks of emergency equipment so that we could now efficiently find the trauma supplies if needed. The clinic also invested in its own inverter generator so that now electricity and lighting is available 24/7.  We also got to work writing the trauma and wound care protocols, and running group-training sessions for everyone at the clinic. Now when the emergencies come in after dark we can provide the best possible service to those with critical need.

Two days later, the wound is healing well! (Photo by Corinna Heiberg)

Interning at the clinic has given me so much invaluable experience. With no, senior colleagues to shy behind, you are really forced to develop quickly into a competent clinician. I will miss working with my Nepali team very much. I have never experienced working in such a close nit team and it is really a testament to the other girls at the clinic, how adaptable and supportive they are. And although I was far from home, I really felt like I had a new home in this little village in Nepal.

Chisang Clinic family

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