Meghan and Chloe’s Experience at Chisang Clinic (Vol. I)
Meghan and I are nurses from University of Washington Medical Center in Seattle, Washington. We came to Nepal as first-time international volunteers. With the help of Village Volunteers, we were connected with the Chisang Clinic. After flying to Nepal, we stayed in Kathmandu for several days, then flew south to Biratnagar. We were greeted at the airport by Debendra Karki, the clinic’s founder, and taken to Bhaunne. Bhaunne is a small village in the southeastern part of the Terai. Because of it’s location, area is quite flat, and generally quite warm and humid. We lucked out because we came in the winter, so the nights were cool and foggy, and the days were warm and sunny. The village itself is fairly serene and pastoral. It is mainly agriculturally based, so there are many fields, and farms with animals. Behind the village is a tropical/sub-tropical rainforest with monkeys and a variety of birds. The village is far enough away from the highway to be quiet, but close enough, that after a quick walk, buses to bigger towns are readily accessible.
Although seemingly quite basic, and in some cases lacking by American standards, the people of the Morang district which Bhaunne is located in, actually enjoy the highest standard of living in Nepal. Every day we saw the children going to school, practicing good dental hygiene and eating dahl, bhaat, tarkari (rice, lentils and curried vegetables). However, for as many positive practices as we saw, while at the clinic, we got a chance to learn about a variety of gaps in education, as well as barriers to accessing healthcare in the community.
The majority of presenting complaints we saw at the clinic were rashes, viral infections, wounds, hypertension, and gynecological issues. For a variety of reasons, however, patients frequently do not follow up after their initial visits. Therefore the pace of the clinic was pretty slow. From getting a chance to meet some community members, as well as talking with Debendra, it became evident that there were many people who had health issues that were not being addressed. In some cases, it was due to poverty, in some cases it was lack of access to medical facilities with adequate means for intervention, and in some cases it was a lack of education.
A small example of the need for education was one woman who came into the clinic with her infant who had an ear infection. The child had had the infection for several days, and instead of seeking medical care, the woman had poured heated oil into the ear canal and inserted a chicken feather afterward to clean the opening out. When the infection did not clear, she brought the child in. In addition to treatment, she was given teaching on infection control and hygiene.
However, the goal of the Chisang Clinic is to move away from general practice, and focus solely on mothers and children. Nepal has one of the top ten highest infant and maternal mortality rates in the world. So to utilize our time at the clinic most effectively, we were asked by Debendra to conduct a feasibility study for the development of a birthing center.