Take from the rich, give to the poor!

February 20, 2012

Our action packed weekends unfortunately delay new blog postings…please accept my sincerest apology!

To wrap up the end of our academic week, we had general surgery and dermatology. The general surgeon that led our lectures was Dr. Malla- 5 feet tall, bald head, thick rimmed glasses, great sense of humor and adored by the patients…as Ryan would say, this guy was “money.” Nepal’s unique perspective on surgery centers around typhoid fever (a common illness in third world countries caused by a salmonella strain that is common in unsanitary conditions/contaminated drinking water). A late complication of this infection is a perforated ilium (inflammation around a section of small bowel that punctures through the gut, spilling intestinal contents into the abdominal cavity) which leads to “free air” in the abdominal cavity. This causes intense pain, sepsis and can quickly lead to death if not operated on immediately. We actually got to see 3 patients on rounds with this exact complication! As you can imagine, a common complication (of the perforation) is infection of the surgical wound and abscess formation, which almost all of the patients we saw had. We didn’t see the inside of the OR, but according to Katherine there is 1 OR light per room, electricity went off during a case and they had to bring in a light that was battery powered, no disposable drapes, otherwise very modern with up to date anesthesia machines.

Dermatology was great too! Dhulikhel hospital is the first hospital site to have a laser…making them the only hospital in Nepal to provide cosmetic services. Dermatology is the “money-maker” for the hospital and the head of the department said frankly, “we take from the rich and give to the poor!” implying they are able to provide basic services to many people who cannot afford care because their department makes so much money. We joined him in clinic and he did a great job teaching us on the spot about different skin diseases in Nepal and how they might present differently than in the U.S. All of the diseases we saw in clinic were actually diseases seen in America- psoriasis, lupus (I actually have never seen a real case of this in person- she had many of the classic findings!) & eczema. To top it off, we took an “organic coffee break” and had real drip coffee at around 11a.m! It was so delicious and quite the change from the instant coffee we have been having.

That’s all for now but stay tuned for details about our awesome weekend trek! Miss and love you all, xoxo.